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See the Directory of published versions

Example StructureDefinition/MedicationUsage (XML)

Pharmacy Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Encounter, Patient, Practitioner, RelatedPerson

Raw XML (canonical form + also see XML Format Specification)

Jump past Narrative

StructureDefinition for medicationusage

<?xml version="1.0" encoding="UTF-8"?>

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="MedicationUsage"/> 
  <meta> 
    <lastUpdated value="2022-09-28T21:45:00.467+00:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
       top;">
        <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align:
         top">
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAJUlEQVR4Xu3IIQEAAAgDsHd9/w4EQIOamFnaBgAA4M
          MKAACAKwNp30CqZFfFmwAAAABJRU5ErkJggg==)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
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            wRholJH397AOXcTwHTfzQ1n7q6NnYEAy+DWQVNwKWQJ6vcx557Se7HAzIN1M9rCwVteA/rAYDRRICQgSZEr7WLYO3bzJVJ
            GQBu0D74PkoHkoBnIHvjfkO9AGABmDHCjFWgH8i7kPQh9yEeYH4DfLhBJgA2A7BBQJ9uwXWY3rhJqFo1AaiB1CBngwKZQc
            qAeSFSduL9Akj7qPF64jnALS5VTPwdgPwwJ+uog9Qcx4kRZiPKqxgAAAABJRU5ErkJggg==" style="background-color: white; background-color: inherit" title="Resource"/>  
            <span title="MedicationUsage : A record of a medication that is being consumed by a patient.
               A MedicationUsage may indicate that the patient may be taking the medication
             now or has taken the medication in the past or will be taking the medication in
             the future.  The source of this information can be the patient, significant other
             (such as a family member or spouse), or a clinician.  A common scenario where this
             information is captured is during the history taking process during a patient visit
             or stay.   The medication information may come from sources such as the patient's
             memory, from a prescription bottle,  or from a list of medications the patient,
             clinician or other party maintains. 

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

The MedicationUsage resource was previously called MedicationStatement.">MedicationUsage</span> 
            <a name="MedicationUsage"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold;
             color: black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Record of medication being taken by a patient
            <br/>  
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned,
             this value never changes.">id</a> , 
            <a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.
             Changes to the content might not always be associated with version changes to the
             resource.">meta</a> , 
            <a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed,
             and which must be understood when processing the content. Often, this is a reference
             to an implementation guide that defines the special rules along with other profiles
             etc.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource and can be used
             to represent the content of the resource to a human. The narrative need not encode
             all the structured data, but is required to contain sufficient detail to make it
             &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
             may define what content should be represented in the narrative to ensure clinical
             safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that
             contains them - they cannot be identified independently, nor can they have their
             own independent transaction scope. This is allowed to be a Parameters resource
             if and only if it is referenced by a resource that provides context/meaning.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource. To make the use of extensions safe and manageable, there is a
             strict set of governance  applied to the definition and use of extensions. Though
             any implementer can define an extension, there is a set of requirements that SHALL
             be met as part of the definition of the extension.">extension</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition
             of the resource and that modifies the understanding of the element that contains
             it and/or the understanding of the containing element's descendants. Usually modifier
             elements provide negation or qualification. To make the use of extensions safe
             and manageable, there is a strict set of governance applied to the definition and
             use of extensions. Though any implementer is allowed to define an extension, there
             is a set of requirements that SHALL be met as part of the definition of the extension.
             Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
             DomainResource (including cannot change the meaning of modifierExtension itself).">modifierExtension</a> 
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
          EwfT6/ddA0GBAxO3NrLlKUj9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcS
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            AAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYwbdkoBPnaQkosbG3d3VEpSUlonUoY1Gzo6QkI8SrGxWBOFG4uySgY
            5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iSFVResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuq
            oTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="MedicationUsage.identifier : Identifiers associated with this Medication Usage
             that are defined by business processes and/or used to refer to it when a direct
             URL reference to the resource itself is not appropriate. They are business identifiers
             assigned to this resource by the performer or other systems and remain constant
             as the resource is updated and propagates from server to server.">identifier</span> 
            <a name="MedicationUsage.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">External identifier
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            2P4//8/AxMDAwNdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1
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            6TFi6cHULyz8KOjC7OIQKlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationUsage.partOf : A larger event of which this particular MedicationUsage
             is a component or step.">partOf</span> 
            <a name="MedicationUsage.partOf"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="procedure.html">Procedure</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Part of referenced event
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
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            uYFBgCNmhP4OvTRgwAAAABJRU5ErkJggg==" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="MedicationUsage.status : A code representing the status of recording the medication
             usage.">status</span> 
            <a name="MedicationUsage.status"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">recorded | entered-in-error | draft
            <br/>  
            <a href="valueset-medication-usage-status.html">MedicationUsage Status Codes</a>  (
            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value
             set.">Required</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
          e64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAwEwfT6/ddA0GBAxO3NrLlKUj
          9263wAAAAvrgEAADClAVWFQIBRHMicAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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            <span title="MedicationUsage.category : Type of medication usage (for example, drug classification
             like ATC, where meds would be administered, legal category of the medication.).">category</span> 
            <a name="MedicationUsage.category"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Type of medication usage
            <br/>  
            <a href="valueset-medicationrequest-admin-location.html">medicationRequest Administration Location Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <span title="MedicationUsage.medication : Identifies the medication being administered. This
             is either a link to a resource representing the details of the medication or a
             simple attribute carrying a code that identifies the medication from a known list
             of medications.">medication</span> 
            <a name="MedicationUsage.medication"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#CodeableReference">CodeableReference</a> (
            <a href="medication.html">Medication</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">What medication was taken
            <br/>  
            <a href="valueset-medication-codes.html">SNOMED CT Medication Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1
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            6TFi6cHULyz8KOjC7OIQKlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationUsage.subject : The person, animal or group who is/was taking the medication.">subject</span> 
            <a name="MedicationUsage.subject"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="group.html">Group</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Who is/was taking  the medication
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image:
           url(data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAALUlEQVR4Xu3IoREAIAw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1
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            <span title="MedicationUsage.encounter : The encounter that establishes the context for this
             MedicationUsage.">encounter</span> 
            <a name="MedicationUsage.encounter"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="encounter.html">Encounter</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Encounter associated with MedicationUsage
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;bas
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <span title="MedicationUsage.effective[x] : The interval of time during which it is being asserted
             that the patient is/was/will be taking the medication (or was not taking, when
             the MedicationUsage.adherence element is Not Taking).">effective[x]</span> 
            <a name="MedicationUsage.effective_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">The date/time or interval when the medication is/was/will be taken
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
         #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpw
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            uYFBgCNmhP4OvTRgwAAAABJRU5ErkJggg==" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="A date, date-time or partial date (e.g. just year or year + month).  If hours and
             minutes are specified, a UTC offset SHALL be populated. The format is a union of
             the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided
             due to schema type constraints but may be zero-filled and may be ignored.     
                        Dates SHALL be valid dates.">effectiveDateTime</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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            <span title="A time period defined by a start and end date and optionally time.">effectivePeriod</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="datatypes.html#Period">Period</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
        </tr> 

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            <span title="MedicationUsage.dateAsserted : The date when the Medication Usage was asserted
             by the information source.">dateAsserted</span> 
            <a name="MedicationUsage.dateAsserted"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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            <span title="MedicationUsage.informationSource : The person or organization that provided the
             information about the taking of this medication. Note: Use derivedFrom when a MedicationUsage
             is derived from other resources, e.g. Claim or MedicationRequest.">informationSource</span> 
            <a name="MedicationUsage.informationSource"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a>  | 
            <a href="relatedperson.html">RelatedPerson</a>  | 
            <a href="organization.html">Organization</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Person or organization that provided the information about the taking of this medication
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <span title="MedicationUsage.derivedFrom : Allows linking the MedicationUsage to the underlying
             MedicationRequest, or to other information that supports or is used to derive the
             MedicationUsage.">derivedFrom</span> 
            <a name="MedicationUsage.derivedFrom"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <span title="MedicationUsage.reason : A concept, Condition or observation that supports why
             the medication is being/was taken.">reason</span> 
            <a name="MedicationUsage.reason"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="references.html#CodeableReference">CodeableReference</a> (
            <a href="condition.html">Condition</a>  | 
            <a href="observation.html">Observation</a>  | 
            <a href="diagnosticreport.html">DiagnosticReport</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Reason for why the medication is being/was taken
            <br/>  
            <a href="valueset-condition-code.html">Condition/Problem/Diagnosis Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
            <br/>  
          </td> 
        </tr> 

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            <span title="MedicationUsage.note : Provides extra information about the Medication Usage that
             is not conveyed by the other attributes.">note</span> 
            <a name="MedicationUsage.note"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="datatypes.html#Annotation">Annotation</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Further information about the usage
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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            <span title="MedicationUsage.relatedClinicalInformation : Link to information that is relevant
             to a medication usage, for example, illicit drug use, gestational age, etc.">relatedClinicalInformation</span> 
            <a name="MedicationUsage.relatedClinicalInformation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="observation.html">Observation</a>  | 
            <a href="condition.html">Condition</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Link to information relevant to the usage of a medication
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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            <span title="MedicationUsage.renderedDosageInstruction : The full representation of the dose
             of the medication included in all dosage instructions.  To be used when multiple
             dosage instructions are included to represent complex dosing such as increasing
             or tapering doses.">renderedDosageInstruction</span> 
            <a name="MedicationUsage.renderedDosageInstruction"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <a href="datatypes.html#string">string</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <span title="MedicationUsage.dosage : Indicates how the medication is/was or should be taken
             by the patient.">dosage</span> 
            <a name="MedicationUsage.dosage"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <a href="dosage.html#Dosage">Dosage</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Details of how medication is/was taken or should be taken
            <br/>  
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <span title="MedicationUsage.adherence : Indicates if the medication is being consumed or administered
             as instructed.">adherence</span> 
            <a name="MedicationUsage.adherence"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="types.html#BackBoneElement">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Indicates if the medication is being consumed or administered as instructed
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
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            <span title="MedicationUsage.adherence.code : Type of the adherence for the medication.">code</span> 
            <a name="MedicationUsage.adherence.code"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Type of adherence
            <br/>  
            <a href="valueset-medication-usage-adherence.html">MedicationUsage Adherence Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color:
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpw
            YAAAAB3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcS
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            5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iSFVResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuq
            oTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="MedicationUsage.adherence.reason : Captures the reason for the current use or adherence
             of a medication.">reason</span> 
            <a name="MedicationUsage.adherence.reason"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px
           #F0F0F0 solid; padding:0px 4px 0px 4px">Details of the reason for the current use of the medication
            <br/>  
            <a href="valueset-reason-medication-status-codes.html">SNOMED CT Drug Therapy Status codes </a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value
             set.  The value set merely provides examples of the types of concepts intended
             to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="phx"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/MedicationUsage"/> 
  <version value="5.0.0-cibuild"/> 
  <name value="MedicationUsage"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2022-09-28T21:45:00+00:00"/> 
  <publisher value="Health Level Seven International (Pharmacy)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/medication/index.cfm"/> 
    </telecom> 
  </contact> 
  <description value="A record of a medication that is being consumed by a patient.   A MedicationUsage
   may indicate that the patient may be taking the medication now or has taken the
   medication in the past or will be taking the medication in the future.  The source
   of this information can be the patient, significant other (such as a family member
   or spouse), or a clinician.  A common scenario where this information is captured
   is during the history taking process during a patient visit or stay.   The medication
   information may come from sources such as the patient's memory, from a prescription
   bottle,  or from a list of medications the patient, clinician or other party maintains.
   

The primary difference between a medicationusage and a medicationadministration
   is that the medication administration has complete administration information and
   is based on actual administration information from the person who administered
   the medication.  A medicationusage is often, if not always, less specific.  There
   is no required date/time when the medication was administered, in fact we only
   know that a source has reported the patient is taking this medication, where details
   such as time, quantity, or rate or even medication product may be incomplete or
   missing or less precise.  As stated earlier, the Medication Usage information may
   come from the patient's memory, from a prescription bottle or from a list of medications
   the patient, clinician or other party maintains.  Medication administration is
   more formal and is not missing detailed information."/> 
  <fhirVersion value="5.0.0-cibuild"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 v2 Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="MedicationUsage"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="MedicationUsage">
      <path value="MedicationUsage"/> 
      <short value="Record of medication being taken by a patient"/> 
      <definition value="A record of a medication that is being consumed by a patient.   A MedicationUsage
       may indicate that the patient may be taking the medication now or has taken the
       medication in the past or will be taking the medication in the future.  The source
       of this information can be the patient, significant other (such as a family member
       or spouse), or a clinician.  A common scenario where this information is captured
       is during the history taking process during a patient visit or stay.   The medication
       information may come from sources such as the patient's memory, from a prescription
       bottle,  or from a list of medications the patient, clinician or other party maintains.
       

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

The MedicationUsage resource was previously called MedicationStatement."/> 
      <alias value="MedicationStatement"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="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"/> 
        <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofTy
        pe(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url)))
         or descendants().where(reference = '#').exists() or descendants().where(as(canonical)
         = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched
        ', id).empty()"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f
        :reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@va
        lue='#']))]))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId
         or a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdat
        ed))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can
           display the resource to a human safely. Including a human readable representation
           in the resource makes for a much more robust eco-system and cheaper handling of
           resources by intermediary systems. Some ecosystems restrict distribution of resources
           to only those systems that do fully understand the resources, and as a consequence
           implementers may believe that the narrative is superfluous. However experience
           shows that such eco-systems often open up to new participants over time."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <xpath value="exists(f:text/h:div)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.id">
      <path value="MedicationUsage.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
       for cases like the create and conditional update. Otherwise, the use of the resouce
       id depends on the given use case."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationUsage.meta">
      <path value="MedicationUsage.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the
       resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationUsage.implicitRules">
      <path value="MedicationUsage.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed,
       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles
       etc."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited
       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of it's narrative along with other profiles,
       value sets, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationUsage.language">
      <path value="MedicationUsage.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="Language is provided to support indexing and accessibility (typically, services
       such as text to speech use the language tag). The html language tag in the narrative
       applies  to the narrative. The language tag on the resource may be used to specify
       the language of other presentations generated from the data in the resource. Not
       all the content has to be in the base language. The Resource.language should not
       be assumed to apply to the narrative automatically. If a language is specified,
       it should it also be specified on the div element in the html (see rules in HTML5
       for information about the relationship between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="MedicationUsage.text">
      <path value="MedicationUsage.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="A human-readable narrative that contains a summary of the resource and can be used
       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical
       safety."/> 
      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated
       and encoded information is added later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.contained">
      <path value="MedicationUsage.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that
       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource
       if and only if it is referenced by a resource that provides context/meaning."/> 
      <comment value="This should never be done when the content can be identified properly, as once
       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.extension">
      <path value="MedicationUsage.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. To make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though
       any implementer can define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.modifierExtension">
      <path value="MedicationUsage.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.identifier">
      <path value="MedicationUsage.identifier"/> 
      <short value="External identifier"/> 
      <definition value="Identifiers associated with this Medication Usage that are defined by business
       processes and/or used to refer to it when a direct URL reference to the resource
       itself is not appropriate. They are business identifiers assigned to this resource
       by the performer or other systems and remain constant as the resource is updated
       and propagates from server to server."/> 
      <comment value="This is a business identifier, not a resource identifier."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.partOf">
      <path value="MedicationUsage.partOf"/> 
      <short value="Part of referenced event"/> 
      <definition value="A larger event of which this particular MedicationUsage is a component or step."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.partOf"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or
         OBS,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.status">
      <path value="MedicationUsage.status"/> 
      <short value="recorded | entered-in-error | draft"/> 
      <definition value="A code representing the status of recording the medication usage."/> 
      <comment value="This status concerns just the recording of the medication usage.  MedicationUsage.adherence
       should be used for indicating a patient's adherence to the information in this
       resource.  Note, the statuses are different than in previous releases for MedicationUsage
       or MedicationStatement.

This element is labeled as a modifier because the status contains codes that mark
       the resource as not currently valid."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
       status entered-in-error which means that the resource should not be treated as
       valid"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="A coded concept indicating the current status of a MedicationUsage."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-usage-status|5.0.0-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.category">
      <path value="MedicationUsage.category"/> 
      <short value="Type of medication usage"/> 
      <definition value="Type of medication usage (for example, drug classification like ATC, where meds
       would be administered, legal category of the medication.)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.category"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageAdministrationLocation"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying where the medication included in the MedicationUsage
         is expected to be consumed or administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-admin-location"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type
         of medication usage&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.medication">
      <path value="MedicationUsage.medication"/> 
      <short value="What medication was taken"/> 
      <definition value="Identifies the medication being administered. This is either a link to a resource
       representing the details of the medication or a simple attribute carrying a code
       that identifies the medication from a known list of medications."/> 
      <comment value="If only a code is specified, then it needs to be a code for a specific product.
       If more information is required, then the use of the medication resource is recommended.
        For example, if you require form or lot number, then you must reference the Medication
       resource."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.medication"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableReference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying the substance or product being taken."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-codes"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.subject">
      <path value="MedicationUsage.subject"/> 
      <short value="Who is/was taking  the medication"/> 
      <definition value="The person, animal or group who is/was taking the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.subject"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3 Patient ID List"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.encounter">
      <path value="MedicationUsage.encounter"/> 
      <short value="Encounter associated with MedicationUsage"/> 
      <definition value="The encounter that establishes the context for this MedicationUsage."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.encounter"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type
         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.effective[x]">
      <path value="MedicationUsage.effective[x]"/> 
      <short value="The date/time or interval when the medication is/was/will be taken"/> 
      <definition value="The interval of time during which it is being asserted that the patient is/was/will
       be taking the medication (or was not taking, when the MedicationUsage.adherence
       element is Not Taking)."/> 
      <comment value="This attribute reflects the period over which the patient consumed the medication
       and is expected to be populated on the majority of Medication Usages. If the medication
       is still being taken and is expected to continue indefinitely at the time the usage
       is recorded, the &quot;end&quot; date will be omitted.  If the end date is known,
       then it is included as the &quot;end date&quot;.  The date/time attribute supports
       a variety of dates - year, year/month and exact date.  If something more than this
       is required, this should be conveyed as text."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.effective[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.done[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.dateAsserted">
      <path value="MedicationUsage.dateAsserted"/> 
      <short value="When the usage was asserted?"/> 
      <definition value="The date when the Medication Usage was asserted by the information source."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.dateAsserted"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.informationSource">
      <path value="MedicationUsage.informationSource"/> 
      <short value="Person or organization that provided the information about the taking of this medication"/> 
      <definition value="The person or organization that provided the information about the taking of this
       medication. Note: Use derivedFrom when a MedicationUsage is derived from other
       resources, e.g. Claim or MedicationRequest."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.informationSource"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.source"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practitioner or Related
         Person (if PAT is the informer, then syntax for self-reported =true)"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.derivedFrom">
      <path value="MedicationUsage.derivedFrom"/> 
      <short value="Link to information used to derive the MedicationUsage"/> 
      <definition value="Allows linking the MedicationUsage to the underlying MedicationRequest, or to other
       information that supports or is used to derive the MedicationUsage."/> 
      <comment value="Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation
       or QuestionnaireAnswers.  The most common use cases for deriving a MedicationUsage
       comes from creating a MedicationUsage from a MedicationRequest or from a lab observation
       or a claim.  it should be noted that the amount of information that is available
       varies from the type resource that you derive the MedicationUsage from."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.derivedFrom"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.reason">
      <path value="MedicationUsage.reason"/> 
      <short value="Reason for why the medication is being/was taken"/> 
      <definition value="A concept, Condition or observation that supports why the medication is being/was
       taken."/> 
      <comment value="This could be a diagnosis code. If a full condition record exists or additional
       detail is needed, use reasonForUseReference."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.reason"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableReference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying why the medication is being taken."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-code"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.reason"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.note">
      <path value="MedicationUsage.note"/> 
      <short value="Further information about the usage"/> 
      <definition value="Provides extra information about the Medication Usage that is not conveyed by the
       other attributes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.note"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=&quot;annotation&q
        uot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.relatedClinicalInformation">
      <path value="MedicationUsage.relatedClinicalInformation"/> 
      <short value="Link to information relevant to the usage of a medication"/> 
      <definition value="Link to information that is relevant to a medication usage, for example, illicit
       drug use, gestational age, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.relatedClinicalInformation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="TBD"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.renderedDosageInstruction">
      <path value="MedicationUsage.renderedDosageInstruction"/> 
      <short value="Full representation of the dosage instructions"/> 
      <definition value="The full representation of the dose of the medication included in all dosage instructions.
        To be used when multiple dosage instructions are included to represent complex
       dosing such as increasing or tapering doses."/> 
      <requirements value="The content of the renderedDosageInstructions must not be different than the dose
       represented in the dosageInstruction content."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.renderedDosageInstruction"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration.text"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.dosage">
      <path value="MedicationUsage.dosage"/> 
      <short value="Details of how medication is/was taken or should be taken"/> 
      <definition value="Indicates how the medication is/was or should be taken by the patient."/> 
      <comment value="The dates included in the dosage on a Medication Usage reflect the dates for a
       given dose.  For example, &quot;from November 1, 2016 to November 3, 2016, take
       one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets
       daily.&quot;  It is expected that this specificity may only be populated where
       the patient brings in their labeled container or where the Medication Usage is
       derived from a MedicationRequest."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationUsage.dosage"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Dosage"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="refer dosageInstruction mapping"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence">
      <path value="MedicationUsage.adherence"/> 
      <short value="Indicates if the medication is being consumed or administered as instructed"/> 
      <definition value="Indicates if the medication is being consumed or administered as instructed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.adherence"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=PERT].target[classCode=OBV,moodCode=EVN].value[xsi:type=BL]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.id">
      <path value="MedicationUsage.adherence.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
    <!--  Note: special primitive values have a FHIRPath system type. e.g. this is compiler
       magic (j)  -->
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.extension">
      <path value="MedicationUsage.adherence.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and manageable, there is a strict
       set of governance  applied to the definition and use of extensions. Though any
       implementer can define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.modifierExtension">
      <path value="MedicationUsage.adherence.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or
       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification
       to retain a core level of simplicity for everyone."/> 
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition
       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.code">
      <path value="MedicationUsage.adherence.code"/> 
      <short value="Type of adherence"/> 
      <definition value="Type of the adherence for the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.adherence.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageAdherence"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-usage-adherence"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=PERT].target[classCode=OBV,moodCode=EVN].value[xsi:type=BL]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.reason">
      <path value="MedicationUsage.adherence.reason"/> 
      <short value="Details of the reason for the current use of the medication"/> 
      <definition value="Captures the reason for the current use or adherence of a medication."/> 
      <comment value="This is generally only used for &quot;exception&quot; statuses such as &quot;entered-in-error
      &quot;. The reason for performing the event at all is captured in reasonCode, not
       here."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationUsage.adherence.reason"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageStatusReason"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/reason-medication-status-codes"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCode"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="MedicationUsage">
      <path value="MedicationUsage"/> 
      <short value="Record of medication being taken by a patient"/> 
      <definition value="A record of a medication that is being consumed by a patient.   A MedicationUsage
       may indicate that the patient may be taking the medication now or has taken the
       medication in the past or will be taking the medication in the future.  The source
       of this information can be the patient, significant other (such as a family member
       or spouse), or a clinician.  A common scenario where this information is captured
       is during the history taking process during a patient visit or stay.   The medication
       information may come from sources such as the patient's memory, from a prescription
       bottle,  or from a list of medications the patient, clinician or other party maintains.
       

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

The MedicationUsage resource was previously called MedicationStatement."/> 
      <alias value="MedicationStatement"/> 
      <min value="0"/> 
      <max value="*"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.identifier">
      <path value="MedicationUsage.identifier"/> 
      <short value="External identifier"/> 
      <definition value="Identifiers associated with this Medication Usage that are defined by business
       processes and/or used to refer to it when a direct URL reference to the resource
       itself is not appropriate. They are business identifiers assigned to this resource
       by the performer or other systems and remain constant as the resource is updated
       and propagates from server to server."/> 
      <comment value="This is a business identifier, not a resource identifier."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.partOf">
      <path value="MedicationUsage.partOf"/> 
      <short value="Part of referenced event"/> 
      <definition value="A larger event of which this particular MedicationUsage is a component or step."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or
         OBS,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.status">
      <path value="MedicationUsage.status"/> 
      <short value="recorded | entered-in-error | draft"/> 
      <definition value="A code representing the status of recording the medication usage."/> 
      <comment value="This status concerns just the recording of the medication usage.  MedicationUsage.adherence
       should be used for indicating a patient's adherence to the information in this
       resource.  Note, the statuses are different than in previous releases for MedicationUsage
       or MedicationStatement.

This element is labeled as a modifier because the status contains codes that mark
       the resource as not currently valid."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains
       status entered-in-error which means that the resource should not be treated as
       valid"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="A coded concept indicating the current status of a MedicationUsage."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-usage-status|5.0.0-cibuild"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.category">
      <path value="MedicationUsage.category"/> 
      <short value="Type of medication usage"/> 
      <definition value="Type of medication usage (for example, drug classification like ATC, where meds
       would be administered, legal category of the medication.)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageAdministrationLocation"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying where the medication included in the MedicationUsage
         is expected to be consumed or administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-admin-location"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type
         of medication usage&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.medication">
      <path value="MedicationUsage.medication"/> 
      <short value="What medication was taken"/> 
      <definition value="Identifies the medication being administered. This is either a link to a resource
       representing the details of the medication or a simple attribute carrying a code
       that identifies the medication from a known list of medications."/> 
      <comment value="If only a code is specified, then it needs to be a code for a specific product.
       If more information is required, then the use of the medication resource is recommended.
        For example, if you require form or lot number, then you must reference the Medication
       resource."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableReference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying the substance or product being taken."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-codes"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.subject">
      <path value="MedicationUsage.subject"/> 
      <short value="Who is/was taking  the medication"/> 
      <definition value="The person, animal or group who is/was taking the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3 Patient ID List"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.encounter">
      <path value="MedicationUsage.encounter"/> 
      <short value="Encounter associated with MedicationUsage"/> 
      <definition value="The encounter that establishes the context for this MedicationUsage."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type
         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.effective[x]">
      <path value="MedicationUsage.effective[x]"/> 
      <short value="The date/time or interval when the medication is/was/will be taken"/> 
      <definition value="The interval of time during which it is being asserted that the patient is/was/will
       be taking the medication (or was not taking, when the MedicationUsage.adherence
       element is Not Taking)."/> 
      <comment value="This attribute reflects the period over which the patient consumed the medication
       and is expected to be populated on the majority of Medication Usages. If the medication
       is still being taken and is expected to continue indefinitely at the time the usage
       is recorded, the &quot;end&quot; date will be omitted.  If the end date is known,
       then it is included as the &quot;end date&quot;.  The date/time attribute supports
       a variety of dates - year, year/month and exact date.  If something more than this
       is required, this should be conveyed as text."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="Period"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.done[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.dateAsserted">
      <path value="MedicationUsage.dateAsserted"/> 
      <short value="When the usage was asserted?"/> 
      <definition value="The date when the Medication Usage was asserted by the information source."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=AUT].time"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.informationSource">
      <path value="MedicationUsage.informationSource"/> 
      <short value="Person or organization that provided the information about the taking of this medication"/> 
      <definition value="The person or organization that provided the information about the taking of this
       medication. Note: Use derivedFrom when a MedicationUsage is derived from other
       resources, e.g. Claim or MedicationRequest."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.source"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practitioner or Related
         Person (if PAT is the informer, then syntax for self-reported =true)"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.derivedFrom">
      <path value="MedicationUsage.derivedFrom"/> 
      <short value="Link to information used to derive the MedicationUsage"/> 
      <definition value="Allows linking the MedicationUsage to the underlying MedicationRequest, or to other
       information that supports or is used to derive the MedicationUsage."/> 
      <comment value="Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation
       or QuestionnaireAnswers.  The most common use cases for deriving a MedicationUsage
       comes from creating a MedicationUsage from a MedicationRequest or from a lab observation
       or a claim.  it should be noted that the amount of information that is available
       varies from the type resource that you derive the MedicationUsage from."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.reason">
      <path value="MedicationUsage.reason"/> 
      <short value="Reason for why the medication is being/was taken"/> 
      <definition value="A concept, Condition or observation that supports why the medication is being/was
       taken."/> 
      <comment value="This could be a diagnosis code. If a full condition record exists or additional
       detail is needed, use reasonForUseReference."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableReference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying why the medication is being taken."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-code"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.reason"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.note">
      <path value="MedicationUsage.note"/> 
      <short value="Further information about the usage"/> 
      <definition value="Provides extra information about the Medication Usage that is not conveyed by the
       other attributes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=&quot;annotation&q
        uot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.relatedClinicalInformation">
      <path value="MedicationUsage.relatedClinicalInformation"/> 
      <short value="Link to information relevant to the usage of a medication"/> 
      <definition value="Link to information that is relevant to a medication usage, for example, illicit
       drug use, gestational age, etc."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="TBD"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.renderedDosageInstruction">
      <path value="MedicationUsage.renderedDosageInstruction"/> 
      <short value="Full representation of the dosage instructions"/> 
      <definition value="The full representation of the dose of the medication included in all dosage instructions.
        To be used when multiple dosage instructions are included to represent complex
       dosing such as increasing or tapering doses."/> 
      <requirements value="The content of the renderedDosageInstructions must not be different than the dose
       represented in the dosageInstruction content."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="string"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="SubstanceAdministration.text"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.dosage">
      <path value="MedicationUsage.dosage"/> 
      <short value="Details of how medication is/was taken or should be taken"/> 
      <definition value="Indicates how the medication is/was or should be taken by the patient."/> 
      <comment value="The dates included in the dosage on a Medication Usage reflect the dates for a
       given dose.  For example, &quot;from November 1, 2016 to November 3, 2016, take
       one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets
       daily.&quot;  It is expected that this specificity may only be populated where
       the patient brings in their labeled container or where the Medication Usage is
       derived from a MedicationRequest."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Dosage"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="refer dosageInstruction mapping"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence">
      <path value="MedicationUsage.adherence"/> 
      <short value="Indicates if the medication is being consumed or administered as instructed"/> 
      <definition value="Indicates if the medication is being consumed or administered as instructed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=PERT].target[classCode=OBV,moodCode=EVN].value[xsi:type=BL]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.code">
      <path value="MedicationUsage.adherence.code"/> 
      <short value="Type of adherence"/> 
      <definition value="Type of the adherence for the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageAdherence"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-usage-adherence"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="outboundRelationship[typeCode=PERT].target[classCode=OBV,moodCode=EVN].value[xsi:type=BL]"/> 
      </mapping> 
    </element> 
    <element id="MedicationUsage.adherence.reason">
      <path value="MedicationUsage.adherence.reason"/> 
      <short value="Details of the reason for the current use of the medication"/> 
      <definition value="Captures the reason for the current use or adherence of a medication."/> 
      <comment value="This is generally only used for &quot;exception&quot; statuses such as &quot;entered-in-error
      &quot;. The reason for performing the event at all is captured in reasonCode, not
       here."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationUsageStatusReason"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/reason-medication-status-codes"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCode"/> 
      </mapping> 
    </element> 
  </differential> 
</StructureDefinition> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.