PROTECT-CHILD Pediatric Transplant Data Implementation Guide, published by Protect Child. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/protect-child/ and changes regularly. See the Directory of published versions

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Resource Profile: Immunosuppressant to Patient ( Experimental )

Immunosuppressive treatment record for a transplant patient, aligned with the DMv1.2 imm_pat table. The phase — induction, maintenance, or rejection treatment (added by this guide) — is in MedicationStatement.category. The patient is in subject, and is also reachable via context (Visit) → Visit.subject. Pharmacokinetic monitoring values (pre_dose_level, csa_2h_post_dose_level, auc) are represented as linked ImmPatPKObservation resources via Observation.partOf.

Usages:

• Refer to this Profile: Immunosuppressant PK Observation
• Examples for this Profile: MedicationStatement/ImmPatEbvReducedExample1, MedicationStatement/ImmPatInductionExample1, MedicationStatement/ImmPatMaintenanceExample1, MedicationStatement/ImmPatRejectionTreatmentExample1... Show 2 more, MedicationStatement/KidneyImmPatSteroid1 and MedicationStatement/KidneyImmPatTacrolimus1

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationStatement	C	0..*	MedicationStatement	Record of medication being taken by a patient Constraints: pc-dose-1, pc-imm-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	imm_pat_id — treatment record identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/protect-child-id
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	Use #active for ongoing therapy, #completed for finished regimens Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
category	SΣ	1..1	CodeableConcept	phase — Induction, Maintenance or Rejection treatment (ImmPatPhaseVS) Binding: Immunosuppressant Phase ValueSet (required)
medication[x]	SΣ	1..1	Reference(Immunosuppressant)	imm_id — reference to the Immunosuppressant drug catalogue entry
subject	SΣ	1..1	Reference(Transplant Recipient)	Transplant recipient (navigate via context → Visit.subject)
context	SΣ	1..1	Reference(Visit)	visit_id — Visit at which this treatment was recorded
Slices for effective[x]	SΣ	0..1		The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectivePeriod	SΣ	0..1	Period	The date/time or interval when the medication is/was/will be taken
start	ΣC	0..1	dateTime	start_date — date treatment started
end	ΣC	0..1	dateTime	end_date — date treatment ended
reasonReference	S	0..*	Reference(Clinical Event)	The ClinicalEvent this treatment was given for (rejection treatment)
dosage	S	0..1	Dosage	Details of how medication is/was taken or should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	When medication should be administered
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
repeat	SΣC	0..1	Element	When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
count	SΣ	0..1	positiveInt	Number of times to repeat
frequency	SΣ	0..1	positiveInt	Event occurs frequency times per period
period	SΣ	0..1	decimal	Event occurs frequency times per period
periodUnit	SΣ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
doseAndRate	SΣ	0..1	Element	Amount of medication administered
Slices for dose[x]	Σ	0..1		Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
dose[x]:doseQuantity	SΣ	0..1	SimpleQuantity	dose + unit — numeric dose with UCUM unit from ImmPatDoseUnitVS
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit Binding: Immunosuppressant Dose Unit ValueSet (required)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationStatement.​identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
MedicationStatement.​status	Base	required	Medication status codes	📍4.0.1	FHIR Std.
MedicationStatement.​category	Base	required	Immunosuppressant Phase ValueSet	📦0.1.0-ci-build	This IG
MedicationStatement.​dosage.timing.repeat.​periodUnit	Base	required	UnitsOfTime	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.doseAndRate.dose[x]:doseQuantity.​code	Base	required	Immunosuppressant Dose Unit ValueSet	📦0.1.0-ci-build	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
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()
pc-dose-1	error	MedicationStatement	A dose SHALL say what period it covers: either dosage.timing gives the frequency, or the unit is a rate (mg/kg/day, mg/m2/day, mg/day). PROTECT-CHILD records the dose per administration, so a DM-sourced record takes the first route. '0.1 mg/kg' on its own does not say per dose or per day, and the two differ by the number of daily administrations.	dosage.doseAndRate.dose.ofType(Quantity).code.exists() implies (dosage.doseAndRate.dose.ofType(Quantity).code in ('mg.kg-1.d-1'|'mg.m-2.d-1'|'mg.d-1') or dosage.timing.repeat.exists())
pc-imm-1	warning	MedicationStatement	A record of rejection treatment SHOULD name the episode it treated.	category.coding.where(code = 'rejection-treatment').exists() implies reasonReference.exists()
tim-1	error	MedicationStatement.dosage.timing.repeat	if there's a duration, there needs to be duration units	duration.empty() or durationUnit.exists()
tim-2	error	MedicationStatement.dosage.timing.repeat	if there's a period, there needs to be period units	period.empty() or periodUnit.exists()
tim-4	error	MedicationStatement.dosage.timing.repeat	duration SHALL be a non-negative value	duration.exists() implies duration >= 0
tim-5	error	MedicationStatement.dosage.timing.repeat	period SHALL be a non-negative value	period.exists() implies period >= 0
tim-6	error	MedicationStatement.dosage.timing.repeat	If there's a periodMax, there must be a period	periodMax.empty() or period.exists()
tim-7	error	MedicationStatement.dosage.timing.repeat	If there's a durationMax, there must be a duration	durationMax.empty() or duration.exists()
tim-8	error	MedicationStatement.dosage.timing.repeat	If there's a countMax, there must be a count	countMax.empty() or count.exists()
tim-9	error	MedicationStatement.dosage.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV)	offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationStatement.dosage.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa	timeOfDay.empty() or when.empty()

This structure is derived from MedicationStatement

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationStatement	C	0..*	MedicationStatement	Record of medication being taken by a patient Constraints: pc-dose-1, pc-imm-1
identifier	S	1..1	Identifier	imm_pat_id — treatment record identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/protect-child-id
value		1..1	string	The value that is unique
status	S	1..1	code	Use #active for ongoing therapy, #completed for finished regimens
category	S	1..1	CodeableConcept	phase — Induction, Maintenance or Rejection treatment (ImmPatPhaseVS) Binding: Immunosuppressant Phase ValueSet (required)
medication[x]	S	1..1	Reference(Immunosuppressant)	imm_id — reference to the Immunosuppressant drug catalogue entry
subject	S	1..1	Reference(Transplant Recipient)	Transplant recipient (navigate via context → Visit.subject)
context	S	1..1	Reference(Visit)	visit_id — Visit at which this treatment was recorded
Slices for effective[x]	S	0..1	dateTime, Period	The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effective[x]:effectivePeriod	S	0..1	Period	The date/time or interval when the medication is/was/will be taken
start		0..1	dateTime	start_date — date treatment started
end		0..1	dateTime	end_date — date treatment ended
reasonReference	S	0..*	Reference(Clinical Event)	The ClinicalEvent this treatment was given for (rejection treatment)
dosage	S	0..1	Dosage	Details of how medication is/was taken or should be taken
text	S	0..1	string	Free text dosage instructions e.g. SIG
timing	S	0..1	Timing	When medication should be administered
repeat	S	0..1	Element	When the event is to occur
count	S	0..1	positiveInt	Number of times to repeat
frequency	S	0..1	positiveInt	Event occurs frequency times per period
period	S	0..1	decimal	Event occurs frequency times per period
periodUnit	S	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM)
doseAndRate	S	0..1	Element	Amount of medication administered
Slices for dose[x]		0..1	Range, SimpleQuantity(4.0.1)	Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity	S	0..1	SimpleQuantity	dose + unit — numeric dose with UCUM unit from ImmPatDoseUnitVS
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code		0..1	code	Coded form of the unit Binding: Immunosuppressant Dose Unit ValueSet (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
MedicationStatement.​category	Base	required	Immunosuppressant Phase ValueSet	📦0.1.0-ci-build	This IG
MedicationStatement.​dosage.doseAndRate.dose[x]:doseQuantity.​code	Base	required	Immunosuppressant Dose Unit ValueSet	📦0.1.0-ci-build	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
pc-dose-1	error	MedicationStatement	A dose SHALL say what period it covers: either dosage.timing gives the frequency, or the unit is a rate (mg/kg/day, mg/m2/day, mg/day). PROTECT-CHILD records the dose per administration, so a DM-sourced record takes the first route. '0.1 mg/kg' on its own does not say per dose or per day, and the two differ by the number of daily administrations.	dosage.doseAndRate.dose.ofType(Quantity).code.exists() implies (dosage.doseAndRate.dose.ofType(Quantity).code in ('mg.kg-1.d-1'|'mg.m-2.d-1'|'mg.d-1') or dosage.timing.repeat.exists())
pc-imm-1	warning	MedicationStatement	A record of rejection treatment SHOULD name the episode it treated.	category.coding.where(code = 'rejection-treatment').exists() implies reasonReference.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationStatement	C	0..*	MedicationStatement	Record of medication being taken by a patient Constraints: pc-dose-1, pc-imm-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	imm_pat_id — treatment record identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/protect-child-id
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
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	?!SΣ	1..1	code	Use #active for ongoing therapy, #completed for finished regimens 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	SΣ	1..1	CodeableConcept	phase — Induction, Maintenance or Rejection treatment (ImmPatPhaseVS) Binding: Immunosuppressant Phase ValueSet (required)
medication[x]	SΣ	1..1	Reference(Immunosuppressant)	imm_id — reference to the Immunosuppressant drug catalogue entry
subject	SΣ	1..1	Reference(Transplant Recipient)	Transplant recipient (navigate via context → Visit.subject)
context	SΣ	1..1	Reference(Visit)	visit_id — Visit at which this treatment was recorded
Slices for effective[x]	SΣ	0..1		The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectivePeriod	SΣ	0..1	Period	The date/time or interval when the medication is/was/will 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
start	ΣC	0..1	dateTime	start_date — date treatment started
end	ΣC	0..1	dateTime	end_date — date treatment ended
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	S	0..*	Reference(Clinical Event)	The ClinicalEvent this treatment was given for (rejection treatment)
note		0..*	Annotation	Further information about the statement
dosage	S	0..1	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
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
event	Σ	0..*	dateTime	When the event occurs
repeat	SΣC	0..1	Element	When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x]	Σ	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
count	SΣ	0..1	positiveInt	Number of times to repeat
countMax	Σ	0..1	positiveInt	Maximum number of times to repeat
duration	Σ	0..1	decimal	How long when it happens
durationMax	Σ	0..1	decimal	How long when it happens (Max)
durationUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	SΣ	0..1	positiveInt	Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	Event occurs up to frequencyMax times per period
period	SΣ	0..1	decimal	Event occurs frequency times per period
periodMax	Σ	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	SΣ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	Σ	0..*	time	Time of day for action
when	Σ	0..*	code	Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset	Σ	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
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	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
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	SΣ	0..1	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.
Slices for dose[x]	Σ	0..1		Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
dose[x]:doseQuantity	SΣ	0..1	SimpleQuantity	dose + unit — numeric dose with UCUM unit from ImmPatDoseUnitVS
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit Binding: Immunosuppressant Dose Unit ValueSet (required)
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(4.0.1)	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity(4.0.1)	Upper limit on medication per lifetime of the patient
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationStatement.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
MedicationStatement.​identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
MedicationStatement.​identifier.type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
MedicationStatement.​status	Base	required	Medication status codes	📍4.0.1	FHIR Std.
MedicationStatement.​statusReason	Base	example	SNOMED CT Drug Therapy Status codes	📍4.0.1	FHIR Std.
MedicationStatement.​category	Base	required	Immunosuppressant Phase ValueSet	📦0.1.0-ci-build	This IG
MedicationStatement.​reasonCode	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.additionalInstruction	Base	example	SNOMED CT Additional Dosage Instructions	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​durationUnit	Base	required	UnitsOfTime	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​periodUnit	Base	required	UnitsOfTime	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​dayOfWeek	Base	required	DaysOfWeek	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​when	Base	required	EventTiming	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.code	Base	preferred	TimingAbbreviation	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.asNeeded[x]	Base	example	SNOMED CT Medication As Needed Reason Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.site	Base	example	SNOMED CT Anatomical Structure for Administration Site Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.route	Base	example	SNOMED CT Route Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.method	Base	example	SNOMED CT Administration Method Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.doseAndRate.type	Base	example	DoseAndRateType	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.doseAndRate.dose[x]:doseQuantity.​code	Base	required	Immunosuppressant Dose Unit ValueSet	📦0.1.0-ci-build	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
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()
pc-dose-1	error	MedicationStatement	A dose SHALL say what period it covers: either dosage.timing gives the frequency, or the unit is a rate (mg/kg/day, mg/m2/day, mg/day). PROTECT-CHILD records the dose per administration, so a DM-sourced record takes the first route. '0.1 mg/kg' on its own does not say per dose or per day, and the two differ by the number of daily administrations.	dosage.doseAndRate.dose.ofType(Quantity).code.exists() implies (dosage.doseAndRate.dose.ofType(Quantity).code in ('mg.kg-1.d-1'|'mg.m-2.d-1'|'mg.d-1') or dosage.timing.repeat.exists())
pc-imm-1	warning	MedicationStatement	A record of rejection treatment SHOULD name the episode it treated.	category.coding.where(code = 'rejection-treatment').exists() implies reasonReference.exists()
tim-1	error	MedicationStatement.dosage.timing.repeat	if there's a duration, there needs to be duration units	duration.empty() or durationUnit.exists()
tim-2	error	MedicationStatement.dosage.timing.repeat	if there's a period, there needs to be period units	period.empty() or periodUnit.exists()
tim-4	error	MedicationStatement.dosage.timing.repeat	duration SHALL be a non-negative value	duration.exists() implies duration >= 0
tim-5	error	MedicationStatement.dosage.timing.repeat	period SHALL be a non-negative value	period.exists() implies period >= 0
tim-6	error	MedicationStatement.dosage.timing.repeat	If there's a periodMax, there must be a period	periodMax.empty() or period.exists()
tim-7	error	MedicationStatement.dosage.timing.repeat	If there's a durationMax, there must be a duration	durationMax.empty() or duration.exists()
tim-8	error	MedicationStatement.dosage.timing.repeat	If there's a countMax, there must be a count	countMax.empty() or count.exists()
tim-9	error	MedicationStatement.dosage.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV)	offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationStatement.dosage.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa	timeOfDay.empty() or when.empty()

This structure is derived from MedicationStatement

Summary

Mandatory: 5 elements
Must-Support: 19 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• Immunosuppressant (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressant)
• Transplant Recipient (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/patient-transplant)
• Visit (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/visit)
• Clinical Event (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/clinical-event)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationStatement.effective[x]
• The element 1 is sliced based on the value of MedicationStatement.dosage.doseAndRate.dose[x]

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationStatement	C	0..*	MedicationStatement	Record of medication being taken by a patient Constraints: pc-dose-1, pc-imm-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	imm_pat_id — treatment record identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/protect-child-id
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	Use #active for ongoing therapy, #completed for finished regimens Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
category	SΣ	1..1	CodeableConcept	phase — Induction, Maintenance or Rejection treatment (ImmPatPhaseVS) Binding: Immunosuppressant Phase ValueSet (required)
medication[x]	SΣ	1..1	Reference(Immunosuppressant)	imm_id — reference to the Immunosuppressant drug catalogue entry
subject	SΣ	1..1	Reference(Transplant Recipient)	Transplant recipient (navigate via context → Visit.subject)
context	SΣ	1..1	Reference(Visit)	visit_id — Visit at which this treatment was recorded
Slices for effective[x]	SΣ	0..1		The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectivePeriod	SΣ	0..1	Period	The date/time or interval when the medication is/was/will be taken
start	ΣC	0..1	dateTime	start_date — date treatment started
end	ΣC	0..1	dateTime	end_date — date treatment ended
reasonReference	S	0..*	Reference(Clinical Event)	The ClinicalEvent this treatment was given for (rejection treatment)
dosage	S	0..1	Dosage	Details of how medication is/was taken or should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	When medication should be administered
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
repeat	SΣC	0..1	Element	When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
count	SΣ	0..1	positiveInt	Number of times to repeat
frequency	SΣ	0..1	positiveInt	Event occurs frequency times per period
period	SΣ	0..1	decimal	Event occurs frequency times per period
periodUnit	SΣ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
doseAndRate	SΣ	0..1	Element	Amount of medication administered
Slices for dose[x]	Σ	0..1		Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
dose[x]:doseQuantity	SΣ	0..1	SimpleQuantity	dose + unit — numeric dose with UCUM unit from ImmPatDoseUnitVS
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit Binding: Immunosuppressant Dose Unit ValueSet (required)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationStatement.​identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
MedicationStatement.​status	Base	required	Medication status codes	📍4.0.1	FHIR Std.
MedicationStatement.​category	Base	required	Immunosuppressant Phase ValueSet	📦0.1.0-ci-build	This IG
MedicationStatement.​dosage.timing.repeat.​periodUnit	Base	required	UnitsOfTime	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.doseAndRate.dose[x]:doseQuantity.​code	Base	required	Immunosuppressant Dose Unit ValueSet	📦0.1.0-ci-build	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
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()
pc-dose-1	error	MedicationStatement	A dose SHALL say what period it covers: either dosage.timing gives the frequency, or the unit is a rate (mg/kg/day, mg/m2/day, mg/day). PROTECT-CHILD records the dose per administration, so a DM-sourced record takes the first route. '0.1 mg/kg' on its own does not say per dose or per day, and the two differ by the number of daily administrations.	dosage.doseAndRate.dose.ofType(Quantity).code.exists() implies (dosage.doseAndRate.dose.ofType(Quantity).code in ('mg.kg-1.d-1'|'mg.m-2.d-1'|'mg.d-1') or dosage.timing.repeat.exists())
pc-imm-1	warning	MedicationStatement	A record of rejection treatment SHOULD name the episode it treated.	category.coding.where(code = 'rejection-treatment').exists() implies reasonReference.exists()
tim-1	error	MedicationStatement.dosage.timing.repeat	if there's a duration, there needs to be duration units	duration.empty() or durationUnit.exists()
tim-2	error	MedicationStatement.dosage.timing.repeat	if there's a period, there needs to be period units	period.empty() or periodUnit.exists()
tim-4	error	MedicationStatement.dosage.timing.repeat	duration SHALL be a non-negative value	duration.exists() implies duration >= 0
tim-5	error	MedicationStatement.dosage.timing.repeat	period SHALL be a non-negative value	period.exists() implies period >= 0
tim-6	error	MedicationStatement.dosage.timing.repeat	If there's a periodMax, there must be a period	periodMax.empty() or period.exists()
tim-7	error	MedicationStatement.dosage.timing.repeat	If there's a durationMax, there must be a duration	durationMax.empty() or duration.exists()
tim-8	error	MedicationStatement.dosage.timing.repeat	If there's a countMax, there must be a count	countMax.empty() or count.exists()
tim-9	error	MedicationStatement.dosage.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV)	offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationStatement.dosage.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa	timeOfDay.empty() or when.empty()

Differential View

This structure is derived from MedicationStatement

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationStatement	C	0..*	MedicationStatement	Record of medication being taken by a patient Constraints: pc-dose-1, pc-imm-1
identifier	S	1..1	Identifier	imm_pat_id — treatment record identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/protect-child-id
value		1..1	string	The value that is unique
status	S	1..1	code	Use #active for ongoing therapy, #completed for finished regimens
category	S	1..1	CodeableConcept	phase — Induction, Maintenance or Rejection treatment (ImmPatPhaseVS) Binding: Immunosuppressant Phase ValueSet (required)
medication[x]	S	1..1	Reference(Immunosuppressant)	imm_id — reference to the Immunosuppressant drug catalogue entry
subject	S	1..1	Reference(Transplant Recipient)	Transplant recipient (navigate via context → Visit.subject)
context	S	1..1	Reference(Visit)	visit_id — Visit at which this treatment was recorded
Slices for effective[x]	S	0..1	dateTime, Period	The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effective[x]:effectivePeriod	S	0..1	Period	The date/time or interval when the medication is/was/will be taken
start		0..1	dateTime	start_date — date treatment started
end		0..1	dateTime	end_date — date treatment ended
reasonReference	S	0..*	Reference(Clinical Event)	The ClinicalEvent this treatment was given for (rejection treatment)
dosage	S	0..1	Dosage	Details of how medication is/was taken or should be taken
text	S	0..1	string	Free text dosage instructions e.g. SIG
timing	S	0..1	Timing	When medication should be administered
repeat	S	0..1	Element	When the event is to occur
count	S	0..1	positiveInt	Number of times to repeat
frequency	S	0..1	positiveInt	Event occurs frequency times per period
period	S	0..1	decimal	Event occurs frequency times per period
periodUnit	S	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM)
doseAndRate	S	0..1	Element	Amount of medication administered
Slices for dose[x]		0..1	Range, SimpleQuantity(4.0.1)	Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity	S	0..1	SimpleQuantity	dose + unit — numeric dose with UCUM unit from ImmPatDoseUnitVS
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code		0..1	code	Coded form of the unit Binding: Immunosuppressant Dose Unit ValueSet (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
MedicationStatement.​category	Base	required	Immunosuppressant Phase ValueSet	📦0.1.0-ci-build	This IG
MedicationStatement.​dosage.doseAndRate.dose[x]:doseQuantity.​code	Base	required	Immunosuppressant Dose Unit ValueSet	📦0.1.0-ci-build	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
pc-dose-1	error	MedicationStatement	A dose SHALL say what period it covers: either dosage.timing gives the frequency, or the unit is a rate (mg/kg/day, mg/m2/day, mg/day). PROTECT-CHILD records the dose per administration, so a DM-sourced record takes the first route. '0.1 mg/kg' on its own does not say per dose or per day, and the two differ by the number of daily administrations.	dosage.doseAndRate.dose.ofType(Quantity).code.exists() implies (dosage.doseAndRate.dose.ofType(Quantity).code in ('mg.kg-1.d-1'|'mg.m-2.d-1'|'mg.d-1') or dosage.timing.repeat.exists())
pc-imm-1	warning	MedicationStatement	A record of rejection treatment SHOULD name the episode it treated.	category.coding.where(code = 'rejection-treatment').exists() implies reasonReference.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationStatement	C	0..*	MedicationStatement	Record of medication being taken by a patient Constraints: pc-dose-1, pc-imm-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	imm_pat_id — treatment record identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/NamingSystem/protect-child-id
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
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	?!SΣ	1..1	code	Use #active for ongoing therapy, #completed for finished regimens 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	SΣ	1..1	CodeableConcept	phase — Induction, Maintenance or Rejection treatment (ImmPatPhaseVS) Binding: Immunosuppressant Phase ValueSet (required)
medication[x]	SΣ	1..1	Reference(Immunosuppressant)	imm_id — reference to the Immunosuppressant drug catalogue entry
subject	SΣ	1..1	Reference(Transplant Recipient)	Transplant recipient (navigate via context → Visit.subject)
context	SΣ	1..1	Reference(Visit)	visit_id — Visit at which this treatment was recorded
Slices for effective[x]	SΣ	0..1		The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effective[x]:effectivePeriod	SΣ	0..1	Period	The date/time or interval when the medication is/was/will 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
start	ΣC	0..1	dateTime	start_date — date treatment started
end	ΣC	0..1	dateTime	end_date — date treatment ended
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	S	0..*	Reference(Clinical Event)	The ClinicalEvent this treatment was given for (rejection treatment)
note		0..*	Annotation	Further information about the statement
dosage	S	0..1	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
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
event	Σ	0..*	dateTime	When the event occurs
repeat	SΣC	0..1	Element	When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x]	Σ	0..1		Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
count	SΣ	0..1	positiveInt	Number of times to repeat
countMax	Σ	0..1	positiveInt	Maximum number of times to repeat
duration	Σ	0..1	decimal	How long when it happens
durationMax	Σ	0..1	decimal	How long when it happens (Max)
durationUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	SΣ	0..1	positiveInt	Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	Event occurs up to frequencyMax times per period
period	SΣ	0..1	decimal	Event occurs frequency times per period
periodMax	Σ	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	SΣ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	Σ	0..*	time	Time of day for action
when	Σ	0..*	code	Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset	Σ	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
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	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
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	SΣ	0..1	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.
Slices for dose[x]	Σ	0..1		Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
dose[x]:doseQuantity	SΣ	0..1	SimpleQuantity	dose + unit — numeric dose with UCUM unit from ImmPatDoseUnitVS
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit Binding: Immunosuppressant Dose Unit ValueSet (required)
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(4.0.1)	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity(4.0.1)	Upper limit on medication per lifetime of the patient
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationStatement.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
MedicationStatement.​identifier.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
MedicationStatement.​identifier.type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
MedicationStatement.​status	Base	required	Medication status codes	📍4.0.1	FHIR Std.
MedicationStatement.​statusReason	Base	example	SNOMED CT Drug Therapy Status codes	📍4.0.1	FHIR Std.
MedicationStatement.​category	Base	required	Immunosuppressant Phase ValueSet	📦0.1.0-ci-build	This IG
MedicationStatement.​reasonCode	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.additionalInstruction	Base	example	SNOMED CT Additional Dosage Instructions	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​durationUnit	Base	required	UnitsOfTime	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​periodUnit	Base	required	UnitsOfTime	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​dayOfWeek	Base	required	DaysOfWeek	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.repeat.​when	Base	required	EventTiming	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.timing.code	Base	preferred	TimingAbbreviation	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.asNeeded[x]	Base	example	SNOMED CT Medication As Needed Reason Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.site	Base	example	SNOMED CT Anatomical Structure for Administration Site Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.route	Base	example	SNOMED CT Route Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.method	Base	example	SNOMED CT Administration Method Codes	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.doseAndRate.type	Base	example	DoseAndRateType	📍4.0.1	FHIR Std.
MedicationStatement.​dosage.doseAndRate.dose[x]:doseQuantity.​code	Base	required	Immunosuppressant Dose Unit ValueSet	📦0.1.0-ci-build	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
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()
pc-dose-1	error	MedicationStatement	A dose SHALL say what period it covers: either dosage.timing gives the frequency, or the unit is a rate (mg/kg/day, mg/m2/day, mg/day). PROTECT-CHILD records the dose per administration, so a DM-sourced record takes the first route. '0.1 mg/kg' on its own does not say per dose or per day, and the two differ by the number of daily administrations.	dosage.doseAndRate.dose.ofType(Quantity).code.exists() implies (dosage.doseAndRate.dose.ofType(Quantity).code in ('mg.kg-1.d-1'|'mg.m-2.d-1'|'mg.d-1') or dosage.timing.repeat.exists())
pc-imm-1	warning	MedicationStatement	A record of rejection treatment SHOULD name the episode it treated.	category.coding.where(code = 'rejection-treatment').exists() implies reasonReference.exists()
tim-1	error	MedicationStatement.dosage.timing.repeat	if there's a duration, there needs to be duration units	duration.empty() or durationUnit.exists()
tim-2	error	MedicationStatement.dosage.timing.repeat	if there's a period, there needs to be period units	period.empty() or periodUnit.exists()
tim-4	error	MedicationStatement.dosage.timing.repeat	duration SHALL be a non-negative value	duration.exists() implies duration >= 0
tim-5	error	MedicationStatement.dosage.timing.repeat	period SHALL be a non-negative value	period.exists() implies period >= 0
tim-6	error	MedicationStatement.dosage.timing.repeat	If there's a periodMax, there must be a period	periodMax.empty() or period.exists()
tim-7	error	MedicationStatement.dosage.timing.repeat	If there's a durationMax, there must be a duration	durationMax.empty() or duration.exists()
tim-8	error	MedicationStatement.dosage.timing.repeat	If there's a countMax, there must be a count	countMax.empty() or count.exists()
tim-9	error	MedicationStatement.dosage.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV)	offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationStatement.dosage.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa	timeOfDay.empty() or when.empty()

This structure is derived from MedicationStatement

Summary

Mandatory: 5 elements
Must-Support: 19 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• Immunosuppressant (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/immunosuppressant)
• Transplant Recipient (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/patient-transplant)
• Visit (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/visit)
• Clinical Event (https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/clinical-event)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationStatement.effective[x]
• The element 1 is sliced based on the value of MedicationStatement.dosage.doseAndRate.dose[x]

Other representations of profile: CSV, Excel, Schematron