RIVO-Noord Zorgviewer Implementation Guide
1.21.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.21.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: MedicationUse

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/MedicationStatement | Version: 1.21.0
Active as of 2025-10-28 | Computable Name: MedicationUse

Medicatie Gebruik

> Dit Profiel is het resultaat van de vergelijking tussen de zib2017 FHIR Profiel en de implementaties in Epic, Chipsoft, Topicus en Nexus. De elementen die in ieder geval in alle output beschikbaar zullen zijn. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

### Zorginformatiebouwsteen

ZIB Medicatie Gebruik2

### View Definition

ViewDefinition voor MedicationStatement

### UI Wireframe

Medicatie Gebruik

>< | Bron | Start | Eind | Medicatie | Dosering & instructies | Toedieningsweg
--- | --- | --- | --- | --- | --- | ---
+ | Epic |  |  | simvastatine 20mg tablet | innemen. s Avonds innemen; Bij dit middel GEEN grapefruit(sap) gebruiken | Oraal
| Registratiedatum 15-3-2018

### Kolom Definities

Kolom label | FHIR Path Expression | FHIR Type | Zib element | Toelichting of regels
Bron | `meta.extension('http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source').valueUri` | `string` | nvt | Lookup adhv uri (AGB-Z of OID) `<adressering-base>/Organization?identifier=<.meta.tag.code>` en gebruik dan `Organization.name`
Start | `effectivePeriod.start` | `dateTime` | Gebruiksperiode::TijdsInterval/startDatumTijd |
Eind | `effectivePeriod.end` | `dateTime` | Gebruiksperiode::TijdsInterval/eindDatumTijd |
Medicatie | `medication.display` | `string` | Gebruiksproduct::FarmaceutischProduct |
Dosering & instructies | `dosage.text` | `string` | Gebruiksinstructie/Omschrijving, Gebruiksinstructie/AanvullendeInstructie | N.B. Als text niet beschikbaar dan samenstellen uit discrete informatie en markeren met een icoontje ⓘ
Toedieningsweg | `dosage.route.text` | `string` | Gebruiksinstructie/Toedieningsweg |
UITKLAPVELD
+Medicatie vorm | `medication.resolve().form.coding.display` | `string` | Gebruiksproduct::FarmaceutischProduct/FarmaceutischeVorm |
+Registratiedatum | `dateAsserted` | `dateTime` | MedicatieGebruikDatumTijd |
+Voorschrijver | `extension('http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber').valueReference.display` | `string` | Voorschrijver::Zorgverlener |

### Request

1. Opvragen (search) definities

   `GET <ontsluiten-bronsysteem-base>/MedicationStatement?category=urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3|6&_include=MedicationStatement:medication&patient=<fhir_patient_id>`

### Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

    "meta": {
        "extension": [ {
            "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
            "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
        } ]
    }

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (`<resource>.subject|patient`). Elke patient heeft een `Patient.managingOrganization` en in de gerefereerde `Organization.identifier` staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

Usages:

- Use this Profile: Medicatiegegevens
- CapabilityStatements using this Profile: Ontsluiten Bronsysteem

You can also check for usages in the FHIR IG Statistics

Changes since version 1.20.0:

- New Content

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement | C | 0..* | Zib MedicationUse(2.2.11) | MedicationUse Constraints: mst-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:asAgreedIndicator |  | 0..1 | (Complex) | AsAgreedIndicator URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueBoolean |  | 0..1 | boolean | Value of extension Example Example of asAgreed: true
extension:prescriber | S | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7)) | Who ordered the initial medication(s) URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber Constraints: ext-1
extension:author |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5)) | Author URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author Constraints: ext-1
extension:medicationTreatment |  | 0..1 | Identifier | Medical Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:reasonForChangeOrDiscontinuationOfUse |  | 0..* | (Complex) | ReasonForChangeOrDiscontinuationOfUse URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | ReasonForChangeOrDiscontinuationOfUse Binding: RedenWijzigenOfStoppenGebruikCodelijst (extensible): ReasonForChangeOrDiscontinuationOfUseCodeList Example Example of ReasonForChangeOrDiscontinuationOfUse: {"coding":[{"system":"http://snomed.info/sct","code":"79899007","display":"Drug interaction (finding)"}]}
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
status | ?!Σ | 1..1 | code | MedicationUseStopType Binding: MedicationStatementStatus (required): Allergy Intolerance critically Code list
category | Σ | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationStatementCategory (preferred): A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationUseCode | Σ | 0..* | Coding | MedicationUseCode
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 6
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | ProductUsed
display | S Σ | 0..1 | string | Text alternative for the resource
Slices for effectivePeriod |  |  |  | Content/Rules for all slices
effectivePeriod:effectivePeriod | S Σ | 0..1 | Period | PeriodOfUse
Slices for extension |  |  |  | Content/Rules for all slices
extension:Duration |  | 0..1 | (Complex) | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueDuration |  | 0..1 | Duration | UsageDuration Example Example of Duration: {"value":3,"unit":"day","system":"http://unitsofmeasure.org","code":"d"}
start | S Σ C | 0..1 | dateTime | StartDate
end | S Σ C | 0..1 | dateTime | EndDate
dateAsserted | S Σ | 1..1 | dateTime | MedicationUseDateTime Example Example of MedicationUseDateTime: 2017-06-14
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5)) | Who is/was taking the medication
taken | ?!Σ | 1..1 | code | UseIndicator Binding: MedicationStatementTaken (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication Example Example of taken: y
dosage |  | 0..* | Zib InstructionsForUse | InstructionsForUse
text | S Σ | 0..1 | string | Description
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​extension:reasonForChangeOrDiscontinuationOfUse.​value[x]:valueCodeableConcept | Base | extensible | RedenWijzigenOfStoppenGebruikCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​status | Base | required | MedicationStatementStatus | 📦3.0.2 | FHIR Std.
MedicationStatement.​category | Base | preferred | MedicationStatementCategory | 📦3.0.2 | FHIR Std.
MedicationStatement.​taken | Base | required | MedicationStatementTaken | 📦3.0.2 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource | `contained.where(('#'+id in %resource.descendants().reference).not()).empty()`
dom-4 | error | MedicationStatement | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationStatement.extension:asAgreedIndicator, MedicationStatement.extension:prescriber, MedicationStatement.extension:author, MedicationStatement.extension:medicationTreatment, MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse, MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule, MedicationStatement.effectivePeriod:effectivePeriod.extension:Duration | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mst-1 | error | MedicationStatement | Reason not taken is only permitted if Taken is No | `reasonNotTaken.exists().not() or (taken = 'n')`

This structure is derived from Zib MedicationUse

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  |  | Zib MedicationUse(2.2.11) |
Slices for extension |  |  |  | Content/Rules for all slices
extension:prescriber | S | 0..1 | Zib MedicationUse Prescriber | Who ordered the initial medication(s)
category |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
​ medicationReference | S | 1..1 | Reference(Medication) | ProductUsed
​ display | S | 0..1 | string | Text alternative for the resource
​ effectivePeriod | S | 0..1 | Period | PeriodOfUse
​ start | S | 0..1 | dateTime | StartDate
​ end | S | 0..1 | dateTime | EndDate
dateAsserted | S | 1..1 | dateTime | MedicationUseDateTime
dosage |  |  |  |
text | S | 0..1 | string | Description
route |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement | C | 0..* | Zib MedicationUse(2.2.11) | MedicationUse Constraints: mst-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:asAgreedIndicator |  | 0..1 | (Complex) | AsAgreedIndicator URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueBoolean |  | 0..1 | boolean | Value of extension Example Example of asAgreed: true
extension:prescriber | S | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7)) | Who ordered the initial medication(s) URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber Constraints: ext-1
extension:author |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5)) | Author URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author Constraints: ext-1
extension:medicationTreatment |  | 0..1 | Identifier | Medical Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:reasonForChangeOrDiscontinuationOfUse |  | 0..* | (Complex) | ReasonForChangeOrDiscontinuationOfUse URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | ReasonForChangeOrDiscontinuationOfUse Binding: RedenWijzigenOfStoppenGebruikCodelijst (extensible): ReasonForChangeOrDiscontinuationOfUseCodeList Example Example of ReasonForChangeOrDiscontinuationOfUse: {"coding":[{"system":"http://snomed.info/sct","code":"79899007","display":"Drug interaction (finding)"}]}
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
identifier | Σ | 0..* | Identifier | External identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
status | ?!Σ | 1..1 | code | MedicationUseStopType Binding: MedicationStatementStatus (required): Allergy Intolerance critically Code list
category | Σ | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationStatementCategory (preferred): A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationUseCode | Σ | 0..* | Coding | MedicationUseCode
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 6
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | ProductUsed
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 0..1 | string | Text alternative for the resource
Slices for effectivePeriod |  |  |  | Content/Rules for all slices
effectivePeriod:effectivePeriod | S Σ | 0..1 | Period | PeriodOfUse
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:Duration |  | 0..1 | (Complex) | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueDuration |  | 0..1 | Duration | UsageDuration Example Example of Duration: {"value":3,"unit":"day","system":"http://unitsofmeasure.org","code":"d"}
start | S Σ C | 0..1 | dateTime | StartDate
end | S Σ C | 0..1 | dateTime | EndDate
dateAsserted | S Σ | 1..1 | dateTime | MedicationUseDateTime Example Example of MedicationUseDateTime: 2017-06-14
informationSource |  | 0..1 | Reference(nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5) | nl-core-organization(2.0.6)) | Person or organization that provided the information about the taking of this medication
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5)) | Who is/was taking the medication
derivedFrom |  | 0..* | Reference(Resource) | Additional supporting information
taken | ?!Σ | 1..1 | code | UseIndicator Binding: MedicationStatementTaken (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication Example Example of taken: y
reasonNotTaken | C | 0..* | CodeableConcept | True if asserting medication was not given Binding: SNOMED CT Drugs not taken/completed Codes (example): A coded concept indicating the reason why the medication was not taken
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken Binding: Condition/Problem/Diagnosis Codes (example): A coded concept identifying why the medication is being taken.
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | ReasonForUse
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Comment
dosage |  | 0..* | Zib InstructionsForUse | InstructionsForUse
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
sequence | Σ | 0..1 | integer | SequenceNumber
text | S Σ | 0..1 | string | Description
additionalInstruction | Σ | 0..* | CodeableConcept | AdditionalInstructions Binding: Aanvullende gebruiksinstructie (extensible)
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Zib AdministrationSchedule | When medication should be administered
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
low | Σ C | 0..1 | SimpleQuantity | Low limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
high | Σ C | 0..1 | SimpleQuantity | High limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
maxDosePerPeriod | Σ | 0..1 | Ratio | MaximumDose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
numerator | Σ | 0..1 | Quantity | Numerator value Binding: G-Standaard Eenhedentabel (required): GstdTabel902
denominator | Σ | 0..1 | Quantity | Denominator value
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
rate[x] | Σ | 0..1 |  | AdministeringSpeed
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
MedicationStatement.​extension:reasonForChangeOrDiscontinuationOfUse.​value[x]:valueCodeableConcept | Base | extensible | RedenWijzigenOfStoppenGebruikCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​status | Base | required | MedicationStatementStatus | 📦3.0.2 | FHIR Std.
MedicationStatement.​category | Base | preferred | MedicationStatementCategory | 📦3.0.2 | FHIR Std.
MedicationStatement.​taken | Base | required | MedicationStatementTaken | 📦3.0.2 | FHIR Std.
MedicationStatement.​reasonNotTaken | Base | example | SNOMED CT Drugs not taken/completed Codes | 📦3.0.2 | FHIR Std.
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦3.0.2 | FHIR Std.
MedicationStatement.​dosage.additionalInstruction | Base | extensible | Aanvullende gebruiksinstructie | 📦2016-04-07T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.dose[x]:doseRange.​low | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.dose[x]:doseRange.​high | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.maxDosePerPeriod.​numerator | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource | `contained.where(('#'+id in %resource.descendants().reference).not()).empty()`
dom-4 | error | MedicationStatement | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationStatement.extension:asAgreedIndicator, MedicationStatement.extension:prescriber, MedicationStatement.extension:author, MedicationStatement.extension:medicationTreatment, MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse, MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule, MedicationStatement.effectivePeriod:effectivePeriod.extension:Duration, MedicationStatement.informationSource.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mst-1 | error | MedicationStatement | Reason not taken is only permitted if Taken is No | `reasonNotTaken.exists().not() or (taken = 'n')`

This structure is derived from Zib MedicationUse

Summary

Must-Support: 10 elements

Structures

This structure refers to these other structures:

- Medication (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Medication)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement | C | 0..* | Zib MedicationUse(2.2.11) | MedicationUse Constraints: mst-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:asAgreedIndicator |  | 0..1 | (Complex) | AsAgreedIndicator URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueBoolean |  | 0..1 | boolean | Value of extension Example Example of asAgreed: true
extension:prescriber | S | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7)) | Who ordered the initial medication(s) URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber Constraints: ext-1
extension:author |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5)) | Author URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author Constraints: ext-1
extension:medicationTreatment |  | 0..1 | Identifier | Medical Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:reasonForChangeOrDiscontinuationOfUse |  | 0..* | (Complex) | ReasonForChangeOrDiscontinuationOfUse URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | ReasonForChangeOrDiscontinuationOfUse Binding: RedenWijzigenOfStoppenGebruikCodelijst (extensible): ReasonForChangeOrDiscontinuationOfUseCodeList Example Example of ReasonForChangeOrDiscontinuationOfUse: {"coding":[{"system":"http://snomed.info/sct","code":"79899007","display":"Drug interaction (finding)"}]}
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
status | ?!Σ | 1..1 | code | MedicationUseStopType Binding: MedicationStatementStatus (required): Allergy Intolerance critically Code list
category | Σ | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationStatementCategory (preferred): A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationUseCode | Σ | 0..* | Coding | MedicationUseCode
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 6
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | ProductUsed
display | S Σ | 0..1 | string | Text alternative for the resource
Slices for effectivePeriod |  |  |  | Content/Rules for all slices
effectivePeriod:effectivePeriod | S Σ | 0..1 | Period | PeriodOfUse
Slices for extension |  |  |  | Content/Rules for all slices
extension:Duration |  | 0..1 | (Complex) | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueDuration |  | 0..1 | Duration | UsageDuration Example Example of Duration: {"value":3,"unit":"day","system":"http://unitsofmeasure.org","code":"d"}
start | S Σ C | 0..1 | dateTime | StartDate
end | S Σ C | 0..1 | dateTime | EndDate
dateAsserted | S Σ | 1..1 | dateTime | MedicationUseDateTime Example Example of MedicationUseDateTime: 2017-06-14
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5)) | Who is/was taking the medication
taken | ?!Σ | 1..1 | code | UseIndicator Binding: MedicationStatementTaken (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication Example Example of taken: y
dosage |  | 0..* | Zib InstructionsForUse | InstructionsForUse
text | S Σ | 0..1 | string | Description
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​extension:reasonForChangeOrDiscontinuationOfUse.​value[x]:valueCodeableConcept | Base | extensible | RedenWijzigenOfStoppenGebruikCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​status | Base | required | MedicationStatementStatus | 📦3.0.2 | FHIR Std.
MedicationStatement.​category | Base | preferred | MedicationStatementCategory | 📦3.0.2 | FHIR Std.
MedicationStatement.​taken | Base | required | MedicationStatementTaken | 📦3.0.2 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource | `contained.where(('#'+id in %resource.descendants().reference).not()).empty()`
dom-4 | error | MedicationStatement | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationStatement.extension:asAgreedIndicator, MedicationStatement.extension:prescriber, MedicationStatement.extension:author, MedicationStatement.extension:medicationTreatment, MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse, MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule, MedicationStatement.effectivePeriod:effectivePeriod.extension:Duration | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mst-1 | error | MedicationStatement | Reason not taken is only permitted if Taken is No | `reasonNotTaken.exists().not() or (taken = 'n')`

Differential View

This structure is derived from Zib MedicationUse

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  |  | Zib MedicationUse(2.2.11) |
Slices for extension |  |  |  | Content/Rules for all slices
extension:prescriber | S | 0..1 | Zib MedicationUse Prescriber | Who ordered the initial medication(s)
category |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
​ medicationReference | S | 1..1 | Reference(Medication) | ProductUsed
​ display | S | 0..1 | string | Text alternative for the resource
​ effectivePeriod | S | 0..1 | Period | PeriodOfUse
​ start | S | 0..1 | dateTime | StartDate
​ end | S | 0..1 | dateTime | EndDate
dateAsserted | S | 1..1 | dateTime | MedicationUseDateTime
dosage |  |  |  |
text | S | 0..1 | string | Description
route |  |  |  |
text | S | 0..1 | string | Plain text representation of the concept
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement | C | 0..* | Zib MedicationUse(2.2.11) | MedicationUse Constraints: mst-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:asAgreedIndicator |  | 0..1 | (Complex) | AsAgreedIndicator URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueBoolean |  | 0..1 | boolean | Value of extension Example Example of asAgreed: true
extension:prescriber | S | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7)) | Who ordered the initial medication(s) URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber Constraints: ext-1
extension:author |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7) | nl-core-practitioner(2.0.7) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5)) | Author URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author Constraints: ext-1
extension:medicationTreatment |  | 0..1 | Identifier | Medical Treatment URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints: ext-1
extension:reasonForChangeOrDiscontinuationOfUse |  | 0..* | (Complex) | ReasonForChangeOrDiscontinuationOfUse URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | ReasonForChangeOrDiscontinuationOfUse Binding: RedenWijzigenOfStoppenGebruikCodelijst (extensible): ReasonForChangeOrDiscontinuationOfUseCodeList Example Example of ReasonForChangeOrDiscontinuationOfUse: {"coding":[{"system":"http://snomed.info/sct","code":"79899007","display":"Drug interaction (finding)"}]}
Slices for modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:repeatPeriodCyclicalSchedule | ?! | 0..1 | Duration | RepeatPeriodCyclicalSchedule URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule Constraints: ext-1
identifier | Σ | 0..* | Identifier | External identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
status | ?!Σ | 1..1 | code | MedicationUseStopType Binding: MedicationStatementStatus (required): Allergy Intolerance critically Code list
category | Σ | 1..1 | CodeableConcept | Type of medication usage Binding: MedicationStatementCategory (preferred): A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:medicationUseCode | Σ | 0..* | Coding | MedicationUseCode
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 6
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
Slices for medicationReference |  |  |  | Content/Rules for all slices
medicationReference:medicationReference | S Σ | 1..1 | Reference(Medication) | ProductUsed
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 0..1 | string | Text alternative for the resource
Slices for effectivePeriod |  |  |  | Content/Rules for all slices
effectivePeriod:effectivePeriod | S Σ | 0..1 | Period | PeriodOfUse
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:Duration |  | 0..1 | (Complex) | Duration URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueDuration |  | 0..1 | Duration | UsageDuration Example Example of Duration: {"value":3,"unit":"day","system":"http://unitsofmeasure.org","code":"d"}
start | S Σ C | 0..1 | dateTime | StartDate
end | S Σ C | 0..1 | dateTime | EndDate
dateAsserted | S Σ | 1..1 | dateTime | MedicationUseDateTime Example Example of MedicationUseDateTime: 2017-06-14
informationSource |  | 0..1 | Reference(nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5) | nl-core-organization(2.0.6)) | Person or organization that provided the information about the taking of this medication
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole(2.0.7)) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
subject | Σ | 1..1 | Reference(nl-core-patient(2.2.5)) | Who is/was taking the medication
derivedFrom |  | 0..* | Reference(Resource) | Additional supporting information
taken | ?!Σ | 1..1 | code | UseIndicator Binding: MedicationStatementTaken (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication Example Example of taken: y
reasonNotTaken | C | 0..* | CodeableConcept | True if asserting medication was not given Binding: SNOMED CT Drugs not taken/completed Codes (example): A coded concept indicating the reason why the medication was not taken
reasonCode |  | 0..* | CodeableConcept | Reason for why the medication is being/was taken Binding: Condition/Problem/Diagnosis Codes (example): A coded concept identifying why the medication is being taken.
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | ReasonForUse
reasonReference |  | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Comment
dosage |  | 0..* | Zib InstructionsForUse | InstructionsForUse
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
sequence | Σ | 0..1 | integer | SequenceNumber
text | S Σ | 0..1 | string | Description
additionalInstruction | Σ | 0..* | CodeableConcept | AdditionalInstructions Binding: Aanvullende gebruiksinstructie (extensible)
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Zib AdministrationSchedule | When medication should be administered
Slices for asNeeded[x] | Σ | 0..1 | CodeableConcept | Take "as needed" (for x) Slice: Unordered, Closed by type:$this Binding: SNOMED CT Medication As Needed Reason Codes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeeded[x]:asNeededCodeableConcept | Σ | 0..1 | CodeableConcept | AsNeeded Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | RouteOfAdministration Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.
Slices for dose[x] | Σ | 0..1 |  | Dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantity | Amount of medication per dose Binding: G-Standaard Eenhedentabel (required): GstdTabel902
dose[x]:doseRange | Σ | 0..1 | Range | Amount of medication per dose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
low | Σ C | 0..1 | SimpleQuantity | Low limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
high | Σ C | 0..1 | SimpleQuantity | High limit Binding: G-Standaard Eenhedentabel (required): GstdTabel902
maxDosePerPeriod | Σ | 0..1 | Ratio | MaximumDose
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
numerator | Σ | 0..1 | Quantity | Numerator value Binding: G-Standaard Eenhedentabel (required): GstdTabel902
denominator | Σ | 0..1 | Quantity | Denominator value
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
rate[x] | Σ | 0..1 |  | AdministeringSpeed
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
MedicationStatement.​extension:reasonForChangeOrDiscontinuationOfUse.​value[x]:valueCodeableConcept | Base | extensible | RedenWijzigenOfStoppenGebruikCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​status | Base | required | MedicationStatementStatus | 📦3.0.2 | FHIR Std.
MedicationStatement.​category | Base | preferred | MedicationStatementCategory | 📦3.0.2 | FHIR Std.
MedicationStatement.​taken | Base | required | MedicationStatementTaken | 📦3.0.2 | FHIR Std.
MedicationStatement.​reasonNotTaken | Base | example | SNOMED CT Drugs not taken/completed Codes | 📦3.0.2 | FHIR Std.
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦3.0.2 | FHIR Std.
MedicationStatement.​dosage.additionalInstruction | Base | extensible | Aanvullende gebruiksinstructie | 📦2016-04-07T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x]:asNeededCodeableConcept | Base | extensible | ZonodigCriteriumCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.route | Base | extensible | MedicatieToedieningswegCodelijst | 📦2017-12-31T00:00:00 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍3.0.2 | FHIR Std.
MedicationStatement.​dosage.dose[x]:doseQuantity | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.dose[x]:doseRange.​low | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.dose[x]:doseRange.​high | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0
MedicationStatement.​dosage.maxDosePerPeriod.​numerator | Base | required | G-Standaard Eenhedentabel | 📦2016-08-30T20:24:53 | nictiz.fhir.nl.stu3.zib2017 v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource | `contained.where(('#'+id in %resource.descendants().reference).not()).empty()`
dom-4 | error | MedicationStatement | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | MedicationStatement.extension:asAgreedIndicator, MedicationStatement.extension:prescriber, MedicationStatement.extension:author, MedicationStatement.extension:medicationTreatment, MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse, MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule, MedicationStatement.effectivePeriod:effectivePeriod.extension:Duration, MedicationStatement.informationSource.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mst-1 | error | MedicationStatement | Reason not taken is only permitted if Taken is No | `reasonNotTaken.exists().not() or (taken = 'n')`

This structure is derived from Zib MedicationUse

Summary

Must-Support: 10 elements

Structures

This structure refers to these other structures:

- Medication (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Medication)

Other representations of profile: CSV, Excel, Schematron