XpanDH Hospital Discharge Report, published by XpanDH Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/xpandh-hdr/ and changes regularly. See the Directory of published versions

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Resource Profile: Medication (Xpandh)

This profile represents the constraints applied to the Medication resource by the Xpandh project FHIR Implementation Guide, based on FHIR R4.

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

Usage:

• Refer to this Resource Profile: MedicationRequest and MedicationStatement

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
Medication		0..*	MedicationIPS	Definition of a Medication dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Additional Bindings Purpose Medications - SNOMED CT IPS Free Set candidate WHO ATC - IPS candidate Absent or Unknown Medication - IPS candidate ele-1: All FHIR elements must have a @value or children
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use. ele-1: All FHIR elements must have a @value or children
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred) ele-1: All FHIR elements must have a @value or children
ingredient	S	0..*	BackboneElement	Active or inactive ingredient ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances ele-1: All FHIR elements must have a @value or children
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator ele-1: All FHIR elements must have a @value or children rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.code	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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	Medication	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	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	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()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

This structure is derived from MedicationIPS

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	MedicationIPS	Definition of a Medication
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	MedicationIPS	Definition of a Medication
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	Business identifier for this medication
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Additional Bindings Purpose Medications - SNOMED CT IPS Free Set candidate WHO ATC - IPS candidate Absent or Unknown Medication - IPS candidate
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer	Σ	0..1	Reference(Organization)	Manufacturer of the item
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
amount	Σ	0..1	Ratio	Amount of drug in package
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
isActive		0..1	boolean	Active ingredient indicator
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
batch		0..1	BackboneElement	Details about packaged medications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
lotNumber		0..1	string	Identifier assigned to batch
expirationDate		0..1	dateTime	When batch will expire
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Medication.code	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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	Medication	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	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	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()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

This structure is derived from MedicationIPS

Summary

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	MedicationIPS	Definition of a Medication dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Additional Bindings Purpose Medications - SNOMED CT IPS Free Set candidate WHO ATC - IPS candidate Absent or Unknown Medication - IPS candidate ele-1: All FHIR elements must have a @value or children
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use. ele-1: All FHIR elements must have a @value or children
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred) ele-1: All FHIR elements must have a @value or children
ingredient	S	0..*	BackboneElement	Active or inactive ingredient ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances ele-1: All FHIR elements must have a @value or children
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator ele-1: All FHIR elements must have a @value or children rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.code	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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	Medication	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	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	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()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Differential View

This structure is derived from MedicationIPS

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	MedicationIPS	Definition of a Medication
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Medication		0..*	MedicationIPS	Definition of a Medication
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	Business identifier for this medication
code	S	1..1	CodeableConceptIPS	Medication that was administered or was to be administered (medication code from any code system) Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication Additional Bindings Purpose Medications - SNOMED CT IPS Free Set candidate WHO ATC - IPS candidate Absent or Unknown Medication - IPS candidate
status	?!Σ	0..1	code	active | inactive | entered-in-error Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer	Σ	0..1	Reference(Organization)	Manufacturer of the item
form	S	0..1	CodeableConceptIPS	Concept - reference to a terminology or just text Binding: Medicine Doseform - IPS (preferred)
amount	Σ	0..1	Ratio	Amount of drug in package
ingredient	S	0..*	BackboneElement	Active or inactive ingredient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	S	1..1		The actual ingredient or content Binding: Medicine Active Substances - IPS (preferred): SNOMED CT drug substances
itemCodeableConcept			CodeableConcept(CodeableConceptIPS)
itemReference			Reference(Substance | Medication)
isActive		0..1	boolean	Active ingredient indicator
strength	SC	0..1	RatioIPS	A ratio of two Quantity values - a numerator and a denominator rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
batch		0..1	BackboneElement	Details about packaged medications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
lotNumber		0..1	string	Identifier assigned to batch
expirationDate		0..1	dateTime	When batch will expire
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Medication.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Medication.code	preferred	MedicationSnomedCodesAbsentUnknown http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-absent-unknown-uv-ips
Medication.status	required	Medication Status Codes http://hl7.org/fhir/ValueSet/medication-status|4.0.1 from the FHIR Standard
Medication.form	preferred	MedicineDoseFormUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform
Medication.ingredient.item[x]	preferred	MedicineActiveSubstancesUvIps http://hl7.org/fhir/uv/ips/ValueSet/medicine-active-substances-uv-ips

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Medication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Medication	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	Medication	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	Medication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Medication	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()
rat-1	error	Medication.ingredient.strength	Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

This structure is derived from MedicationIPS

Summary

Other representations of profile: CSV, Excel, Schematron