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 2.0.0 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

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Resource Profile: Medication (IPS)

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

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

Usage:

• Use this Resource Profile: Bundle (IPS)
• Refer to this Resource Profile: MedicationRequest (IPS) and MedicationStatement (IPS)

Formal Views of Profile Content

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

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

This structure is derived from Medication

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	Medication	Definition of a Medication
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication Additional Bindings Purpose WHO ATC - IPS candidate
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
strength	S	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Medication.code	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform from this IG
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips from this IG

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	Medication	Definition of a Medication
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication Additional Bindings Purpose WHO ATC - IPS candidate
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.code	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform from this IG
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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 : 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-4	error	Medication	If 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-5	error	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	Medication	Definition of a Medication
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	Business identifier for this medication
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication Additional Bindings Purpose WHO ATC - IPS candidate
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer	Σ	0..1	Reference(Organization)	Manufacturer of the item
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
amount	Σ	0..1	Ratio	Amount of drug in package
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
isActive		0..1	boolean	Active ingredient indicator
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
batch		0..1	BackboneElement	Details about packaged medications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
lotNumber		0..1	string	Identifier assigned to batch
expirationDate		0..1	dateTime	When batch will expire
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Medication.code	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform from this IG
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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 : 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-4	error	Medication	If 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-5	error	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

This structure is derived from Medication

Summary

Mandatory: 1 element
Must-Support: 5 elements

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
• Ratio (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Ratio-uv-ips)

Maturity: 2

Differential View

This structure is derived from Medication

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	Medication	Definition of a Medication
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication Additional Bindings Purpose WHO ATC - IPS candidate
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
strength	S	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Medication.code	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform from this IG
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	Medication	Definition of a Medication
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication Additional Bindings Purpose WHO ATC - IPS candidate
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.code	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform from this IG
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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 : 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-4	error	Medication	If 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-5	error	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	Medication	Definition of a Medication
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	Business identifier for this medication
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication Additional Bindings Purpose WHO ATC - IPS candidate
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer	Σ	0..1	Reference(Organization)	Manufacturer of the item
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
amount	Σ	0..1	Ratio	Amount of drug in package
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
isActive		0..1	boolean	Active ingredient indicator
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
batch		0..1	BackboneElement	Details about packaged medications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
lotNumber		0..1	string	Identifier assigned to batch
expirationDate		0..1	dateTime	When batch will expire
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Medication.code	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform from this IG
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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 : 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-4	error	Medication	If 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-5	error	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

This structure is derived from Medication

Summary

Mandatory: 1 element
Must-Support: 5 elements

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
• Ratio (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Ratio-uv-ips)

Maturity: 2

Other representations of profile: CSV, Excel, Schematron