International Patient Access
1.1.0 - STU1

International Patient Access, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-ipa/ and changes regularly. See the Directory of published versions

## Resource Profile: IPA-MedicationStatement

Official URL: http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medicationstatement | Version: 1.1.0
Standards status: Trial-use | Computable Name: IPAMedicationStatement
Copyright/Legal: Used by permission of HL7 International all rights reserved Creative Commons License

Minimum expectations for a MedicationStatement resource when accessed via a International Patient Access API. The MedicationStatement resource represents all medications a patient is taking, be it those ordered by a clinician or reported by another organization, the patient or a caregiver.

> We propose to remove MS from statusReason. Implementer feedback is encouraged.

### Mandatory and Must Support Data Elements

The following data elements must always be present (in other words, mandatory resource properties where the minimum cardinality is 1) or must be supported (Must Support definition). Servers cannot restrict access to mandatory elements when authorizing an application. However, servers may choose to provide additional information or may be required to do so by national or other profiles that apply to the server's context.

Each MedicationStatement SHALL have:

- a status
- a medication*
- a patient

* see guidance below

Applications must also support:

- a status reason
- the encounter/episode of care
- the date/time or interval when the medication is/was/will be taken
- person or organization that provided the information
- the prescription Sig

### Profile Specific Implementation Rules and Guidance

#### Medication Statement and Medication Request

While the relationship between Medication Statement and Medication Request is clear in principle, in practice, when patients report medications, these may also be implicitly treated as statements of intent about what the patient should be taking. As such, information systems may record these statements as either Medication Requests or Medication Statements, or as both. The choice between these options may be influenced by many factors including wording in legislation and regulations.

For this reason, clients implementing the International Patient Access specification SHALL query for both MedicationStatement and MedicationRequest when fetching patient Medication information.

As noted there is currently no consensus how a patient can access their active, historical and future (planned) medications list. Feedback is welcome on what additional guidance can be given to promote more international alignment.

#### Fetching Medications

The MedicationRequest and MedicationStatement resources can represent a medication using either a code or refer to the Medication resource. When referencing Medication, the resource may be contained or an external resource. The server application MAY choose any one way or more than one method, but if an external reference to Medication is used, the server SHALL support the `_include` parameter for searching this element. The client application SHALL support all methods. For example, A server SHALL be capable of returning all medications for a patient using one of or both:

`GET /MedicationStatement?patient=[id]`

`GET/MedicationStatement?patient=[id]&_include=MedicationStatement:medication`

Usage:

- Examples for this Resource Profile: MedicationStatement/MedStatementExample1
- CapabilityStatements using this Resource Profile: International Patient Access Client CapabilityStatement and International Patient Access Server CapabilityStatement

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!SO Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
statusReason | S | 0..* | CodeableConcept | Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement. ele-1: All FHIR elements must have a @value or children
medication[x] | SO Σ | 1..1 |  | What medication was taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(IPA-Medication) |
subject | SO Σ | 1..1 | Reference(IPA-Patient) | Who is/was taking the medication ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
context | SO Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
effective[x] | SO Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
informationSource | SO | 0..1 | Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient | Organization | RelatedPerson) | Person or organization that provided the information about the taking of this medication ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
dosage | SO | 0..* | Dosage | Details of how medication is/was taken or should be taken ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationStatement.status | required | Medication Status Codes `http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1` from the FHIR Standard
MedicationStatement.statusReason | example | SNOMEDCTDrugTherapyStatusCodes `http://hl7.org/fhir/ValueSet/reason-medication-status-codes` from the FHIR Standard
MedicationStatement.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard

This structure is derived from MedicationStatement

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
status | SO | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
statusReason | S | 0..* | CodeableConcept | Reason for current status
medication[x] | SO | 1..1 |  | What medication was taken
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(IPA-Medication) |
subject | SO | 1..1 | Reference(IPA-Patient) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
context | SO | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Obligations | Actor
SHALL:populate-if-known | Server
effective[x] | SO | 0..1 | dateTime, Period | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
informationSource | SO | 0..1 | Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient | Organization | RelatedPerson) | Person or organization that provided the information about the taking of this medication
Obligations | Actor
SHALL:populate-if-known | Server
dosage | SO | 0..* | Dosage | Details of how medication is/was taken or should be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
text | SO | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!SO Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
statusReason | S | 0..* | CodeableConcept | Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category | Σ | 0..1 | CodeableConcept | Type of medication usage Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
medication[x] | SO Σ | 1..1 |  | What medication was taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(IPA-Medication) |
subject | SO Σ | 1..1 | Reference(IPA-Patient) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
context | SO Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Obligations | Actor
SHALL:populate-if-known | Server
effective[x] | SO Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource | SO | 0..1 | Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient | Organization | RelatedPerson) | Person or organization that provided the information about the taking of this medication
Obligations | Actor
SHALL:populate-if-known | Server
derivedFrom |  | 0..* | Reference(Resource) | Additional supporting information
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
dosage | SO | 0..* | Dosage | Details of how medication is/was taken or should be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationStatement.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationStatement.status | required | Medication Status Codes `http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1` from the FHIR Standard
MedicationStatement.statusReason | example | SNOMEDCTDrugTherapyStatusCodes `http://hl7.org/fhir/ValueSet/reason-medication-status-codes` from the FHIR Standard
MedicationStatement.category | preferred | Medication usage category codes `http://hl7.org/fhir/ValueSet/medication-statement-category` from the FHIR Standard
MedicationStatement.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationStatement.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` from the FHIR Standard
MedicationStatement.dosage.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` from the FHIR Standard
MedicationStatement.dosage.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` from the FHIR Standard
MedicationStatement.dosage.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` from the FHIR Standard
MedicationStatement.dosage.route | example | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` from the FHIR Standard
MedicationStatement.dosage.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` from the FHIR Standard
MedicationStatement.dosage.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` from the FHIR Standard

This structure is derived from MedicationStatement

Summary

Must-Support: 9 elements

Structures

This structure refers to these other structures:

- IPA-Medication (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medication)
- IPA-Patient (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-patient)
- IPA-Practitioner (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-practitioner)
- IPA-PractitionerRole (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-practitionerrole)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!SO Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
statusReason | S | 0..* | CodeableConcept | Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement. ele-1: All FHIR elements must have a @value or children
medication[x] | SO Σ | 1..1 |  | What medication was taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken. ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(IPA-Medication) |
subject | SO Σ | 1..1 | Reference(IPA-Patient) | Who is/was taking the medication ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
context | SO Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
effective[x] | SO Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
informationSource | SO | 0..1 | Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient | Organization | RelatedPerson) | Person or organization that provided the information about the taking of this medication ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
dosage | SO | 0..* | Dosage | Details of how medication is/was taken or should be taken ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationStatement.status | required | Medication Status Codes `http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1` from the FHIR Standard
MedicationStatement.statusReason | example | SNOMEDCTDrugTherapyStatusCodes `http://hl7.org/fhir/ValueSet/reason-medication-status-codes` from the FHIR Standard
MedicationStatement.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard

Differential View

This structure is derived from MedicationStatement

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
status | SO | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
statusReason | S | 0..* | CodeableConcept | Reason for current status
medication[x] | SO | 1..1 |  | What medication was taken
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(IPA-Medication) |
subject | SO | 1..1 | Reference(IPA-Patient) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
context | SO | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Obligations | Actor
SHALL:populate-if-known | Server
effective[x] | SO | 0..1 | dateTime, Period | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
informationSource | SO | 0..1 | Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient | Organization | RelatedPerson) | Person or organization that provided the information about the taking of this medication
Obligations | Actor
SHALL:populate-if-known | Server
dosage | SO | 0..* | Dosage | Details of how medication is/was taken or should be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
text | SO | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatement | Record of medication being taken by a patient
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!SO Σ | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
statusReason | S | 0..* | CodeableConcept | Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category | Σ | 0..1 | CodeableConcept | Type of medication usage Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
medication[x] | SO Σ | 1..1 |  | What medication was taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(IPA-Medication) |
subject | SO Σ | 1..1 | Reference(IPA-Patient) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Server
SHALL:handle | Client
context | SO Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Obligations | Actor
SHALL:populate-if-known | Server
effective[x] | SO Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource | SO | 0..1 | Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient | Organization | RelatedPerson) | Person or organization that provided the information about the taking of this medication
Obligations | Actor
SHALL:populate-if-known | Server
derivedFrom |  | 0..* | Reference(Resource) | Additional supporting information
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
dosage | SO | 0..* | Dosage | Details of how medication is/was taken or should be taken
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | SO Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Server
SHOULD:handle | Client
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationStatement.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationStatement.status | required | Medication Status Codes `http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1` from the FHIR Standard
MedicationStatement.statusReason | example | SNOMEDCTDrugTherapyStatusCodes `http://hl7.org/fhir/ValueSet/reason-medication-status-codes` from the FHIR Standard
MedicationStatement.category | preferred | Medication usage category codes `http://hl7.org/fhir/ValueSet/medication-statement-category` from the FHIR Standard
MedicationStatement.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` from the FHIR Standard
MedicationStatement.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` from the FHIR Standard
MedicationStatement.dosage.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` from the FHIR Standard
MedicationStatement.dosage.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` from the FHIR Standard
MedicationStatement.dosage.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` from the FHIR Standard
MedicationStatement.dosage.route | example | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` from the FHIR Standard
MedicationStatement.dosage.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` from the FHIR Standard
MedicationStatement.dosage.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` from the FHIR Standard

This structure is derived from MedicationStatement

Summary

Must-Support: 9 elements

Structures

This structure refers to these other structures:

- IPA-Medication (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medication)
- IPA-Patient (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-patient)
- IPA-Practitioner (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-practitioner)
- IPA-PractitionerRole (http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-practitionerrole)

Other representations of profile: CSV, Excel, Schematron