Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: EETISMedicationInteraction

Ravimite omavahelised koostoimed. This profile is for the representation of the interactions between medication A and medication B in order to display warnings related to medications.

Usage:

• Examples for this Resource Profile: ClinicalUseDefinition/medication-interaction1

Formal Views of Profile Content

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

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

This structure is derived from ClinicalUseDefinition

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition		0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
contained		2..2	Medication	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
affected		0..*	Reference(EETISMedicationStatement)	MedicationStatements affected by interactions. URL: https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
link		0..*	string	Additional information from external source. URL: https://fhir.ee/StructureDefinition/ee-tis-additional-information-link
type		1..1	code	indication | contraindication | interaction | undesirable-effect | warning Fixed Value: interaction
subject		1..*	Reference(Medication)	medication A
display		0..1	string	Text alternative for the resource Required Pattern: siia toimeaine nimetus
contraindication		0..0
indication		0..0
interaction
interactant
item[x]		1..1	Reference(Medication)	medication B
type		0..1	CodeableConcept	The type of the interaction e.g. drug-drug interaction, drug-lab test interaction Fixed Value: As shown
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/interaction-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: drug-drug
display		1..1	string	Representation defined by the system Fixed Value: drug to drug interaction
text		1..1	string	Plain text representation of the concept Fixed Value: drug to drug interaction
effect		0..1	CodeableReference(ObservationDefinition)	Consequences (SYNBASE)
concept		0..1	CodeableConcept	Consequences
text		0..1	string	If not codeable, use text to represent consequenses
reference		0..0
incidence		0..1	CodeableConcept	Classification (SYNBASE. e.g. D0)
text		0..1	string	Classification
management		0..1	CodeableConcept	Recommendation (SYNBASE)
text		0..1	string	If not codeable, use text to represent recommendation
population		0..0
library		0..0
undesirableEffect		0..0
warning		0..0
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		2..2	Medication	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
affected		0..*	Reference(EETISMedicationStatement)	MedicationStatements affected by interactions. URL: https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
link		0..*	string	Additional information from external source. URL: https://fhir.ee/StructureDefinition/ee-tis-additional-information-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition. Fixed Value: interaction
subject	Σ	1..*	Reference(Medication)	medication A
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
display	ΣC	0..1	string	Text alternative for the resource Required Pattern: siia toimeaine nimetus
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ClinicalUseDefinition.type	required	Fixed Value: interaction http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
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: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		2..2	Medication	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
affected		0..*	Reference(EETISMedicationStatement)	MedicationStatements affected by interactions. URL: https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
link		0..*	string	Additional information from external source. URL: https://fhir.ee/StructureDefinition/ee-tis-additional-information-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier for this issue
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition. Fixed Value: interaction
category	Σ	0..*	CodeableConcept	A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose" Binding: ClinicalUseDefinitionCategory (preferred): A categorisation for a clinical use information item.
subject	Σ	1..*	Reference(Medication)	medication A
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource Required Pattern: siia toimeaine nimetus
status	Σ	0..1	CodeableConcept	Whether this is a current issue or one that has been retired etc Binding: PublicationStatus (preferred): The lifecycle status of an artifact.
interaction	ΣC	0..1	BackboneElement	Specifics for when this is an interaction
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
interactant	Σ	0..*	BackboneElement	The specific medication, product, food etc. or laboratory test that interacts
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	Σ	1..1	Reference(Medication)	medication B
type	Σ	0..1	CodeableConcept	The type of the interaction e.g. drug-drug interaction, drug-lab test interaction Binding: InteractionType (example): A categorisation for an interaction between two substances. Fixed Value: As shown
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/interaction-type
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: drug-drug
display		1..1	string	Representation defined by the system Fixed Value: drug to drug interaction
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		1..1	string	Plain text representation of the concept Fixed Value: drug to drug interaction
effect	Σ	0..1	CodeableReference(ObservationDefinition)	Consequences (SYNBASE) Binding: InteractionEffect (example): A interaction effect of clinical use of a medication or other substance.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
concept	Σ	0..1	CodeableConcept	Consequences
id		0..1	id	Unique id for inter-element referencing
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	If not codeable, use text to represent consequenses
incidence	Σ	0..1	CodeableConcept	Classification (SYNBASE. e.g. D0) Binding: InteractionIncidence (example): A categorisation for incidence of occurence of an interaction.
id		0..1	id	Unique id for inter-element referencing
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	Classification
management	Σ	0..1	CodeableConcept	Recommendation (SYNBASE) Binding: InteractionManagement (example): A type of management for an interaction of a medication or other substance.
id		0..1	id	Unique id for inter-element referencing
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	If not codeable, use text to represent recommendation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ClinicalUseDefinition.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
ClinicalUseDefinition.type	required	Fixed Value: interaction http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0 from the FHIR Standard
ClinicalUseDefinition.category	preferred	ClinicalUseDefinitionCategory http://hl7.org/fhir/ValueSet/clinical-use-definition-category from the FHIR Standard
ClinicalUseDefinition.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
ClinicalUseDefinition.status	preferred	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.contraindication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.relationshipType	preferred	TherapyRelationshipType http://hl7.org/fhir/ValueSet/therapy-relationship-type from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.treatment	example	Therapy http://hl7.org/fhir/ValueSet/therapy from the FHIR Standard
ClinicalUseDefinition.indication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.indication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.intendedEffect	preferred	ProductIntendedUse http://hl7.org/fhir/ValueSet/product-intended-use from the FHIR Standard
ClinicalUseDefinition.interaction.type	example	Fixed Value: "drug to drug interaction" http://hl7.org/fhir/ValueSet/interaction-type from the FHIR Standard
ClinicalUseDefinition.interaction.effect	example	InteractionEffect http://hl7.org/fhir/ValueSet/interaction-effect from the FHIR Standard
ClinicalUseDefinition.interaction.incidence	example	InteractionIncidence http://hl7.org/fhir/ValueSet/interaction-incidence from the FHIR Standard
ClinicalUseDefinition.interaction.management	example	InteractionManagement http://hl7.org/fhir/ValueSet/interaction-management from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.symptomConditionEffect	example	UndesirableEffectSymptom http://hl7.org/fhir/ValueSet/undesirable-effect-symptom from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.classification	example	UndesirableEffectClassification http://hl7.org/fhir/ValueSet/undesirable-effect-classification from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrence	example	UndesirablEffectFrequency http://hl7.org/fhir/ValueSet/undesirable-effect-frequency from the FHIR Standard
ClinicalUseDefinition.warning.code	example	WarningType http://hl7.org/fhir/ValueSet/warning-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 1 element
Fixed: 2 elements
Prohibited: 7 elements

Extensions

This structure refers to these extensions:

• https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
• https://fhir.ee/StructureDefinition/ee-tis-additional-information-link

Differential View

This structure is derived from ClinicalUseDefinition

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition		0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
contained		2..2	Medication	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
affected		0..*	Reference(EETISMedicationStatement)	MedicationStatements affected by interactions. URL: https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
link		0..*	string	Additional information from external source. URL: https://fhir.ee/StructureDefinition/ee-tis-additional-information-link
type		1..1	code	indication | contraindication | interaction | undesirable-effect | warning Fixed Value: interaction
subject		1..*	Reference(Medication)	medication A
display		0..1	string	Text alternative for the resource Required Pattern: siia toimeaine nimetus
contraindication		0..0
indication		0..0
interaction
interactant
item[x]		1..1	Reference(Medication)	medication B
type		0..1	CodeableConcept	The type of the interaction e.g. drug-drug interaction, drug-lab test interaction Fixed Value: As shown
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/interaction-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: drug-drug
display		1..1	string	Representation defined by the system Fixed Value: drug to drug interaction
text		1..1	string	Plain text representation of the concept Fixed Value: drug to drug interaction
effect		0..1	CodeableReference(ObservationDefinition)	Consequences (SYNBASE)
concept		0..1	CodeableConcept	Consequences
text		0..1	string	If not codeable, use text to represent consequenses
reference		0..0
incidence		0..1	CodeableConcept	Classification (SYNBASE. e.g. D0)
text		0..1	string	Classification
management		0..1	CodeableConcept	Recommendation (SYNBASE)
text		0..1	string	If not codeable, use text to represent recommendation
population		0..0
library		0..0
undesirableEffect		0..0
warning		0..0
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		2..2	Medication	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
affected		0..*	Reference(EETISMedicationStatement)	MedicationStatements affected by interactions. URL: https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
link		0..*	string	Additional information from external source. URL: https://fhir.ee/StructureDefinition/ee-tis-additional-information-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition. Fixed Value: interaction
subject	Σ	1..*	Reference(Medication)	medication A
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
display	ΣC	0..1	string	Text alternative for the resource Required Pattern: siia toimeaine nimetus
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ClinicalUseDefinition.type	required	Fixed Value: interaction http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
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: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		2..2	Medication	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
affected		0..*	Reference(EETISMedicationStatement)	MedicationStatements affected by interactions. URL: https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
link		0..*	string	Additional information from external source. URL: https://fhir.ee/StructureDefinition/ee-tis-additional-information-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier for this issue
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition. Fixed Value: interaction
category	Σ	0..*	CodeableConcept	A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose" Binding: ClinicalUseDefinitionCategory (preferred): A categorisation for a clinical use information item.
subject	Σ	1..*	Reference(Medication)	medication A
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource Required Pattern: siia toimeaine nimetus
status	Σ	0..1	CodeableConcept	Whether this is a current issue or one that has been retired etc Binding: PublicationStatus (preferred): The lifecycle status of an artifact.
interaction	ΣC	0..1	BackboneElement	Specifics for when this is an interaction
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
interactant	Σ	0..*	BackboneElement	The specific medication, product, food etc. or laboratory test that interacts
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	Σ	1..1	Reference(Medication)	medication B
type	Σ	0..1	CodeableConcept	The type of the interaction e.g. drug-drug interaction, drug-lab test interaction Binding: InteractionType (example): A categorisation for an interaction between two substances. Fixed Value: As shown
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/interaction-type
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: drug-drug
display		1..1	string	Representation defined by the system Fixed Value: drug to drug interaction
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		1..1	string	Plain text representation of the concept Fixed Value: drug to drug interaction
effect	Σ	0..1	CodeableReference(ObservationDefinition)	Consequences (SYNBASE) Binding: InteractionEffect (example): A interaction effect of clinical use of a medication or other substance.
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
concept	Σ	0..1	CodeableConcept	Consequences
id		0..1	id	Unique id for inter-element referencing
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	If not codeable, use text to represent consequenses
incidence	Σ	0..1	CodeableConcept	Classification (SYNBASE. e.g. D0) Binding: InteractionIncidence (example): A categorisation for incidence of occurence of an interaction.
id		0..1	id	Unique id for inter-element referencing
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	Classification
management	Σ	0..1	CodeableConcept	Recommendation (SYNBASE) Binding: InteractionManagement (example): A type of management for an interaction of a medication or other substance.
id		0..1	id	Unique id for inter-element referencing
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	If not codeable, use text to represent recommendation
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ClinicalUseDefinition.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
ClinicalUseDefinition.type	required	Fixed Value: interaction http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0 from the FHIR Standard
ClinicalUseDefinition.category	preferred	ClinicalUseDefinitionCategory http://hl7.org/fhir/ValueSet/clinical-use-definition-category from the FHIR Standard
ClinicalUseDefinition.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
ClinicalUseDefinition.status	preferred	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.contraindication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.relationshipType	preferred	TherapyRelationshipType http://hl7.org/fhir/ValueSet/therapy-relationship-type from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.treatment	example	Therapy http://hl7.org/fhir/ValueSet/therapy from the FHIR Standard
ClinicalUseDefinition.indication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.indication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.intendedEffect	preferred	ProductIntendedUse http://hl7.org/fhir/ValueSet/product-intended-use from the FHIR Standard
ClinicalUseDefinition.interaction.type	example	Fixed Value: "drug to drug interaction" http://hl7.org/fhir/ValueSet/interaction-type from the FHIR Standard
ClinicalUseDefinition.interaction.effect	example	InteractionEffect http://hl7.org/fhir/ValueSet/interaction-effect from the FHIR Standard
ClinicalUseDefinition.interaction.incidence	example	InteractionIncidence http://hl7.org/fhir/ValueSet/interaction-incidence from the FHIR Standard
ClinicalUseDefinition.interaction.management	example	InteractionManagement http://hl7.org/fhir/ValueSet/interaction-management from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.symptomConditionEffect	example	UndesirableEffectSymptom http://hl7.org/fhir/ValueSet/undesirable-effect-symptom from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.classification	example	UndesirableEffectClassification http://hl7.org/fhir/ValueSet/undesirable-effect-classification from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrence	example	UndesirablEffectFrequency http://hl7.org/fhir/ValueSet/undesirable-effect-frequency from the FHIR Standard
ClinicalUseDefinition.warning.code	example	WarningType http://hl7.org/fhir/ValueSet/warning-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 1 element
Fixed: 2 elements
Prohibited: 7 elements

Extensions

This structure refers to these extensions:

• https://fhir.ee/StructureDefinition/ee-tis-affected-medication-statements
• https://fhir.ee/StructureDefinition/ee-tis-additional-information-link

Other representations of profile: CSV, Excel, Schematron