US Quality Core Implementation Guide
1.0.0-ballot - STU 1 - ballot United States of America flag

US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions

Resource Profile: US Quality Core Medication

Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-medication Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: USQualityCoreMedication
Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.24

Profile of Medication for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

Profile element Description USCDI+ Quality Data Element(s)
code Codes that identify this medication Medications: Medications

Because this profile is derived directly or indirectly from US Core, systems are also expected to support the Must Support and Additional USCDI requirements specified by the US Core profile this profile inherits from. For more information about those requirements, refer to the US Core Medication Profile. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(9.0.0) 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 SΣ 1..1 CodeableConcept (USCDI+ Quality) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... manufacturer Σ 0..1 Reference(US Quality Core Organization) Manufacturer of the item

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.code Base extensible Medication Clinical Drug . ⏿20240606 tx.fhir.org
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(9.0.0) Definition of a Medication
... code 1..1 CodeableConcept (USCDI+ Quality) Codes that identify this medication
... manufacturer 0..1 Reference(US Quality Core Organization) Manufacturer of the item
... ingredient
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(9.0.0) 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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 SΣ 1..1 CodeableConcept (USCDI+ Quality) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... 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(US Quality Core Organization) Manufacturer of the item
... form 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 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] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Medication.code Base extensible Medication Clinical Drug . ⏿20240606 tx.fhir.org
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.
Medication.form Base example SNOMED CT Form Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(9.0.0) 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 SΣ 1..1 CodeableConcept (USCDI+ Quality) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... manufacturer Σ 0..1 Reference(US Quality Core Organization) Manufacturer of the item

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.code Base extensible Medication Clinical Drug . ⏿20240606 tx.fhir.org
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(9.0.0) Definition of a Medication
... code 1..1 CodeableConcept (USCDI+ Quality) Codes that identify this medication
... manufacturer 0..1 Reference(US Quality Core Organization) Manufacturer of the item
... ingredient
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(9.0.0) 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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 SΣ 1..1 CodeableConcept (USCDI+ Quality) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... 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(US Quality Core Organization) Manufacturer of the item
... form 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 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] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Medication.code Base extensible Medication Clinical Drug . ⏿20240606 tx.fhir.org
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.
Medication.form Base example SNOMED CT Form Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Element Conformance Indicators by Profile Layer

Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.

Element conformance indicators organized by the profile layer where they are first introduced
Profile element FHIR US Core US Quality Core
code Mandatory Must Support USCDI+ Quality
ingredient.item[x] Mandatory

Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.

Mandatory US Quality Core Server Search Parameters

The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.

Because this profile derives directly or indirectly from US Core, servers SHALL also support all mandatory searches described in the US Core Server CapabilityStatement requirements for Medication. When possible, this guide reuses mandatory searches from US Core and notes them with the EXISTING US CORE REQUIREMENT flag. While US Quality Core may restate US Core requirements to highlight searches directly relevant to USCDI+ Quality data access, US Core requirements not restated here remain applicable.

See the US Quality Core Server CapabilityStatement for complete requirements for the underlying Medication resource and Search Requirement Selection for how this focused set was selected.

Servers supporting this profile SHALL support the following search parameters and search parameter combinations:

  1. SHALL support searching for all Medication resources using the code search parameter.

    • Including optional support for OR search on code (e.g.code={system|}[search_code],{system|}[search_code],...).

    GET [base]/Medication?code={system|}[search_code]

    Example:

    GET [base]/Medication?code=http://www.nlm.nih.gov/research/umls/rxnorm|1594663

    Implementation Notes: Fetches a bundle of US Quality Core Medication resources matching the specified search criteria. See how to search by token.

    Rationale for inclusion: Supports retrieval of Medication resources filtered by code for USCDI+ Quality workflows.