Guide d'implémentation du médicament
0.1.0 - ci-build

Guide d'implémentation du médicament, published by Interop'Santé. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Interop-Sante/hl7.fhir.fr.medication/ and changes regularly. See the Directory of published versions

Resource Profile: FrMedicationReconciliationMedicationStatement - Detailed Descriptions

Draft as of 2021-06-24

Definitions for the FrMedicationReconciliationMedicationStatement resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MedicationStatement
Definition

Ligne de traitement médicamenteux de la FCT (Fiche de Conciliation ds Traitements médicamenteux), avec ses propriétés de documentation de la conciliation.

ShortLigne de traitement médicamenteux de la FCT (Fiche de Conciliation ds Traitements médicamenteux)
Must Supporttrue
2. MedicationStatement.meta
4. MedicationStatement.meta.profile
Fixed Valuehttp://interopsante.org/fhir/StructureDefinition/FrMedicationReconciliationMedicationStatement
6. MedicationStatement.meta.tag
Control0..0
8. MedicationStatement.implicitRules
Control0..0
10. MedicationStatement.extension
SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. MedicationStatement.extension:reconciliation
    Slice Namereconciliation
    Definition

    Documentation de la conciliation : statut, divergence, commentaire, type d'erreur/écart, conséquence de l'erreur/écart, résolution de l'erreur/écart

    ShortPropriétés de la conciliation de cette ligne de traitement médicamenteux
    Comments

    La documentation de la conciliation est renseignée progressivement par le pharmacien puis le prescripteur lors du dialogue qui s'instaure entre eux-deux. L'élément complexe reconciliation peut porter tout l'historique de ce renseignement progressif ou ne porter que son état courant, c'est-à-dire pour chaque propriété, l'information à sa dernière date d'enregistrement par son ou ses auteurs.

    Control0..1
    TypeExtension(FrMedicationStatementReconciliationProperties) (Complex Extension)
    Must Supporttrue
    Requirements

    Porter la documentation de la Conciliation Médicamenteuse selon les règles de gestion en vigueur en France

    14. MedicationStatement.status
    Must Supporttrue
    16. MedicationStatement.medication[x]
    Definition

    Identifie le médicament constitutif de cette ligne. C'est lien vers une ressource Medication qui décrit ce médicament. Identifies the medication being administered. This is a link to a resource representing the details of the medication.

    ShortLe médicament constitutif de cette ligne | What medication was taken
    Comments

    Même si le médicament n'est composé que d'une spécialité (par exemple un comprimé), il est défini par référence à une Medication qui décrira sa composition d'une seule spécialité

    TypeReference(FrMedication), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Must Supporttrue
    Requirements

    traitement univoque de l'élément medication[x]

    18. MedicationStatement.subject
    Definition

    Le patient qui prend ou a pris cette ligne de traitement médicamenteux.

    Comments

    Obligatoire dans la ressource FHIR MedicationStatement originelle, donc DOIT ABSOLUMENT être identique au patient identifé dans la ressource Composition de la Fiche. Cf. Composition.subjet.

    TypeReference(FR Core Patient Profile)
    Must Supporttrue
    Requirements

    La Fiche de Conciliation des Traitements médicamenteux ne s'applique qu'à un patient

    20. MedicationStatement.subject.reference
    Control1..?
    Must Supporttrue
    Requirements

    référence la ressource Patient selon la profile fr-patient défini par Interop'Santé

    22. MedicationStatement.subject.type
    Fixed ValuePatient
    24. MedicationStatement.subject.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0
    Requirements

    Identification du patient exclusivement par référence à une ressource Patient selon le profil fr-patient défini par Interop'Santé

    26. MedicationStatement.informationSource
    Comments

    Dans le contexte de la Conciliation des Traitements médicamenteux, le sourcing des informations de la ligne de la Fiche de Conciliation des Traitements médicamenteux doit être réalisé à travers la collection d'éléments derivedFrom et à travers elle seulement.

    Control0..0
    Must Supporttrue
    Requirements

    Garantir la règle de gestion du sourcing exclusivement à travers la collection d'éléments derivedFrom

    28. MedicationStatement.derivedFrom
    Comments

    Une ligne de la Fiche de Conciliation doit être en relation avec au moins une ligne du Bilan d'Admission ou une ligne de la Prescription d'Admission

    Control1..2
    Must Supporttrue
    Requirements

    fournir le lien entre la Fiche de Conciliation et le Bilan Médicamenteux et la Prescription d'Admission.

    SlicingThis element introduces a set of slices on MedicationStatement.derivedFrom. The slices areUnordered and Open, and defines no disciminators to differentiate the slices
    30. MedicationStatement.derivedFrom:fromMedicationHistory
    Slice NamefromMedicationHistory
    Definition

    Ligne du Bilan Médicamenteux en relation avec cette ligne de la Fiche de Conciliation

    ShortLigne du Bilan Médicamenteux
    Comments

    Un ligne de la Fiche de Conciliation peut n'être en relation avec aucune des lignes du bilan Médicamenteux (ligne initiée lors de la Prescription d'Admission)

    Control0..1
    TypeReference(FrMedicationHistoryMedicationStatement)
    Must Supporttrue
    Requirements

    Référencer une ressource ligne de Bilan Médicamenteux

    Meaning if MissingAucune ligne du Bilan Médicamenteux n'est en relation avec cette ligne de la Fiche de Conciliation
    32. MedicationStatement.derivedFrom:fromMedicationHistory.reference
    Control1..?
    34. MedicationStatement.derivedFrom:fromMedicationHistory.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0
    Requirements

    identifier la ligne de Bilan Médicamenteux par référence à une ressource MedicationStatement profilée SiPh

    36. MedicationStatement.derivedFrom:fromCurrentMedication
    Slice NamefromCurrentMedication
    Definition

    Ligne du Traitement Médicamenteux Courant en relation avec cette ligne de la Fiche de Conciliation

    ShortLigne du Traitement Médicamenteux Courant
    Comments

    Un ligne de la Fiche de Conciliation peut n'être en relation avec aucune des lignes de la Prescription d'Admission (ligne arrêtée ou oubliée lors de la Prescription d'Admission)

    Control0..1
    TypeReference(FrCurrentMedicationMedicationStatement)
    Must Supporttrue
    Requirements

    Référencer une ressource ligne de Traitement Médicamenteux Courant

    38. MedicationStatement.derivedFrom:fromCurrentMedication.reference
    Control1..?
    40. MedicationStatement.derivedFrom:fromCurrentMedication.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0
    Requirements

    identifier la ligne du Bilan d'Admission par référence à une ressource MedicationStatement profilée SiPh

    42. MedicationStatement.note
    Definition

    Information textuelle complémentaire pour ce médicament, A L'EXCEPTION des notes concernant la documentation de la Conciliation proprement-dite de ce médicament qui doivent figurer dans l'élément commentaire de l'extension reconciliation.

    Comments

    Bien distinguer les informations complémentaires relatives au traitement médicamenteux que représente cette ligne, qui doivent figurer ici, de celles relative à la conciliation proprement-dite de cette ligne avec le Bilan Médicamenteux et le Traitement Médicamenteux Courant, qui doivent figurer dans l'extension reconciliation

    Must Supporttrue
    Requirements

    Bien distinguer information complémentaire concernant le traitement médicamenteux de celle concernant la conciliation proprement-dite.

    Meaning if MissingToute l'information nécessaire à la compréhension du traitement médicamenteux que représente cette ressource *MedicationStatement* est contenue dans ses autres éléments.
    44. MedicationStatement.dosage
    46. MedicationStatement.dosage.doseAndRate
    48. MedicationStatement.dosage.doseAndRate.dose[x]
    Definition

    Amount of medication per dose. No use of element 'comparator' in the simpleQuantity definitions.

    ShortPrecise amount of medication per dose
    TypeChoice of: Range(Range with UCUM quantity units), Quantity(SimpleQuantity with UCUM quantity unit)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    50. MedicationStatement.dosage.doseAndRate.rate[x]
    Definition

    Amount of medication per unit of time No use of element 'comparator' in the simpleQuantity definitions.

    ShortPrecise amount of medication per unit of time
    TypeChoice of: Ratio(Ratio with UCUM quantity units), Range(Range with UCUM quantity units), Quantity(SimpleQuantity with UCUM quantity unit)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    52. MedicationStatement.dosage.maxDosePerPeriod
    TypeRatio(Ratio with UCUM quantity units)
    Must Supporttrue
    54. MedicationStatement.dosage.maxDosePerAdministration
    TypeQuantity(SimpleQuantity with UCUM quantity unit)
    Must Supporttrue
    56. MedicationStatement.dosage.maxDosePerLifetime
    TypeQuantity(SimpleQuantity with UCUM quantity unit)
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. MedicationStatement
    Definition

    Ligne de traitement médicamenteux de la FCT (Fiche de Conciliation ds Traitements médicamenteux), avec ses propriétés de documentation de la conciliation.


    A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

    The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

    ShortLigne de traitement médicamenteux de la FCT (Fiche de Conciliation ds Traitements médicamenteux)Record of medication being taken by a patient
    Comments

    When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

    Control0..*
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. MedicationStatement.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..01
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. MedicationStatement.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. MedicationStatement.extension:reconciliation
      Slice Namereconciliation
      Definition

      Documentation de la conciliation : statut, divergence, commentaire, type d'erreur/écart, conséquence de l'erreur/écart, résolution de l'erreur/écart

      ShortPropriétés de la conciliation de cette ligne de traitement médicamenteux
      Comments

      La documentation de la conciliation est renseignée progressivement par le pharmacien puis le prescripteur lors du dialogue qui s'instaure entre eux-deux. L'élément complexe reconciliation peut porter tout l'historique de ce renseignement progressif ou ne porter que son état courant, c'est-à-dire pour chaque propriété, l'information à sa dernière date d'enregistrement par son ou ses auteurs.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(FrMedicationStatementReconciliationProperties) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Porter la documentation de la Conciliation Médicamenteuse selon les règles de gestion en vigueur en France

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. MedicationStatement.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. MedicationStatement.status
      Definition

      A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

      Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
      Comments

      MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

      A coded concept indicating the current status of a MedicationStatement.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. MedicationStatement.medication[x]
      Definition

      Identifie le médicament constitutif de cette ligne. C'est lien vers une ressource Medication qui décrit ce médicament. Identifies the medication being administered. This is a link to a resource representing the details of the medication.


      Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

      ShortLe médicament constitutif de cette ligne | What medication was takenWhat medication was taken
      Comments

      Même si le médicament n'est composé que d'une spécialité (par exemple un comprimé), il est défini par référence à une Medication qui décrira sa composition d'une seule spécialité


      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

      Control1..1
      TypeReference(FrMedication, Medication), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      traitement univoque de l'élément medication[x]

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. MedicationStatement.subject
      Definition

      Le patient qui prend ou a pris cette ligne de traitement médicamenteux.


      The person, animal or group who is/was taking the medication.

      ShortWho is/was taking the medication
      Comments

      Obligatoire dans la ressource FHIR MedicationStatement originelle, donc DOIT ABSOLUMENT être identique au patient identifé dans la ressource Composition de la Fiche. Cf. Composition.subjet.

      Control1..1
      TypeReference(FR Core Patient Profile, Patient, Group)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      La Fiche de Conciliation des Traitements médicamenteux ne s'applique qu'à un patient

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. MedicationStatement.subject.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      référence la ressource Patient selon la profile fr-patient défini par Interop'Santé

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. MedicationStatement.subject.type
      Definition

      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

      ShortType the reference refers to (e.g. "Patient")
      Comments

      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

      Aa resource (or, for logical models, the URI of the logical model).

      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Fixed ValuePatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. MedicationStatement.subject.identifier
      Definition

      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

      ShortLogical reference, when literal reference is not known
      Comments

      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..01
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      Identification du patient exclusivement par référence à une ressource Patient selon le profil fr-patient défini par Interop'Santé

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. MedicationStatement.informationSource
      Definition

      The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

      ShortPerson or organization that provided the information about the taking of this medication
      Comments

      Dans le contexte de la Conciliation des Traitements médicamenteux, le sourcing des informations de la ligne de la Fiche de Conciliation des Traitements médicamenteux doit être réalisé à travers la collection d'éléments derivedFrom et à travers elle seulement.

      Control0..01
      TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Requirements

      Garantir la règle de gestion du sourcing exclusivement à travers la collection d'éléments derivedFrom

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. MedicationStatement.derivedFrom
      Definition

      Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

      ShortAdditional supporting information
      Comments

      Une ligne de la Fiche de Conciliation doit être en relation avec au moins une ligne du Bilan d'Admission ou une ligne de la Prescription d'Admission


      Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

      Control10..2*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      fournir le lien entre la Fiche de Conciliation et le Bilan Médicamenteux et la Prescription d'Admission.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationStatement.derivedFrom. The slices areUnordered and Open, and defines no disciminators to differentiate the slices
      26. MedicationStatement.derivedFrom:fromMedicationHistory
      Slice NamefromMedicationHistory
      Definition

      Ligne du Bilan Médicamenteux en relation avec cette ligne de la Fiche de Conciliation


      Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

      ShortLigne du Bilan MédicamenteuxAdditional supporting information
      Comments

      Un ligne de la Fiche de Conciliation peut n'être en relation avec aucune des lignes du bilan Médicamenteux (ligne initiée lors de la Prescription d'Admission)


      Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

      Control0..1*
      TypeReference(FrMedicationHistoryMedicationStatement, Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Référencer une ressource ligne de Bilan Médicamenteux

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. MedicationStatement.derivedFrom:fromMedicationHistory.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. MedicationStatement.derivedFrom:fromMedicationHistory.identifier
      Definition

      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

      ShortLogical reference, when literal reference is not known
      Comments

      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..01
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      identifier la ligne de Bilan Médicamenteux par référence à une ressource MedicationStatement profilée SiPh

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MedicationStatement.derivedFrom:fromCurrentMedication
      Slice NamefromCurrentMedication
      Definition

      Ligne du Traitement Médicamenteux Courant en relation avec cette ligne de la Fiche de Conciliation


      Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

      ShortLigne du Traitement Médicamenteux CourantAdditional supporting information
      Comments

      Un ligne de la Fiche de Conciliation peut n'être en relation avec aucune des lignes de la Prescription d'Admission (ligne arrêtée ou oubliée lors de la Prescription d'Admission)


      Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

      Control0..1*
      TypeReference(FrCurrentMedicationMedicationStatement, Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Référencer une ressource ligne de Traitement Médicamenteux Courant

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationStatement.derivedFrom:fromCurrentMedication.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MedicationStatement.derivedFrom:fromCurrentMedication.identifier
      Definition

      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

      ShortLogical reference, when literal reference is not known
      Comments

      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..01
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      identifier la ligne du Bilan d'Admission par référence à une ressource MedicationStatement profilée SiPh

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. MedicationStatement.note
      Definition

      Information textuelle complémentaire pour ce médicament, A L'EXCEPTION des notes concernant la documentation de la Conciliation proprement-dite de ce médicament qui doivent figurer dans l'élément commentaire de l'extension reconciliation.


      Provides extra information about the medication statement that is not conveyed by the other attributes.

      ShortFurther information about the statement
      Comments

      Bien distinguer les informations complémentaires relatives au traitement médicamenteux que représente cette ligne, qui doivent figurer ici, de celles relative à la conciliation proprement-dite de cette ligne avec le Bilan Médicamenteux et le Traitement Médicamenteux Courant, qui doivent figurer dans l'extension reconciliation

      Control0..*
      TypeAnnotation
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Bien distinguer information complémentaire concernant le traitement médicamenteux de celle concernant la conciliation proprement-dite.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. MedicationStatement.dosage
      Definition

      Indicates how the medication is/was or should be taken by the patient.

      ShortDetails of how medication is/was taken or should be taken
      Comments

      The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

      Control0..*
      TypeDosage
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. MedicationStatement.dosage.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      44. MedicationStatement.dosage.doseAndRate
      Definition

      The amount of medication administered.

      ShortAmount of medication administered
      Control0..*
      TypeElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. MedicationStatement.dosage.doseAndRate.dose[x]
      Definition

      Amount of medication per dose. No use of element 'comparator' in the simpleQuantity definitions.


      Amount of medication per dose.

      ShortPrecise amount of medication per doseAmount of medication per dose
      Comments

      Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

      Control0..1
      TypeChoice of: Range(Range with UCUM quantity units), Quantity(SimpleQuantity with UCUM quantity unit, SimpleQuantity)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      The amount of therapeutic or other substance given at one administration event.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. MedicationStatement.dosage.doseAndRate.rate[x]
      Definition

      Amount of medication per unit of time No use of element 'comparator' in the simpleQuantity definitions.


      Amount of medication per unit of time.

      ShortPrecise amount of medication per unit of timeAmount of medication per unit of time
      Comments

      It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

      It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

      Control0..1
      TypeChoice of: Ratio(Ratio with UCUM quantity units), Range(Range with UCUM quantity units), Quantity(SimpleQuantity with UCUM quantity unit, SimpleQuantity)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. MedicationStatement.dosage.maxDosePerPeriod
      Definition

      A relationship of two Quantity values - expressed as a precise numerator and a precise denominator.


      Upper limit on medication per unit of time.

      ShortA ratio of two precise Quantity values - a numerator and a denominatorUpper limit on medication per unit of time
      Comments

      The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.


      This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeRatio(Ratio with UCUM quantity units)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      rat-1: 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()))
      52. MedicationStatement.dosage.maxDosePerAdministration
      Definition

      The comparator is not used on a SimpleQuantity. The unit SHALL be a UCUM code.


      Upper limit on medication per administration.

      ShortA fixed quantity (no comparator) with UCUM unitUpper limit on medication per administration
      Comments

      The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use explicitely excludes the use of the simpleQuantity "comparator" element.


      This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeQuantity(SimpleQuantity with UCUM quantity unit, SimpleQuantity)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
      sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
      54. MedicationStatement.dosage.maxDosePerLifetime
      Definition

      The comparator is not used on a SimpleQuantity. The unit SHALL be a UCUM code.


      Upper limit on medication per lifetime of the patient.

      ShortA fixed quantity (no comparator) with UCUM unitUpper limit on medication per lifetime of the patient
      Comments

      The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use explicitely excludes the use of the simpleQuantity "comparator" element.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeQuantity(SimpleQuantity with UCUM quantity unit, SimpleQuantity)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
      sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())

      Guidance on how to interpret the contents of this table can be found here

      0. MedicationStatement
      Definition

      Ligne de traitement médicamenteux de la FCT (Fiche de Conciliation ds Traitements médicamenteux), avec ses propriétés de documentation de la conciliation.

      ShortLigne de traitement médicamenteux de la FCT (Fiche de Conciliation ds Traitements médicamenteux)
      Comments

      When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

      Control0..*
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationStatement.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. MedicationStatement.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MedicationStatement.meta.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      8. MedicationStatement.meta.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationStatement.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. MedicationStatement.meta.versionId
        Definition

        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

        ShortVersion specific identifier
        Comments

        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

        Control0..1
        Typeid
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. MedicationStatement.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        ShortWhen the resource version last changed
        Comments

        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control0..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. MedicationStatement.meta.source
        Definition

        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

        ShortIdentifies where the resource comes from
        Comments

        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. MedicationStatement.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        ShortProfiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control0..*
        Typecanonical(StructureDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Fixed Valuehttp://interopsante.org/fhir/StructureDefinition/FrMedicationReconciliationMedicationStatement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. MedicationStatement.meta.security
        Definition

        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

        ShortSecurity Labels applied to this resource
        Comments

        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
        (extensible to http://hl7.org/fhir/ValueSet/security-labels)

        Security Labels from the Healthcare Privacy and Security Classification System.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. MedicationStatement.meta.tag
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        ShortTags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..0
        BindingFor example codes, see CommonTags
        (example to http://hl7.org/fhir/ValueSet/common-tags)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. MedicationStatement.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..0
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationStatement.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MedicationStatement.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. MedicationStatement.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        30. MedicationStatement.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 32. MedicationStatement.extension:reconciliation
          Slice Namereconciliation
          Definition

          Documentation de la conciliation : statut, divergence, commentaire, type d'erreur/écart, conséquence de l'erreur/écart, résolution de l'erreur/écart

          ShortPropriétés de la conciliation de cette ligne de traitement médicamenteux
          Comments

          La documentation de la conciliation est renseignée progressivement par le pharmacien puis le prescripteur lors du dialogue qui s'instaure entre eux-deux. L'élément complexe reconciliation peut porter tout l'historique de ce renseignement progressif ou ne porter que son état courant, c'est-à-dire pour chaque propriété, l'information à sa dernière date d'enregistrement par son ou ses auteurs.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(FrMedicationStatementReconciliationProperties) (Complex Extension)
          Is Modifierfalse
          Must Supporttrue
          Requirements

          Porter la documentation de la Conciliation Médicamenteuse selon les règles de gestion en vigueur en France

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          34. MedicationStatement.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          36. MedicationStatement.identifier
          Definition

          Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

          ShortExternal identifier
          Comments

          This is a business identifier, not a resource identifier.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. MedicationStatement.basedOn
          Definition

          A plan, proposal or order that is fulfilled in whole or in part by this event.

          ShortFulfils plan, proposal or order
          Control0..*
          TypeReference(MedicationRequest, CarePlan, ServiceRequest)
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. MedicationStatement.partOf
          Definition

          A larger event of which this particular event is a component or step.

          ShortPart of referenced event
          Control0..*
          TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
          Is Modifierfalse
          Summarytrue
          Requirements

          This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. MedicationStatement.status
          Definition

          A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

          Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
          Comments

          MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

          Control1..1
          BindingThe codes SHALL be taken from Medication Status Codes
          (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

          A coded concept indicating the current status of a MedicationStatement.

          Typecode
          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. MedicationStatement.statusReason
          Definition

          Captures the reason for the current state of the MedicationStatement.

          ShortReason for current status
          Comments

          This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

          Control0..*
          BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodes
          (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes)

          A coded concept indicating the reason for the status of the statement.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. MedicationStatement.category
          Definition

          Indicates where the medication is expected to be consumed or administered.

          ShortType of medication usage
          Control0..1
          BindingThe codes SHOULD be taken from Medication usage category codes
          (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category)

          A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. MedicationStatement.medication[x]
          Definition

          Identifie le médicament constitutif de cette ligne. C'est lien vers une ressource Medication qui décrit ce médicament. Identifies the medication being administered. This is a link to a resource representing the details of the medication.

          ShortLe médicament constitutif de cette ligne | What medication was taken
          Comments

          Même si le médicament n'est composé que d'une spécialité (par exemple un comprimé), il est défini par référence à une Medication qui décrira sa composition d'une seule spécialité

          Control1..1
          TypeReference(FrMedication)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          traitement univoque de l'élément medication[x]

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. MedicationStatement.subject
          Definition

          Le patient qui prend ou a pris cette ligne de traitement médicamenteux.

          ShortWho is/was taking the medication
          Comments

          Obligatoire dans la ressource FHIR MedicationStatement originelle, donc DOIT ABSOLUMENT être identique au patient identifé dans la ressource Composition de la Fiche. Cf. Composition.subjet.

          Control1..1
          TypeReference(FR Core Patient Profile)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          La Fiche de Conciliation des Traitements médicamenteux ne s'applique qu'à un patient

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationStatement.subject.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          54. MedicationStatement.subject.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MedicationStatement.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 56. MedicationStatement.subject.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control1..1
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            référence la ressource Patient selon la profile fr-patient défini par Interop'Santé

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. MedicationStatement.subject.type
            Definition

            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

            ShortType the reference refers to (e.g. "Patient")
            Comments

            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from ResourceType
            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

            Aa resource (or, for logical models, the URI of the logical model).

            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Fixed ValuePatient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. MedicationStatement.subject.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..0
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Identification du patient exclusivement par référence à une ressource Patient selon le profil fr-patient défini par Interop'Santé

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. MedicationStatement.subject.display
            Definition

            Plain text narrative that identifies the resource in addition to the resource reference.

            ShortText alternative for the resource
            Comments

            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. MedicationStatement.context
            Definition

            The encounter or episode of care that establishes the context for this MedicationStatement.

            ShortEncounter / Episode associated with MedicationStatement
            Control0..1
            TypeReference(Encounter, EpisodeOfCare)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. MedicationStatement.effective[x]
            Definition

            The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

            ShortThe date/time or interval when the medication is/was/will be taken
            Comments

            This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

            Control0..1
            TypeChoice of: dateTime, Period
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. MedicationStatement.dateAsserted
            Definition

            The date when the medication statement was asserted by the information source.

            ShortWhen the statement was asserted?
            Control0..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. MedicationStatement.informationSource
            Definition

            The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

            ShortPerson or organization that provided the information about the taking of this medication
            Comments

            Dans le contexte de la Conciliation des Traitements médicamenteux, le sourcing des informations de la ligne de la Fiche de Conciliation des Traitements médicamenteux doit être réalisé à travers la collection d'éléments derivedFrom et à travers elle seulement.

            Control0..0
            TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summaryfalse
            Requirements

            Garantir la règle de gestion du sourcing exclusivement à travers la collection d'éléments derivedFrom

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. MedicationStatement.derivedFrom
            Definition

            Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

            ShortAdditional supporting information
            Comments

            Une ligne de la Fiche de Conciliation doit être en relation avec au moins une ligne du Bilan d'Admission ou une ligne de la Prescription d'Admission

            Control1..2
            TypeReference(Resource)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            fournir le lien entre la Fiche de Conciliation et le Bilan Médicamenteux et la Prescription d'Admission.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationStatement.derivedFrom. The slices areUnordered and Open, and defines no disciminators to differentiate the slices
            74. MedicationStatement.derivedFrom:fromMedicationHistory
            Slice NamefromMedicationHistory
            Definition

            Ligne du Bilan Médicamenteux en relation avec cette ligne de la Fiche de Conciliation

            ShortLigne du Bilan Médicamenteux
            Comments

            Un ligne de la Fiche de Conciliation peut n'être en relation avec aucune des lignes du bilan Médicamenteux (ligne initiée lors de la Prescription d'Admission)

            Control0..1
            TypeReference(FrMedicationHistoryMedicationStatement)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Référencer une ressource ligne de Bilan Médicamenteux

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. MedicationStatement.derivedFrom:fromMedicationHistory.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            78. MedicationStatement.derivedFrom:fromMedicationHistory.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on MedicationStatement.derivedFrom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 80. MedicationStatement.derivedFrom:fromMedicationHistory.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control1..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. MedicationStatement.derivedFrom:fromMedicationHistory.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. MedicationStatement.derivedFrom:fromMedicationHistory.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..0
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Requirements

              identifier la ligne de Bilan Médicamenteux par référence à une ressource MedicationStatement profilée SiPh

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. MedicationStatement.derivedFrom:fromMedicationHistory.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. MedicationStatement.derivedFrom:fromCurrentMedication
              Slice NamefromCurrentMedication
              Definition

              Ligne du Traitement Médicamenteux Courant en relation avec cette ligne de la Fiche de Conciliation

              ShortLigne du Traitement Médicamenteux Courant
              Comments

              Un ligne de la Fiche de Conciliation peut n'être en relation avec aucune des lignes de la Prescription d'Admission (ligne arrêtée ou oubliée lors de la Prescription d'Admission)

              Control0..1
              TypeReference(FrCurrentMedicationMedicationStatement)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Référencer une ressource ligne de Traitement Médicamenteux Courant

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. MedicationStatement.derivedFrom:fromCurrentMedication.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              92. MedicationStatement.derivedFrom:fromCurrentMedication.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on MedicationStatement.derivedFrom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 94. MedicationStatement.derivedFrom:fromCurrentMedication.reference
                Definition

                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                ShortLiteral reference, Relative, internal or absolute URL
                Comments

                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                Control1..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. MedicationStatement.derivedFrom:fromCurrentMedication.type
                Definition

                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                ShortType the reference refers to (e.g. "Patient")
                Comments

                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                Aa resource (or, for logical models, the URI of the logical model).

                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. MedicationStatement.derivedFrom:fromCurrentMedication.identifier
                Definition

                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                ShortLogical reference, when literal reference is not known
                Comments

                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..0
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Requirements

                identifier la ligne du Bilan d'Admission par référence à une ressource MedicationStatement profilée SiPh

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                100. MedicationStatement.derivedFrom:fromCurrentMedication.display
                Definition

                Plain text narrative that identifies the resource in addition to the resource reference.

                ShortText alternative for the resource
                Comments

                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                102. MedicationStatement.reasonCode
                Definition

                A reason for why the medication is being/was taken.

                ShortReason for why the medication is being/was taken
                Comments

                This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

                Control0..*
                BindingFor example codes, see Condition/Problem/DiagnosisCodes
                (example to http://hl7.org/fhir/ValueSet/condition-code)

                A coded concept identifying why the medication is being taken.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                104. MedicationStatement.reasonReference
                Definition

                Condition or observation that supports why the medication is being/was taken.

                ShortCondition or observation that supports why the medication is being/was taken
                Comments

                This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

                Control0..*
                TypeReference(Condition, Observation, DiagnosticReport)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. MedicationStatement.note
                Definition

                Information textuelle complémentaire pour ce médicament, A L'EXCEPTION des notes concernant la documentation de la Conciliation proprement-dite de ce médicament qui doivent figurer dans l'élément commentaire de l'extension reconciliation.

                ShortFurther information about the statement
                Comments

                Bien distinguer les informations complémentaires relatives au traitement médicamenteux que représente cette ligne, qui doivent figurer ici, de celles relative à la conciliation proprement-dite de cette ligne avec le Bilan Médicamenteux et le Traitement Médicamenteux Courant, qui doivent figurer dans l'extension reconciliation

                Control0..*
                TypeAnnotation
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                Bien distinguer information complémentaire concernant le traitement médicamenteux de celle concernant la conciliation proprement-dite.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. MedicationStatement.dosage
                Definition

                Indicates how the medication is/was or should be taken by the patient.

                ShortDetails of how medication is/was taken or should be taken
                Comments

                The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

                Control0..*
                TypeDosage
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. MedicationStatement.dosage.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                112. MedicationStatement.dosage.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 114. MedicationStatement.dosage.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  116. MedicationStatement.dosage.sequence
                  Definition

                  Indicates the order in which the dosage instructions should be applied or interpreted.

                  ShortThe order of the dosage instructions
                  Control0..1
                  Typeinteger
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  118. MedicationStatement.dosage.text
                  Definition

                  Free text dosage instructions e.g. SIG.

                  ShortFree text dosage instructions e.g. SIG
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  120. MedicationStatement.dosage.additionalInstruction
                  Definition

                  Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                  ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                  Comments

                  Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                  Control0..*
                  BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                  (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

                  A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  122. MedicationStatement.dosage.patientInstruction
                  Definition

                  Instructions in terms that are understood by the patient or consumer.

                  ShortPatient or consumer oriented instructions
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  124. MedicationStatement.dosage.timing
                  Definition

                  When medication should be administered.

                  ShortWhen medication should be administered
                  Comments

                  This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                  Control0..1
                  TypeTiming
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  126. MedicationStatement.dosage.asNeeded[x]
                  Definition

                  Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                  ShortTake "as needed" (for x)
                  Comments

                  Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                  Control0..1
                  BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                  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.

                  TypeChoice of: boolean, CodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  128. MedicationStatement.dosage.site
                  Definition

                  Body site to administer to.

                  ShortBody site to administer to
                  Comments

                  If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                  Control0..1
                  BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                  (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

                  A coded concept describing the site location the medicine enters into or onto the body.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  A coded specification of the anatomic site where the medication first enters the body.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  130. MedicationStatement.dosage.route
                  Definition

                  How drug should enter body.

                  ShortHow drug should enter body
                  Control0..1
                  BindingFor example codes, see SNOMEDCTRouteCodes
                  (example to http://hl7.org/fhir/ValueSet/route-codes)

                  A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  132. MedicationStatement.dosage.method
                  Definition

                  Technique for administering medication.

                  ShortTechnique for administering medication
                  Comments

                  Terminologies used often pre-coordinate this term with the route and or form of administration.

                  Control0..1
                  BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                  (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

                  A coded concept describing the technique by which the medicine is administered.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  134. MedicationStatement.dosage.doseAndRate
                  Definition

                  The amount of medication administered.

                  ShortAmount of medication administered
                  Control0..*
                  TypeElement
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  136. MedicationStatement.dosage.doseAndRate.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  138. MedicationStatement.dosage.doseAndRate.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 140. MedicationStatement.dosage.doseAndRate.type
                    Definition

                    The kind of dose or rate specified, for example, ordered or calculated.

                    ShortThe kind of dose or rate specified
                    Control0..1
                    BindingFor example codes, see DoseAndRateType
                    (example to http://hl7.org/fhir/ValueSet/dose-rate-type)

                    The kind of dose or rate specified.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    If the type is not populated, assume to be "ordered".

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    142. MedicationStatement.dosage.doseAndRate.dose[x]
                    Definition

                    Amount of medication per dose. No use of element 'comparator' in the simpleQuantity definitions.

                    ShortPrecise amount of medication per dose
                    Comments

                    Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                    Control0..1
                    TypeChoice of: Range(Range with UCUM quantity units), Quantity(SimpleQuantity with UCUM quantity unit)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summarytrue
                    Requirements

                    The amount of therapeutic or other substance given at one administration event.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    144. MedicationStatement.dosage.doseAndRate.rate[x]
                    Definition

                    Amount of medication per unit of time No use of element 'comparator' in the simpleQuantity definitions.

                    ShortPrecise amount of medication per unit of time
                    Comments

                    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                    Control0..1
                    TypeChoice of: Ratio(Ratio with UCUM quantity units), Range(Range with UCUM quantity units), Quantity(SimpleQuantity with UCUM quantity unit)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summarytrue
                    Requirements

                    Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    146. MedicationStatement.dosage.maxDosePerPeriod
                    Definition

                    A relationship of two Quantity values - expressed as a precise numerator and a precise denominator.

                    ShortA ratio of two precise Quantity values - a numerator and a denominator
                    Comments

                    The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeRatio(Ratio with UCUM quantity units)
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    rat-1: 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()))
                    148. MedicationStatement.dosage.maxDosePerAdministration
                    Definition

                    The comparator is not used on a SimpleQuantity. The unit SHALL be a UCUM code.

                    ShortA fixed quantity (no comparator) with UCUM unit
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use explicitely excludes the use of the simpleQuantity "comparator" element.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity with UCUM quantity unit)
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                    150. MedicationStatement.dosage.maxDosePerLifetime
                    Definition

                    The comparator is not used on a SimpleQuantity. The unit SHALL be a UCUM code.

                    ShortA fixed quantity (no comparator) with UCUM unit
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use explicitely excludes the use of the simpleQuantity "comparator" element.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity with UCUM quantity unit)
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())