Medication Scheme Implementation Guide
1.0.0 - draft Estonia flag

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

Resource Profile: EETISMedicationStatement - Detailed Descriptions

Draft as of 2024-02-23

Definitions for the ee-tis-medication-statement resource profile.

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

0. MedicationStatement
2. MedicationStatement.text
ShortMedicationStatement is part of Medication Scheme representing one treatmentline
4. MedicationStatement.extension
Control1..?
SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. MedicationStatement.extension:extensionEETISPrescriptionValidityTime
    Slice NameextensionEETISPrescriptionValidityTime
    Control0..1
    TypeExtension(ExtensionEETISPrescriptionValidityTime) (Extension Type: dateTime)
    8. MedicationStatement.extension:extensionEETISMedicationRemainder
    Slice NameextensionEETISMedicationRemainder
    Control0..1
    TypeExtension(ExtensionEETISMedicationRemainder) (Complex Extension)
    10. MedicationStatement.extension:extensionEETISTotalPrescribedAmount
    Slice NameextensionEETISTotalPrescribedAmount
    Control0..*
    TypeExtension(ExtensionEETISTotalPrescribedAmount) (Extension Type: Quantity(SimpleQuantity))
    12. MedicationStatement.extension:extensionEETISDispensationAuthorization
    Slice NameextensionEETISDispensationAuthorization
    Control1..1
    TypeExtension(ExtensionEETISDispensationAuthorization) (Extension Type: CodeableConcept)
    14. MedicationStatement.extension:extensionEETISCancelledStatusReason
    Slice NameextensionEETISCancelledStatusReason
    Control0..1
    TypeExtension(ExtensionEETISCancelledStatusReason) (Extension Type: CodeableConcept)
    16. MedicationStatement.extension:extensionEETISReimbursementRate
    Slice NameextensionEETISReimbursementRate
    Control0..1
    TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
    18. MedicationStatement.extension:extensionEETISUnauthorizedProductRequest
    Slice NameextensionEETISUnauthorizedProductRequest
    Control0..1
    TypeExtension(ExtensionEETISUnauthorizedProductRequest) (Complex Extension)
    20. MedicationStatement.extension:extensionEETISSubstitution
    Slice NameextensionEETISSubstitution
    Control0..1
    TypeExtension(ExtensionEETISSubstitution) (Complex Extension)
    22. MedicationStatement.extension:extensionEETISVerification
    Slice NameextensionEETISVerification
    Definition

    Optional Extension Element - found in all resources.

    Control0..*
    TypeExtension(ExtensionEETISVerification) (Complex Extension)
    24. MedicationStatement.extension:extensionEETISPrescriptionIntent
    Slice NameextensionEETISPrescriptionIntent
    Control0..*
    TypeExtension(ExtensionEETISPrescriptionIntent) (Extension Type: code)
    26. MedicationStatement.extension:ExtensionEETISPrescriptionChange
    Slice NameExtensionEETISPrescriptionChange
    Control0..*
    TypeExtension(ExtensionEETISPrescriptionChange) (Complex Extension)
    28. MedicationStatement.partOf
    TypeReference(EETISMedicationStatement)
    30. MedicationStatement.status
    Definition

    recorded = Kinnitatud; draft = Kinnitamata. Retseptikeskuse retsepti põhjal genereeritud kinnitamata rida on staatuses recorded/kinnitatud.

    ShortA code representing the status of recording the medication statement. recorded = KINNITATUD; draft = KINNITAMATA
    32. MedicationStatement.category
    Control3..?
    SlicingThis element introduces a set of slices on MedicationStatement.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 34. MedicationStatement.category:courseOfTherapyType
      Slice NamecourseOfTherapyType
      ShortWhat type of medication course is
      Control1..*
      BindingThe codes SHALL be taken from ER_Ravikuuritüüp
      (required to https://fhir.ee/ValueSet/ravikuuri-tyyp)

      RAVIKUURI TÜÜP. LOEND. pidev | fikseeritud | vajadusel | muutuv | ühekordne |

      36. MedicationStatement.category:statementOriginCategory
      Slice NamestatementOriginCategory
      Definition

      Seda kategooriat kasutada AINULT juhul, kui ravimiskeemi rida genereeritakse patsiendi sõnul. Kasutada koodi |ASK| loendist ravimi-andmete-tyyp. Retseptikeskuse retseptidest loodud ravimiskeemi rea puhul jääb see kategooria TÜHJAKS.

      ShortCategory defining the origin of MedicationStatement. USED ONLY when medication scheme line is based on patient's statement.
      Control0..*
      BindingThe codes SHALL be taken from Ravimi andmete tüüp
      (required to https://fhir.ee/ValueSet/ravimi-andmete-tyyp)

      Category defining the origin of MedicationStatement. Use only code |ASK| from ValueSet ravimi-andmete-tyyp.

      38. MedicationStatement.category:prescriptionCategory
      Slice NameprescriptionCategory
      ShortWhether the prescription is for regular medication, narcotics or medical device
      Control1..*
      BindingThe codes SHALL be taken from ER_Retsepti liik
      (required to https://fhir.ee/ValueSet/retsepti-liik)

      RETSEPTI LIIK. LOEND. tavaretsept | narkootilise ravimi retsept | meditsiiniseadme retsept

      40. MedicationStatement.category:repeatCategory
      Slice NamerepeatCategory
      ShortWhether the prescription is one-time prescription or multiple
      Control1..*
      BindingThe codes SHALL be taken from ER_Retsepti kordsus
      (required to https://fhir.ee/ValueSet/retsepti-kordsus)

      RETSEPTI KORDSUS. LOEND. 1-kordne | 2-kordne | 3-kordne | 6-kordne

      42. MedicationStatement.medication
      TypeCodeableReference(EETISMedicationEPC, EETISMedicationExtemporal)
      44. MedicationStatement.subject
      TypeReference(EE MPI Patient Verified)
      46. MedicationStatement.encounter
      Control0..0
      48. MedicationStatement.effective[x]
      Definition

      Ravimiskeemi rea kehtivuse algus

      ShortTime period when the treatment line begins and ends
      Control1..?
      TypePeriod, dateTime, Timing
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      50. MedicationStatement.informationSource
      Definition

      AUTOR KES KOOSTAB RAVIMISKEEMI REA (arst). Ravimiskeemi rea (algne) koostaja.

      ShortInitial author of the MedicationStatement. The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.
      TypeReference(EETISPractitioner, EETISPractitionerRole)
      52. MedicationStatement.derivedFrom
      Definition

      SEOTUD RETSEPTID.

      ShortPrescriptions created elsewhere than in TJT. Link to information used to derive the MedicationStatement
      TypeReference(EETISPrescription)referenced
      54. MedicationStatement.reason
      Definition

      Diagnoosikoodid (RHK-10) DIAGNOOSIKOOD retseptikeskusest

      ShortDiagnose for medication. ICD-10 codes from Estonian Prescription Centre. Reimbursement of medication depends on which ICD-10 code is used.
      BindingThe codes SHOULD be taken from https://fhir.ee/ValueSet/rhk-10
      (preferred to https://fhir.ee/ValueSet/rhk-10)
      56. MedicationStatement.note
      ShortSiia saab kirjutada märkusi ravimiskeemi rea kohta.
      58. MedicationStatement.note.author[x]
      Control1..?
      TypeChoice of: Reference(EETISPractitionerRole, EETISPractitioner), string
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      60. MedicationStatement.relatedClinicalInformation
      Control0..0
      62. MedicationStatement.dosage
      Definition

      ANNUSTAMISEJUHIS

      ShortIndicates how the medication is/was or should be taken by the patient.
      TypeDosage(EETISDosage)
      64. MedicationStatement.dosage.additionalInstruction
      Definition

      VALMISTAMISEJUHIS

      ShortSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
      66. MedicationStatement.dosage.maxDosePerAdministration
      68. MedicationStatement.dosage.maxDosePerAdministration.unit
      Control0..0
      70. MedicationStatement.adherence
      Control0..0

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

      0. MedicationStatement
      Definition

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

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

      The MedicationStatement resource was previously called MedicationStatement.

      ShortRecord of medication being taken by a patient
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamesMedicationStatement
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationStatement.implicitRules
      Definition

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

      ShortA set of rules under which this content was created
      Comments

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

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

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

      ShortMedicationStatement is part of Medication Scheme representing one treatmentlineText summary of the resource, for human interpretation
      Comments

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

      Control0..1
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MedicationStatement.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

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

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      8. MedicationStatement.extension
      Definition

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

      Control10..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. MedicationStatement.extension:extensionEETISPrescriptionValidityTime
        Slice NameextensionEETISPrescriptionValidityTime
        Definition

        Retsepti kehtivuse lõpu aeg.

        ShortValidity end date of the prescription(s) in one MedicationStatement.
        Control0..1
        TypeExtension(ExtensionEETISPrescriptionValidityTime) (Extension Type: dateTime)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. MedicationStatement.extension:extensionEETISMedicationRemainder
        Slice NameextensionEETISMedicationRemainder
        Definition

        Arvutuslik ravimi jääk päevades.

        ShortMedication left on prescription calculated in days.
        Control0..1
        TypeExtension(ExtensionEETISMedicationRemainder) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. MedicationStatement.extension:extensionEETISTotalPrescribedAmount
        Slice NameextensionEETISTotalPrescribedAmount
        Definition

        Kui palju on ravimit koguseliselt välja kirutatud - näiteks 120 tabletti. Selle pealt saab arvutada JÄÄKI.
        Väljakirjutatud kogus.

        ShortHow much in total there is medication prescribed on one Medication Request. Used for calculating the current status of how much medication is left on one Medication Statement row.
        Control0..*
        TypeExtension(ExtensionEETISTotalPrescribedAmount) (Extension Type: Quantity(SimpleQuantity))
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. MedicationStatement.extension:extensionEETISDispensationAuthorization
        Slice NameextensionEETISDispensationAuthorization
        Definition

        Volituse liik. Digiretsepti koostamisel on patsiendil võimalik piirata ravimi väljaostu õiguseid. Vaikimisi on küll kõik retseptid avalikud, kuid seda staatust saab muuta arst retsepti koostamisel või patsient terviseportaalis.

        ShortDefines the authorization of the prescription.
        Control1..1
        TypeExtension(ExtensionEETISDispensationAuthorization) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. MedicationStatement.extension:extensionEETISCancelledStatusReason
        Slice NameextensionEETISCancelledStatusReason
        Definition

        Annulleerimise põhjus

        ShortReason for cancelling the prescription.
        Control0..1
        TypeExtension(ExtensionEETISCancelledStatusReason) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. MedicationStatement.extension:extensionEETISReimbursementRate
        Slice NameextensionEETISReimbursementRate
        Definition

        Ravimi soodustuse määr protsentides Retseptikeskuse loendist "Soodustuste määrad" ning tingimused "Vajalikud tingimused" -loendist soodustuse saamiseks.

        ShortReimbursement rate and reason of prescription medicine.
        Control0..1
        TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. MedicationStatement.extension:extensionEETISUnauthorizedProductRequest
        Slice NameextensionEETISUnauthorizedProductRequest
        Definition

        Used for requesting marketing permit for unauthorized medication.

        ShortMüügiloata ravimi taotlus.
        Control0..1
        TypeExtension(ExtensionEETISUnauthorizedProductRequest) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        24. MedicationStatement.extension:extensionEETISSubstitution
        Slice NameextensionEETISSubstitution
        Definition

        Asendamise mitte-lubamine

        ShortReason for not allowing the substitution of medication.
        Control0..1
        TypeExtension(ExtensionEETISSubstitution) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        26. MedicationStatement.extension:extensionEETISVerification
        Slice NameextensionEETISVerification
        Definition

        Optional Extension Element - found in all resources.

        ShortVerification of medication scheme
        Control0..*
        TypeExtension(ExtensionEETISVerification) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        28. MedicationStatement.extension:extensionEETISPrescriptionIntent
        Slice NameextensionEETISPrescriptionIntent
        Definition

        Kas retsept on "order" või "proposal". Viimane on müügiloata ravimite puhul. Intent of prescription.

        ShortExtension
        Control0..*
        TypeExtension(ExtensionEETISPrescriptionIntent) (Extension Type: code)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        30. MedicationStatement.extension:ExtensionEETISPrescriptionChange
        Slice NameExtensionEETISPrescriptionChange
        Definition

        Retsepti muutmine, kes muutis, millal ja põhjus loendist.

        ShortChanges on prescription - who changed, when and reason.
        Control0..*
        TypeExtension(ExtensionEETISPrescriptionChange) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. MedicationStatement.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored
        Comments

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

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

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

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

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

        ShortPart of referenced event
        Control0..*
        TypeReference(EETISMedicationStatement, Procedure, MedicationStatement)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. MedicationStatement.status
        Definition

        recorded = Kinnitatud; draft = Kinnitamata. Retseptikeskuse retsepti põhjal genereeritud kinnitamata rida on staatuses recorded/kinnitatud.


        A code representing the status of recording the medication statement.

        ShortA code representing the status of recording the medication statement. recorded = KINNITATUD; draft = KINNITAMATArecorded | entered-in-error | draft
        Comments

        This status concerns just the recording of the medication statement. MedicationStatement.adherence should be used for indicating a patient's adherence to the information in this resource. Note, the statuses are different than in previous releases for MedicationStatement or MedicationStatement.

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

        Control1..1
        BindingThe codes SHALL be taken from MedicationStatementStatusCodeshttp://hl7.org/fhir/ValueSet/medication-statement-status|5.0.0
        (required to http://hl7.org/fhir/ValueSet/medication-statement-status|5.0.0)

        A coded concept indicating the current status of a MedicationStatement.

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

        Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

        ShortType of medication statement
        Control30..*
        BindingFor example codes, see MedicationRequestAdministrationLocationCodeshttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
        (example to http://hl7.org/fhir/ValueSet/medicationrequest-admin-location)

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

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on MedicationStatement.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • pattern @ $this
        • 40. MedicationStatement.category:courseOfTherapyType
          Slice NamecourseOfTherapyType
          Definition

          Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

          ShortWhat type of medication course isType of medication statement
          Control10..*
          BindingThe codes SHALL be taken from For example codes, see ER_Ravikuuritüüphttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
          (required to https://fhir.ee/ValueSet/ravikuuri-tyyp)

          RAVIKUURI TÜÜP. LOEND. pidev | fikseeritud | vajadusel | muutuv | ühekordne |


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

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. MedicationStatement.category:statementOriginCategory
          Slice NamestatementOriginCategory
          Definition

          Seda kategooriat kasutada AINULT juhul, kui ravimiskeemi rida genereeritakse patsiendi sõnul. Kasutada koodi |ASK| loendist ravimi-andmete-tyyp. Retseptikeskuse retseptidest loodud ravimiskeemi rea puhul jääb see kategooria TÜHJAKS.


          Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

          ShortCategory defining the origin of MedicationStatement. USED ONLY when medication scheme line is based on patient's statement.Type of medication statement
          Control0..*
          BindingThe codes SHALL be taken from For example codes, see Ravimi andmete tüüphttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
          (required to https://fhir.ee/ValueSet/ravimi-andmete-tyyp)

          Category defining the origin of MedicationStatement. Use only code |ASK| from ValueSet ravimi-andmete-tyyp.


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

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. MedicationStatement.category:prescriptionCategory
          Slice NameprescriptionCategory
          Definition

          Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

          ShortWhether the prescription is for regular medication, narcotics or medical deviceType of medication statement
          Control10..*
          BindingThe codes SHALL be taken from For example codes, see ER_Retsepti liikhttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
          (required to https://fhir.ee/ValueSet/retsepti-liik)

          RETSEPTI LIIK. LOEND. tavaretsept | narkootilise ravimi retsept | meditsiiniseadme retsept


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

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

          Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

          ShortWhether the prescription is one-time prescription or multipleType of medication statement
          Control10..*
          BindingThe codes SHALL be taken from For example codes, see ER_Retsepti kordsushttp://hl7.org/fhir/ValueSet/medicationrequest-admin-location
          (required to https://fhir.ee/ValueSet/retsepti-kordsus)

          RETSEPTI KORDSUS. LOEND. 1-kordne | 2-kordne | 3-kordne | 6-kordne


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

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

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

          ShortWhat medication was taken
          Comments

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

          Control1..1
          BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
          (example to http://hl7.org/fhir/ValueSet/medication-codes)

          A coded concept identifying the substance or product being taken.

          TypeCodeableReference(EETISMedicationEPC, EETISMedicationExtemporal, Medication)
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. MedicationStatement.subject
          Definition

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

          ShortWho is/was taking the medication
          Control1..1
          TypeReference(EE MPI Patient Verified, Patient, Group)
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationStatement.encounter
          Definition

          The encounter that establishes the context for this MedicationStatement.

          ShortEncounter associated with MedicationStatement
          Control0..01
          TypeReference(Encounter)
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. MedicationStatement.effective[x]
          Definition

          Ravimiskeemi rea kehtivuse algus


          The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.adherence element is Not Taking).

          ShortTime period when the treatment line begins and endsThe date/time or interval when the medication is/was/will be taken
          Comments

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

          Control10..1
          TypePeriod, dateTime, Timing
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. MedicationStatement.informationSource
          Definition

          AUTOR KES KOOSTAB RAVIMISKEEMI REA (arst). Ravimiskeemi rea (algne) koostaja.


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

          ShortInitial author of the MedicationStatement. The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.Person or organization that provided the information about the taking of this medication
          Control0..*
          TypeReference(EETISPractitioner, EETISPractitionerRole, Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. MedicationStatement.derivedFrom
          Definition

          SEOTUD RETSEPTID.


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

          ShortPrescriptions created elsewhere than in TJT. Link to information used to derive the MedicationStatementLink to information used to derive the MedicationStatement
          Comments

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

          Control0..*
          TypeReference(EETISPrescription, Resource)referenced
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. MedicationStatement.reason
          Definition

          Diagnoosikoodid (RHK-10) DIAGNOOSIKOOD retseptikeskusest


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

          ShortDiagnose for medication. ICD-10 codes from Estonian Prescription Centre. Reimbursement of medication depends on which ICD-10 code is used.Reason for why the medication is being/was taken
          Comments

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

          Control0..*
          BindingThe codes SHOULD be taken from For example codes, see https://fhir.ee/ValueSet/rhk-10http://hl7.org/fhir/ValueSet/condition-code
          (preferred to https://fhir.ee/ValueSet/rhk-10)
          TypeCodeableReference(Condition, Observation, DiagnosticReport)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. MedicationStatement.note
          Definition

          Provides extra information about the Medication Statement that is not conveyed by the other attributes.

          ShortSiia saab kirjutada märkusi ravimiskeemi rea kohta.Further information about the usage
          Control0..*
          TypeAnnotation
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. MedicationStatement.note.author[x]
          Definition

          The individual responsible for making the annotation.

          ShortIndividual responsible for the annotation
          Comments

          Organization is used when there's no need for specific attribution as to who made the comment.

          Control10..1
          TypeChoice of: Reference(EETISPractitionerRole, EETISPractitioner, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationStatement.note.text
          Definition

          The text of the annotation in markdown format.

          ShortThe annotation - text content (as markdown)
          Control1..1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. MedicationStatement.relatedClinicalInformation
          Definition

          Link to information that is relevant to a medication statement, for example, illicit drug use, gestational age, etc.

          ShortLink to information relevant to the usage of a medication
          Control0..0*
          TypeReference(Observation, Condition)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. MedicationStatement.dosage
          Definition

          ANNUSTAMISEJUHIS


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

          ShortIndicates how the medication is/was or should be taken by the patient.Details of how medication is/was taken or should be taken
          Comments

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

          Control0..*
          TypeDosage(EETISDosage)
          Is Modifierfalse
          Must Supportfalse
          Invariantsdos-1: AsNeededFor can only be set if AsNeeded is empty or true (asNeededFor.empty() or asNeeded.empty() or asNeeded)
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. MedicationStatement.dosage.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

          VALMISTAMISEJUHIS


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

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

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

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

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

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

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

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

          Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept).

          ShortTake "as needed" (for x)
          Comments

          Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed".

          Control0..1*
          This element is affected by the following invariants: dos-1
          BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
          (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

          A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

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

          Indicates whether the medication is or is not being consumed or administered.

          ShortIndicates whether the medication is or is not being consumed or administered
          Comments

          This element can be used to indicate whether a patient is following a course of treatment as instructed/prescribed or whether they are taking medications of their own volition. It can also be used to indicate that a patient is not taking a medication, either because they were told not to or because they decided on their own.

          Control0..01
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

          0. MedicationStatement
          Definition

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

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

          The MedicationStatement resource was previously called MedicationStatement.

          ShortRecord of medication being taken by a patient
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate NamesMedicationStatement
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. MedicationStatement.id
          Definition

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

          ShortLogical id of this artifact
          Comments

          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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

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

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

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

          ShortA set of rules under which this content was created
          Comments

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

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

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

          Control0..1
          BindingThe codes SHALL be taken from AllLanguages
          (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

          IETF language tag for a human language

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

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

          ShortMedicationStatement is part of Medication Scheme representing one treatmentline
          Comments

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

          Control0..1
          This element is affected by the following invariants: dom-6
          TypeNarrative
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. MedicationStatement.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

          ShortContained, inline Resources
          Comments

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

          Control0..*
          This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
          TypeResource
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. MedicationStatement.extension
          Definition

          An Extension

          ShortExtension
          Control1..*
          TypeExtension
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. MedicationStatement.extension:extensionEETISPrescriptionValidityTime
            Slice NameextensionEETISPrescriptionValidityTime
            Definition

            Retsepti kehtivuse lõpu aeg.

            ShortValidity end date of the prescription(s) in one MedicationStatement.
            Control0..1
            TypeExtension(ExtensionEETISPrescriptionValidityTime) (Extension Type: dateTime)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. MedicationStatement.extension:extensionEETISMedicationRemainder
            Slice NameextensionEETISMedicationRemainder
            Definition

            Arvutuslik ravimi jääk päevades.

            ShortMedication left on prescription calculated in days.
            Control0..1
            TypeExtension(ExtensionEETISMedicationRemainder) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. MedicationStatement.extension:extensionEETISTotalPrescribedAmount
            Slice NameextensionEETISTotalPrescribedAmount
            Definition

            Kui palju on ravimit koguseliselt välja kirutatud - näiteks 120 tabletti. Selle pealt saab arvutada JÄÄKI.
            Väljakirjutatud kogus.

            ShortHow much in total there is medication prescribed on one Medication Request. Used for calculating the current status of how much medication is left on one Medication Statement row.
            Control0..*
            TypeExtension(ExtensionEETISTotalPrescribedAmount) (Extension Type: Quantity(SimpleQuantity))
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. MedicationStatement.extension:extensionEETISDispensationAuthorization
            Slice NameextensionEETISDispensationAuthorization
            Definition

            Volituse liik. Digiretsepti koostamisel on patsiendil võimalik piirata ravimi väljaostu õiguseid. Vaikimisi on küll kõik retseptid avalikud, kuid seda staatust saab muuta arst retsepti koostamisel või patsient terviseportaalis.

            ShortDefines the authorization of the prescription.
            Control1..1
            TypeExtension(ExtensionEETISDispensationAuthorization) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. MedicationStatement.extension:extensionEETISCancelledStatusReason
            Slice NameextensionEETISCancelledStatusReason
            Definition

            Annulleerimise põhjus

            ShortReason for cancelling the prescription.
            Control0..1
            TypeExtension(ExtensionEETISCancelledStatusReason) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            26. MedicationStatement.extension:extensionEETISReimbursementRate
            Slice NameextensionEETISReimbursementRate
            Definition

            Ravimi soodustuse määr protsentides Retseptikeskuse loendist "Soodustuste määrad" ning tingimused "Vajalikud tingimused" -loendist soodustuse saamiseks.

            ShortReimbursement rate and reason of prescription medicine.
            Control0..1
            TypeExtension(ExtensionEETISReimbursementRate) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. MedicationStatement.extension:extensionEETISUnauthorizedProductRequest
            Slice NameextensionEETISUnauthorizedProductRequest
            Definition

            Used for requesting marketing permit for unauthorized medication.

            ShortMüügiloata ravimi taotlus.
            Control0..1
            TypeExtension(ExtensionEETISUnauthorizedProductRequest) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. MedicationStatement.extension:extensionEETISSubstitution
            Slice NameextensionEETISSubstitution
            Definition

            Asendamise mitte-lubamine

            ShortReason for not allowing the substitution of medication.
            Control0..1
            TypeExtension(ExtensionEETISSubstitution) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            32. MedicationStatement.extension:extensionEETISVerification
            Slice NameextensionEETISVerification
            Definition

            Optional Extension Element - found in all resources.

            ShortVerification of medication scheme
            Control0..*
            TypeExtension(ExtensionEETISVerification) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            34. MedicationStatement.extension:extensionEETISPrescriptionIntent
            Slice NameextensionEETISPrescriptionIntent
            Definition

            Kas retsept on "order" või "proposal". Viimane on müügiloata ravimite puhul. Intent of prescription.

            ShortExtension
            Control0..*
            TypeExtension(ExtensionEETISPrescriptionIntent) (Extension Type: code)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            36. MedicationStatement.extension:ExtensionEETISPrescriptionChange
            Slice NameExtensionEETISPrescriptionChange
            Definition

            Retsepti muutmine, kes muutis, millal ja põhjus loendist.

            ShortChanges on prescription - who changed, when and reason.
            Control0..*
            TypeExtension(ExtensionEETISPrescriptionChange) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            38. MedicationStatement.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored
            Comments

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

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

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

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

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

            ShortExternal identifier
            Comments

            This is a business identifier, not a resource identifier.

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

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

            ShortPart of referenced event
            Control0..*
            TypeReference(EETISMedicationStatement)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. MedicationStatement.status
            Definition

            recorded = Kinnitatud; draft = Kinnitamata. Retseptikeskuse retsepti põhjal genereeritud kinnitamata rida on staatuses recorded/kinnitatud.

            ShortA code representing the status of recording the medication statement. recorded = KINNITATUD; draft = KINNITAMATA
            Comments

            This status concerns just the recording of the medication statement. MedicationStatement.adherence should be used for indicating a patient's adherence to the information in this resource. Note, the statuses are different than in previous releases for MedicationStatement or MedicationStatement.

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

            Control1..1
            BindingThe codes SHALL be taken from MedicationStatementStatusCodes
            (required to http://hl7.org/fhir/ValueSet/medication-statement-status|5.0.0)

            A coded concept indicating the current status of a MedicationStatement.

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

            Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

            ShortType of medication statement
            Control3..*
            BindingFor example codes, see MedicationRequestAdministrationLocationCodes
            (example to http://hl7.org/fhir/ValueSet/medicationrequest-admin-location)

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

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationStatement.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ $this
            • 48. MedicationStatement.category:courseOfTherapyType
              Slice NamecourseOfTherapyType
              Definition

              Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

              ShortWhat type of medication course is
              Control1..*
              BindingThe codes SHALL be taken from ER_Ravikuuritüüp
              (required to https://fhir.ee/ValueSet/ravikuuri-tyyp)

              RAVIKUURI TÜÜP. LOEND. pidev | fikseeritud | vajadusel | muutuv | ühekordne |

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. MedicationStatement.category:statementOriginCategory
              Slice NamestatementOriginCategory
              Definition

              Seda kategooriat kasutada AINULT juhul, kui ravimiskeemi rida genereeritakse patsiendi sõnul. Kasutada koodi |ASK| loendist ravimi-andmete-tyyp. Retseptikeskuse retseptidest loodud ravimiskeemi rea puhul jääb see kategooria TÜHJAKS.

              ShortCategory defining the origin of MedicationStatement. USED ONLY when medication scheme line is based on patient's statement.
              Control0..*
              BindingThe codes SHALL be taken from Ravimi andmete tüüp
              (required to https://fhir.ee/ValueSet/ravimi-andmete-tyyp)

              Category defining the origin of MedicationStatement. Use only code |ASK| from ValueSet ravimi-andmete-tyyp.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. MedicationStatement.category:prescriptionCategory
              Slice NameprescriptionCategory
              Definition

              Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

              ShortWhether the prescription is for regular medication, narcotics or medical device
              Control1..*
              BindingThe codes SHALL be taken from ER_Retsepti liik
              (required to https://fhir.ee/ValueSet/retsepti-liik)

              RETSEPTI LIIK. LOEND. tavaretsept | narkootilise ravimi retsept | meditsiiniseadme retsept

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. MedicationStatement.category:repeatCategory
              Slice NamerepeatCategory
              Definition

              Type of medication statement (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

              ShortWhether the prescription is one-time prescription or multiple
              Control1..*
              BindingThe codes SHALL be taken from ER_Retsepti kordsus
              (required to https://fhir.ee/ValueSet/retsepti-kordsus)

              RETSEPTI KORDSUS. LOEND. 1-kordne | 2-kordne | 3-kordne | 6-kordne

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

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

              ShortWhat medication was taken
              Comments

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

              Control1..1
              BindingFor example codes, see SNOMEDCTMedicationCodes
              (example to http://hl7.org/fhir/ValueSet/medication-codes)

              A coded concept identifying the substance or product being taken.

              TypeCodeableReference(EETISMedicationEPC, EETISMedicationExtemporal)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. MedicationStatement.subject
              Definition

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

              ShortWho is/was taking the medication
              Control1..1
              TypeReference(EE MPI Patient Verified)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. MedicationStatement.encounter
              Definition

              The encounter that establishes the context for this MedicationStatement.

              ShortEncounter associated with MedicationStatement
              Control0..0
              TypeReference(Encounter)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              62. MedicationStatement.effective[x]
              Definition

              Ravimiskeemi rea kehtivuse algus

              ShortTime period when the treatment line begins and ends
              Comments

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

              Control1..1
              TypePeriod
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              64. MedicationStatement.dateAsserted
              Definition

              The date when the Medication Statement was asserted by the information source.

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

              AUTOR KES KOOSTAB RAVIMISKEEMI REA (arst). Ravimiskeemi rea (algne) koostaja.

              ShortInitial author of the MedicationStatement. The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.
              Control0..*
              TypeReference(EETISPractitioner, EETISPractitionerRole)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. MedicationStatement.derivedFrom
              Definition

              SEOTUD RETSEPTID.

              ShortPrescriptions created elsewhere than in TJT. Link to information used to derive the MedicationStatement
              Comments

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

              Control0..*
              TypeReference(EETISPrescription)referenced
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. MedicationStatement.reason
              Definition

              Diagnoosikoodid (RHK-10) DIAGNOOSIKOOD retseptikeskusest

              ShortDiagnose for medication. ICD-10 codes from Estonian Prescription Centre. Reimbursement of medication depends on which ICD-10 code is used.
              Comments

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

              Control0..*
              BindingThe codes SHOULD be taken from https://fhir.ee/ValueSet/rhk-10
              (preferred to https://fhir.ee/ValueSet/rhk-10)
              TypeCodeableReference(Condition, Observation, DiagnosticReport)
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. MedicationStatement.note
              Definition

              Provides extra information about the Medication Statement that is not conveyed by the other attributes.

              ShortSiia saab kirjutada märkusi ravimiskeemi rea kohta.
              Control0..*
              TypeAnnotation
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. MedicationStatement.note.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              76. MedicationStatement.note.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

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

                The individual responsible for making the annotation.

                ShortIndividual responsible for the annotation
                Comments

                Organization is used when there's no need for specific attribution as to who made the comment.

                Control1..1
                TypeChoice of: Reference(EETISPractitionerRole, EETISPractitioner), string
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                80. MedicationStatement.note.time
                Definition

                Indicates when this particular annotation was made.

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

                The text of the annotation in markdown format.

                ShortThe annotation - text content (as markdown)
                Control1..1
                Typemarkdown
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. MedicationStatement.relatedClinicalInformation
                Definition

                Link to information that is relevant to a medication statement, for example, illicit drug use, gestational age, etc.

                ShortLink to information relevant to the usage of a medication
                Control0..0
                TypeReference(Observation, Condition)
                Is Modifierfalse
                Must Supportfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. MedicationStatement.renderedDosageInstruction
                Definition

                The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

                ShortFull representation of the dosage instructions
                Control0..1
                Typemarkdown
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summaryfalse
                Requirements

                The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

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

                ANNUSTAMISEJUHIS

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

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

                Control0..*
                TypeDosage(EETISDosage)
                Is Modifierfalse
                Must Supportfalse
                Invariantsdos-1: AsNeededFor can only be set if AsNeeded is empty or true (asNeededFor.empty() or asNeeded.empty() or asNeeded)
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                90. MedicationStatement.dosage.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                This element is affected by the following invariants: ele-1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                92. MedicationStatement.dosage.extension
                Definition

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

                ShortAdditional content defined by implementations
                Comments

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

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

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

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

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

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

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

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

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

                  JÄRJEKORD.

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

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

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

                  Free text dosage instructions e.g. SIG.

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

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

                  Max Length:1000
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. MedicationStatement.dosage.additionalInstruction
                  Definition

                  VALMISTAMISEJUHIS

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

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

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

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

                  KOMMENTAAR PATSIENDILE.

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

                  ANNUSTAMISE AEG.

                  ShortWhen medication should be administered
                  Comments

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

                  Control0..1
                  TypeTiming
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  108. MedicationStatement.dosage.timing.extension
                  Definition

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

                    Identifies specific times when the event occurs.

                    ShortWhen the event occurs
                    Control0..*
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

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

                    ANNUSTAMISE KORDUS.

                    ShortWhen the event is to occur.
                    Control0..1
                    TypeElement
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Many timing schedules are determined by regular repetitions.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                    tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                    tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                    tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                    tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                    tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                    tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                    tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse()))
                    tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                    116. MedicationStatement.dosage.timing.repeat.id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    118. MedicationStatement.dosage.timing.repeat.extension
                    Definition

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

                    ShortAdditional content defined by implementations
                    Comments

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

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

                      Ravikuuri piirid (pikkus/ulatus/kestus). Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                      ShortLength/Range of lengths, or (Start and/or end) limits.
                      Control0..1
                      TypeChoice of: Duration, Range, Period
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 122. MedicationStatement.dosage.timing.repeat.count
                        Definition

                        KORDUSED.

                        ShortNumber of times to repeat
                        Comments

                        If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                        Control0..1
                        This element is affected by the following invariants: tim-8
                        TypepositiveInt
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Repetitions may be limited by end time or total occurrences.

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

                        MAKSIMAALNE KORDUSTE ARV. If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                        ShortMaximum number of times to repeat
                        Control0..1
                        This element is affected by the following invariants: tim-8
                        TypepositiveInt
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        126. MedicationStatement.dosage.timing.repeat.duration
                        Definition

                        KESTUS. How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                        ShortHow long when it happens
                        Comments

                        For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                        Control0..1
                        This element is affected by the following invariants: tim-7, tim-1, tim-4
                        Typedecimal
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Some activities are not instantaneous and need to be maintained for a period of time.

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

                        MAKSIMAALNE KESTUS. If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                        ShortHow long when it happens (Max)
                        Comments

                        For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                        Control0..1
                        This element is affected by the following invariants: tim-7
                        Typedecimal
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Some activities are not instantaneous and need to be maintained for a period of time.

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

                        KESTUS ja ÜHIK. The units of time for the duration, in UCUM units Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

                        ShortThe units of time for the duration.
                        Control0..1
                        This element is affected by the following invariants: tim-1
                        BindingThe codes SHALL be taken from UnitsOfTime
                        (required to http://hl7.org/fhir/ValueSet/units-of-time|5.0.0)

                        A unit of time (units from UCUM).

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        132. MedicationStatement.dosage.timing.repeat.frequency
                        Definition

                        SAGEDUS. Ühekordse annuse kordsus/annustamiste arv perioodis. The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

                        ShortIndicates the number of repetitions that should occur within a period. I.e. Event occurs frequency times per period
                        Control0..1
                        TypepositiveInt
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        134. MedicationStatement.dosage.timing.repeat.frequencyMax
                        Definition

                        MAKSIMAALNE ANNUSTAMISTE ARV. If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                        ShortEvent occurs up to frequencyMax times per period
                        Control0..1
                        TypepositiveInt
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        136. MedicationStatement.dosage.timing.repeat.period
                        Definition

                        KUI SAGEDASTI ANNUSTATAKSE JA ÜHIK. Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

                        ShortThe duration to which the frequency applies. I.e. Event occurs frequency times per period
                        Control0..1
                        This element is affected by the following invariants: tim-6, tim-5, tim-2
                        Typedecimal
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        138. MedicationStatement.dosage.timing.repeat.periodMax
                        Definition

                        MAKSIMAALNE PERIOOD ANNUSTAMISE VAHEL. If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                        ShortUpper limit of period (3-4 hours)
                        Control0..1
                        This element is affected by the following invariants: tim-6
                        Typedecimal
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        140. MedicationStatement.dosage.timing.repeat.periodUnit
                        Definition

                        The units of time for the period in UCUM units Normal practice is to use the 'mo' code as a calendar month when calculating the next occurrence.

                        Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                        Control0..1
                        This element is affected by the following invariants: tim-2
                        BindingThe codes SHALL be taken from UnitsOfTime
                        (required to http://hl7.org/fhir/ValueSet/units-of-time|5.0.0)

                        A unit of time (units from UCUM).

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        142. MedicationStatement.dosage.timing.repeat.dayOfWeek
                        Definition

                        NÄDALAPÄEV. If one or more days of week is provided, then the action happens only on the specified day(s).

                        Short If one or more days of week is provided, then the action happens only on the specified day(s).
                        Comments

                        If no days are specified, the action is assumed to happen every day as otherwise specified.

                        Control0..*
                        BindingThe codes SHALL be taken from DaysOfWeek
                        (required to http://hl7.org/fhir/ValueSet/days-of-week|5.0.0)
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        144. MedicationStatement.dosage.timing.repeat.timeOfDay
                        Definition

                        PÄEVA OSA. Specified time of day for action to take place.

                        ShortSpecified time of day for action to take place.
                        Comments

                        When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. If there's a timeOfDay, there cannot be a when, or vice versa.

                        Control0..*
                        This element is affected by the following invariants: tim-10
                        Typetime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        146. MedicationStatement.dosage.timing.repeat.when
                        Definition

                        MILLEGA SEOTUD.

                        ShortCode for time period of occurrence
                        Comments

                        When more than one event is listed, the event is tied to the union of the specified events.

                        Control0..*
                        This element is affected by the following invariants: tim-9, tim-10
                        BindingThe codes SHALL be taken from EventTiming
                        (required to http://hl7.org/fhir/ValueSet/event-timing|5.0.0)

                        Real-world event relating to the schedule.

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Timings are frequently determined by occurrences such as waking, eating and sleep.

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

                        PERIOOD ENNE VÕI PÄRAST.

                        ShortMinutes from event (before or after)
                        Control0..1
                        This element is affected by the following invariants: tim-9
                        TypeunsignedInt
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        150. MedicationStatement.dosage.timing.code
                        Definition

                        A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                        ShortC | BID | TID | QID | AM | PM | QD | QOD | +
                        Comments

                        BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                        Control0..1
                        BindingThe codes SHOULD be taken from TimingAbbreviation
                        (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation)

                        Code for a known / defined timing pattern.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        152. MedicationStatement.dosage.asNeeded
                        Definition

                        VAJADUSEL

                        ShortTake "as needed"
                        Comments

                        Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated.

                        Control0..1
                        This element is affected by the following invariants: dos-1
                        Typeboolean
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        154. MedicationStatement.dosage.asNeededFor
                        Definition

                        Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept).

                        ShortTake "as needed" (for x)
                        Comments

                        Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed".

                        Control0..1
                        This element is affected by the following invariants: dos-1
                        BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                        (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                        A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        156. MedicationStatement.dosage.site
                        Definition

                        KEHAPIIRKOND.

                        ShortBody site to administer to
                        Comments

                        If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

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

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

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

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

                        MANUSTAMISVIIS.

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

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

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

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

                        MANUSTAMISMEETOD. Näiteks subkutaanne

                        ShortTechnique for administering medication
                        Comments

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

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

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

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

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

                        ANNUS JA KIIRUS.

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

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        166. MedicationStatement.dosage.doseAndRate.extension
                        Definition

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

                        ShortAdditional content defined by implementations
                        Comments

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

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

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

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

                          The kind of dose or rate specified.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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

                          RAVIMI KOGUS ANNUSE KOHTA. Loendis on koodid nagu näiteks TA -tablett, TK - tükk, CP- kapsel, MA - mõõtannus jne. Amount of medication per dose.

                          ShortAmount of medication per dose
                          Comments

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

                          Control0..1
                          TypeChoice of: Range, Quantity(SimpleQuantity)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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

                          MANUSTAMISE KIIRUS. Amount of medication per unit of time.

                          ShortAmount of medication per unit of time
                          Comments

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

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

                          Control0..1
                          TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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

                          MAKSIMAALNE ANNUS PERIOODIS. Upper limit on medication per unit of time.

                          ShortUpper limit on medication per unit of time
                          Comments

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

                          Control0..*
                          TypeRatio
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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

                          MAKSIMAALNE ANNUS ÜHE ANNUSTAMISE KOHTA. Upper limit on medication per administration.

                          ShortUpper limit on medication per administration
                          Comments

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

                          Control0..1
                          TypeQuantity(SimpleQuantity)
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typeid
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          180. MedicationStatement.dosage.maxDosePerAdministration.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                            ShortNumerical value (with implicit precision)
                            Comments

                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                            Control0..1
                            Typedecimal
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Precision is handled implicitly in almost all cases of measurement.

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

                            Not allowed to be used in this context

                            Short< | <= | >= | > | ad - how to understand the value
                            Control0..0
                            BindingThe codes SHALL be taken from QuantityComparator
                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                            How the Quantity should be understood and represented.

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            186. MedicationStatement.dosage.maxDosePerAdministration.unit
                            Definition

                            A human-readable form of the unit.

                            ShortUnit representation
                            Control0..0
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

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

                            The identification of the system that provides the coded form of the unit.

                            ShortSystem that defines coded unit form
                            Control0..1
                            This element is affected by the following invariants: qty-3
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to know the system that defines the coded form of the unit.

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

                            A computer processable form of the unit in some unit representation system.

                            ShortCoded form of the unit
                            Comments

                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                            Control0..1
                            This element is affected by the following invariants: qty-3
                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

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

                            MAKSIMAALNE ANNUS ELUS. Upper limit on medication per lifetime of the patient.

                            ShortUpper limit on medication per lifetime of the patient
                            Control0..1
                            TypeQuantity(SimpleQuantity)
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

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

                            Indicates whether the medication is or is not being consumed or administered.

                            ShortIndicates whether the medication is or is not being consumed or administered
                            Comments

                            This element can be used to indicate whether a patient is following a course of treatment as instructed/prescribed or whether they are taking medications of their own volition. It can also be used to indicate that a patient is not taking a medication, either because they were told not to or because they decided on their own.

                            Control0..0
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))