International Patient Summary Implementation Guide
1.1.0 - CI Build International flag

International Patient Summary Implementation Guide, 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-ips/ and changes regularly. See the Directory of published versions

Resource Profile: Medication Statement (IPS)

Official URL: http://hl7.org/fhir/uv/ips/StructureDefinition/MedicationStatement-uv-ips Version: 1.1.0
Standards status: Trial-use Maturity Level: 2 Computable Name: MedicationStatementIPS

This profile represents the constraints applied to the MedicationStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication statement is represented in the patient summary as an instance of a MedicationStatement resource constrained by this profile.

This profile constrains the representation of a medication statement related to the patient, in the context of the international patient summary as specified by the IPS project of HL7 International.

medicationCodeableConcept vs. medicationReference

In the previously balloted versions the medicationCodeableConcept was used only to provide information about the known absent/unknown medications; using the medicationReference to describe the actual medication. To better support local implementations of patient summaries and align with the US Core appoach, both options (medicationCodeableConcept and medicationReference) have been made possible; recognizing however that there are jurisdictions that impose that the medicationReference is always used.

Implemeters are encouraged "to improve global interoperability (...)" to use the medicationReference, limiting the usage of the medicationCodeableConcept only to the cases in which no other information than a simple code is available.

It also should be noted that in an anticipated future version of the IG based on R5, these two slices on medication[x] will be replaced by the 'medication' element in the MedicationUsage resource (which replaces MedicationStatement), as it uses the new CodeableReference data type.

Usage:

Formal Views of Profile Content

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

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... status 1..1 code active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
... medication[x] S 1..1 What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReference Reference(Medication (IPS))
.... medicationCodeableConcept CodeableConcept(CodeableConceptIPS)
... subject S 1..1 Reference(Patient (IPS)) Who is/was taking the medication
.... reference S 1..1 string Literal reference, Relative, internal or absolute URL
.... data-absent-reason S 0..1 code effective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken
.... text S 0..1 string Free text dosage instructions e.g. SIG
.... timing S 0..1 Timing When medication should be administered
.... route 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!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.

.... medicationReference Reference(Medication (IPS))
.... medicationCodeableConcept CodeableConcept(CodeableConceptIPS)
... subject SΣ 1..1 Reference(Patient (IPS)) Who is/was taking the medication
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... effective[x] SΣ 1..1 The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... data-absent-reason S 0..1 code effective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing When medication should be administered
.... route 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... 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 ?!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.

... statusReason 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] SΣ 1..1 What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReference Reference(Medication (IPS))
.... medicationCodeableConcept CodeableConcept(CodeableConceptIPS)
... subject SΣ 1..1 Reference(Patient (IPS)) Who is/was taking the medication
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... context Σ 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with MedicationStatement
... effective[x] SΣ 1..1 The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... data-absent-reason S 0..1 code effective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dateAsserted Σ 0..1 dateTime When the statement was asserted?
... informationSource 0..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) Person or organization that provided the information about the taking of this medication
... 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 S 0..* Dosage Details of how medication is/was taken or should be taken
.... 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 SΣ 0..1 string Free text dosage instructions e.g. SIG
.... 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 SΣ 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 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms

.... 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
http://hl7.org/fhir/ValueSet/reason-medication-status-codes
from the FHIR Standard
MedicationStatement.categorypreferredMedication usage category codes
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... status 1..1 code active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
... medication[x] S 1..1 What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReference Reference(Medication (IPS))
.... medicationCodeableConcept CodeableConcept(CodeableConceptIPS)
... subject S 1..1 Reference(Patient (IPS)) Who is/was taking the medication
.... reference S 1..1 string Literal reference, Relative, internal or absolute URL
.... data-absent-reason S 0..1 code effective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken
.... text S 0..1 string Free text dosage instructions e.g. SIG
.... timing S 0..1 Timing When medication should be administered
.... route 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!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.

.... medicationReference Reference(Medication (IPS))
.... medicationCodeableConcept CodeableConcept(CodeableConceptIPS)
... subject SΣ 1..1 Reference(Patient (IPS)) Who is/was taking the medication
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... effective[x] SΣ 1..1 The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... data-absent-reason S 0..1 code effective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dosage S 0..* Dosage Details of how medication is/was taken or should be taken
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing When medication should be administered
.... route 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... 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 ?!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.

... statusReason 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] SΣ 1..1 What medication was taken
Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication

.... medicationReference Reference(Medication (IPS))
.... medicationCodeableConcept CodeableConcept(CodeableConceptIPS)
... subject SΣ 1..1 Reference(Patient (IPS)) Who is/was taking the medication
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... context Σ 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with MedicationStatement
... effective[x] SΣ 1..1 The date/time or interval when the medication is/was/will be taken
.... effective[x]:All Types Content/Rules for all Types
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... data-absent-reason S 0..1 code effective[x] absence reason
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dateAsserted Σ 0..1 dateTime When the statement was asserted?
... informationSource 0..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) Person or organization that provided the information about the taking of this medication
... 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 S 0..* Dosage Details of how medication is/was taken or should be taken
.... 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 SΣ 0..1 string Free text dosage instructions e.g. SIG
.... 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 SΣ 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 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms

.... 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
http://hl7.org/fhir/ValueSet/reason-medication-status-codes
from the FHIR Standard
MedicationStatement.categorypreferredMedication usage category codes
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationSnomedCodesAbsentUnknown
http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
from this IG
MedicationStatement.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredMedicineRouteOfAdministrationUvIps
http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
from this IG
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

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