XpanDH Hospital Discharge Report
0.1.0 - ci-build 150

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

## Resource Profile: MedicationStatement

Official URL: http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/MedicationStatement-eu-xpandh | Version: 0.1.0
Draft as of 2025-10-10 | Computable Name: MedicationStatementXpandh
Copyright/Legal: Used by permission of the XpanDH project, all rights reserved Creative Commons License

This profile constrains the MedicationStatement IPS FHIR profile for the purpose of the XpanDH project.

Usages:

- Refer to this Profile: Composition: Hospital Discharge Report

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 |  | 0..* | MedicationStatementIPS | 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] | S Σ | 1..1 |  | What medication was taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medicationReference |  |  | Reference(Medication (Xpandh)) |
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
subject | S Σ | 1..1 | Reference(Patient: HDR) | Who is/was taking the medication
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
effective[x] | S Σ | 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
extension: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 |
reasonCode |  | 0..* | CodeableConcept | Reason (e.g. the Rare Disease) 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 Xpandh Profile | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
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 | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | Medications - SNOMED CT + Absent/Unknown (IPS) | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.

#### 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()`

This structure is derived from MedicationStatementIPS

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementIPS | Record of medication being taken by a patient
status |  | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x] |  | 1..1 |  | What medication was taken
medicationReference |  |  | Reference(Medication (Xpandh)) |
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
subject |  | 1..1 | Reference(Patient: HDR) | Who is/was taking the medication
reasonCode |  | 0..* | CodeableConcept | Reason (e.g. the Rare Disease) for why the medication is being/was taken
reasonReference |  | 0..* | Reference(Condition Xpandh Profile | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementIPS | 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 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 | 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] | S Σ | 1..1 |  | What medication was taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medicationReference |  |  | Reference(Medication (Xpandh)) |
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
subject | S Σ | 1..1 | Reference(Patient: HDR) | 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 | S Σ C | 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] | S Σ | 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
extension: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 (e.g. the Rare Disease) 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 Xpandh Profile | 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 | S Σ | 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 | S Σ | 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 | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | preferred | Common Languages | 📦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 | preferred | Medication usage category codes | 📦4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | Medications - SNOMED CT + Absent/Unknown (IPS) | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
MedicationStatement.​subject.type | Base | extensible | ResourceType | 📦4.0.1 | FHIR Std.
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.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 | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
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.

#### 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()`

This structure is derived from MedicationStatementIPS

Summary

Structures

This structure refers to these other structures:

- Medication (Xpandh) (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/medication-xpandh)
- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient: HDR (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Patient-eu-xpandh)
- Condition Xpandh Profile (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/condition-hdr-xpandh)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementIPS | 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] | S Σ | 1..1 |  | What medication was taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medicationReference |  |  | Reference(Medication (Xpandh)) |
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
subject | S Σ | 1..1 | Reference(Patient: HDR) | Who is/was taking the medication
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
effective[x] | S Σ | 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
extension: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 |
reasonCode |  | 0..* | CodeableConcept | Reason (e.g. the Rare Disease) 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 Xpandh Profile | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
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 | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | Medications - SNOMED CT + Absent/Unknown (IPS) | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📦4.0.1 | FHIR Std.

#### 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()`

Differential View

This structure is derived from MedicationStatementIPS

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementIPS | Record of medication being taken by a patient
status |  | 1..1 | code | active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
medication[x] |  | 1..1 |  | What medication was taken
medicationReference |  |  | Reference(Medication (Xpandh)) |
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
subject |  | 1..1 | Reference(Patient: HDR) | Who is/was taking the medication
reasonCode |  | 0..* | CodeableConcept | Reason (e.g. the Rare Disease) for why the medication is being/was taken
reasonReference |  | 0..* | Reference(Condition Xpandh Profile | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementIPS | 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 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 | 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] | S Σ | 1..1 |  | What medication was taken Binding: Medications - SNOMED CT + Absent/Unknown (IPS) (preferred): SNOMED CT medications (Pharmaceutical / biologic product) or a code for absent/unknown medication
medicationReference |  |  | Reference(Medication (Xpandh)) |
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
subject | S Σ | 1..1 | Reference(Patient: HDR) | 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 | S Σ C | 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] | S Σ | 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
extension: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 (e.g. the Rare Disease) 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 Xpandh Profile | 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 | S Σ | 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 | S Σ | 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 | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | preferred | Common Languages | 📦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 | preferred | Medication usage category codes | 📦4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | preferred | Medications - SNOMED CT + Absent/Unknown (IPS) | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
MedicationStatement.​subject.type | Base | extensible | ResourceType | 📦4.0.1 | FHIR Std.
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.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 | preferred | Medicine Route of Administration - IPS | 📦1.1.0 | International Patient Summary Implementation Guide v1.1
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.

#### 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()`

This structure is derived from MedicationStatementIPS

Summary

Structures

This structure refers to these other structures:

- Medication (Xpandh) (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/medication-xpandh)
- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Patient: HDR (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/Patient-eu-xpandh)
- Condition Xpandh Profile (http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/condition-hdr-xpandh)

Other representations of profile: CSV, Excel, Schematron