NOT International Patient Summary Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/costateixeira/fhir-ips/ and changes regularly. See the Directory of published versions

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Resource Profile: Medication Statement (IPS)

This profile represents the constraints applied to the MedicationStatement resource by the International Patient Summary (IPS) FHIR Implementation Guide, based on FHIR R4. A record of a medication statement is represented in the patient summary as an instance of a MedicationStatement resource constrained by this profile.

This profile constrains the representation of a medication statement related to the patient, in the context of the international patient summary as specified by the IPS project of HL7 International.

Usage:

• Use this Resource Profile: Bundle - IPS
• Refer to this Resource Profile: Composition (IPS)

Formal Views of Profile Content

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

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

This structure is derived from MedicationStatement

Name	Flags	Card.	Type	Description & Constraints
MedicationStatement			MedicationStatement
status		1..1	code	active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x]	S	1..1		What medication was taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
medicationCodeableConcept			CodeableConcept(CodeableConceptIPS)
medicationReference			Reference(Medication (IPS))
subject	S	1..1	Reference(Patient (IPS))	Who is/was taking the medication
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	S	1..1	dateTime, Period	The date/time or interval when the medication is/was/will be taken
Slices for extension				Content/Rules for all slices
data-absent-reason	S	0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
dosage	S	0..*	Dosage	Details of how medication is/was taken or should be taken
text	S	0..1	string	Free text dosage instructions e.g. SIG
timing	S	0..1	Timing	When medication should be administered
route		0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationStatement.medication[x]	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
MedicationStatement.dosage.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration from this IG

Name	Flags	Card.	Type	Description & Constraints
MedicationStatement		0..*	MedicationStatement	Record of medication being taken by a patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
medication[x]	SΣ	1..1		What medication was taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
medicationCodeableConcept			CodeableConcept(CodeableConceptIPS)
medicationReference			Reference(Medication (IPS))
subject	SΣ	1..1	Reference(Patient (IPS))	Who is/was taking the medication
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	SΣ	1..1		The date/time or interval when the medication is/was/will be taken
effective[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
data-absent-reason	S	0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
dosage	S	0..*	Dosage	Details of how medication is/was taken or should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	When medication should be administered
route		0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationStatement.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1 from the FHIR Standard
MedicationStatement.medication[x]	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
MedicationStatement.dosage.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationStatement	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationStatement	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationStatement	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationStatement		0..*	MedicationStatement	Record of medication being taken by a patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External identifier
basedOn	Σ	0..*	Reference(MedicationRequest | CarePlan | ServiceRequest)	Fulfils plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)	Part of referenced event
status	?!Σ	1..1	code	active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
statusReason		0..*	CodeableConcept	Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category	Σ	0..1	CodeableConcept	Type of medication usage Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
medication[x]	SΣ	1..1		What medication was taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
medicationCodeableConcept			CodeableConcept(CodeableConceptIPS)
medicationReference			Reference(Medication (IPS))
subject	SΣ	1..1	Reference(Patient (IPS))	Who is/was taking the medication
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
context	Σ	0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with MedicationStatement
effective[x]	SΣ	1..1		The date/time or interval when the medication is/was/will be taken
effective[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
data-absent-reason	S	0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
dateAsserted	Σ	0..1	dateTime	When the statement was asserted?
informationSource		0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)	Person or organization that provided the information about the taking of this medication
derivedFrom		0..*	Reference(Resource)	Additional supporting information
reasonCode		0..*	CodeableConcept	Reason for why the medication is being/was taken Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport)	Condition or observation that supports why the medication is being/was taken
note		0..*	Annotation	Further information about the statement
dosage	S	0..*	Dosage	Details of how medication is/was taken or should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route		0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationStatement.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationStatement.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1 from the FHIR Standard
MedicationStatement.statusReason	example	SNOMEDCTDrugTherapyStatusCodes http://hl7.org/fhir/ValueSet/reason-medication-status-codes from the FHIR Standard
MedicationStatement.category	preferred	Medication usage category codes http://hl7.org/fhir/ValueSet/medication-statement-category from the FHIR Standard
MedicationStatement.medication[x]	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
MedicationStatement.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationStatement.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationStatement.dosage.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationStatement.dosage.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationStatement.dosage.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration from this IG
MedicationStatement.dosage.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationStatement.dosage.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationStatement	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationStatement	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationStatement	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from MedicationStatement

Summary

Mandatory: 2 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
• Medication (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Medication-uv-ips)
• Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/data-absent-reason

Maturity: 2

Differential View

This structure is derived from MedicationStatement

Name	Flags	Card.	Type	Description & Constraints
MedicationStatement			MedicationStatement
status		1..1	code	active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x]	S	1..1		What medication was taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
medicationCodeableConcept			CodeableConcept(CodeableConceptIPS)
medicationReference			Reference(Medication (IPS))
subject	S	1..1	Reference(Patient (IPS))	Who is/was taking the medication
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	S	1..1	dateTime, Period	The date/time or interval when the medication is/was/will be taken
Slices for extension				Content/Rules for all slices
data-absent-reason	S	0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
dosage	S	0..*	Dosage	Details of how medication is/was taken or should be taken
text	S	0..1	string	Free text dosage instructions e.g. SIG
timing	S	0..1	Timing	When medication should be administered
route		0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationStatement.medication[x]	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
MedicationStatement.dosage.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationStatement		0..*	MedicationStatement	Record of medication being taken by a patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
medication[x]	SΣ	1..1		What medication was taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
medicationCodeableConcept			CodeableConcept(CodeableConceptIPS)
medicationReference			Reference(Medication (IPS))
subject	SΣ	1..1	Reference(Patient (IPS))	Who is/was taking the medication
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
effective[x]	SΣ	1..1		The date/time or interval when the medication is/was/will be taken
effective[x]All Types				Content/Rules for all Types
Slices for extension				Content/Rules for all slices
data-absent-reason	S	0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
dosage	S	0..*	Dosage	Details of how medication is/was taken or should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	When medication should be administered
route		0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationStatement.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1 from the FHIR Standard
MedicationStatement.medication[x]	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
MedicationStatement.dosage.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationStatement	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationStatement	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationStatement	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationStatement		0..*	MedicationStatement	Record of medication being taken by a patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External identifier
basedOn	Σ	0..*	Reference(MedicationRequest | CarePlan | ServiceRequest)	Fulfils plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)	Part of referenced event
status	?!Σ	1..1	code	active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
statusReason		0..*	CodeableConcept	Reason for current status Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category	Σ	0..1	CodeableConcept	Type of medication usage Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
medication[x]	SΣ	1..1		What medication was taken Binding: Medications - IPS (preferred): SNOMED CT medications (Medicinal product) or a code for absent/unknown medication
medicationCodeableConcept			CodeableConcept(CodeableConceptIPS)
medicationReference			Reference(Medication (IPS))
subject	SΣ	1..1	Reference(Patient (IPS))	Who is/was taking the medication
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
context	Σ	0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with MedicationStatement
effective[x]	SΣ	1..1		The date/time or interval when the medication is/was/will be taken
effective[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
data-absent-reason	S	0..1	code	effective[x] absence reason URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
effectiveDateTime			dateTime
effectivePeriod			Period
dateAsserted	Σ	0..1	dateTime	When the statement was asserted?
informationSource		0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)	Person or organization that provided the information about the taking of this medication
derivedFrom		0..*	Reference(Resource)	Additional supporting information
reasonCode		0..*	CodeableConcept	Reason for why the medication is being/was taken Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport)	Condition or observation that supports why the medication is being/was taken
note		0..*	Annotation	Further information about the statement
dosage	S	0..*	Dosage	Details of how medication is/was taken or should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route		0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Route of Administration - IPS (preferred): EDQM Standards Terms
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationStatement.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationStatement.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1 from the FHIR Standard
MedicationStatement.statusReason	example	SNOMEDCTDrugTherapyStatusCodes http://hl7.org/fhir/ValueSet/reason-medication-status-codes from the FHIR Standard
MedicationStatement.category	preferred	Medication usage category codes http://hl7.org/fhir/ValueSet/medication-statement-category from the FHIR Standard
MedicationStatement.medication[x]	preferred	MedicationsUvIps http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips from this IG
MedicationStatement.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationStatement.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationStatement.dosage.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationStatement.dosage.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationStatement.dosage.route	preferred	MedicineRouteOfAdministrationUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration from this IG
MedicationStatement.dosage.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationStatement.dosage.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationStatement	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationStatement	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationStatement	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationStatement	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from MedicationStatement

Summary

Mandatory: 2 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

• Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
• Medication (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Medication-uv-ips)
• Patient (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/data-absent-reason

Maturity: 2

Other representations of profile: CSV, Excel, Schematron