{ "resourceType": "StructureDefinition", "id": "medicationstatement-ca-core", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger": 2 } ], "url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medicationstatement-ca-core", "version": "1.1.0", "name": "MedicationStatementCACore", "title": "Medication Statement (CA-Core)", "status": "active", "experimental": false, "date": "2025-08-27", "publisher": "Canada Health Infoway", "contact": [ { "name": "National Standards Release Centre", "telecom": [ { "system": "url", "value": "http://www.infoway-inforoute.ca" }, { "system": "email", "value": "standards@infoway-inforoute.ca" } ] } ], "description": "This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context.", "jurisdiction": [ { "coding": [ { "code": "CA", "system": "urn:iso:std:iso:3166" } ] } ], "copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).", "fhirVersion": "4.0.1", "mapping": [ { "identity": "CACDI", "name": "Canadian Core Data for Interoperability (CACDI)", "comment": "Mapping for MedicationStatementCACore to Canadian Core Data for Interoperability (CACDI)." } ], "kind": "resource", "abstract": false, "type": "MedicationStatement", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement", "derivation": "constraint", "differential": { "element": [ { "id": "MedicationStatement.extension", "path": "MedicationStatement.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" } }, { "id": "MedicationStatement.extension:RenderedDosageInstruction", "path": "MedicationStatement.extension", "sliceName": "RenderedDosageInstruction", "short": "Extension for representing rendered dosage instruction.", "definition": "A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.", "comment": "Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage" ] } ] }, { "id": "MedicationStatement.status", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "SHALL:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.status", "mustSupport": true }, { "id": "MedicationStatement.medication[x]", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "SHALL:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.medication[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "comment": "The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.", "mustSupport": true }, { "id": "MedicationStatement.medication[x]:medicationReference", "path": "MedicationStatement.medication[x]", "sliceName": "medicationReference", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core" ] } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept", "path": "MedicationStatement.medication[x]", "sliceName": "medicationCodeableConcept", "comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept", "profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ] } ], "binding": { "strength": "preferred", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding", "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts" }, { "url": "documentation", "valueMarkdown": "ValueSet for licensed natural health products" } ] }, { "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" }, { "url": "documentation", "valueMarkdown": "per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis" } ], "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding" }, { "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" }, { "url": "documentation", "valueMarkdown": "per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets" } ], "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding" }, { "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/DIN" }, { "url": "documentation", "valueMarkdown": "A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada" } ], "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding" } ] }, "mapping": [ { "identity": "CACDI", "map": "Medication" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system", "path": "MedicationStatement.medication[x].coding.system", "mapping": [ { "identity": "CACDI", "map": "Drug Code System URI" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display", "path": "MedicationStatement.medication[x].coding.display", "mapping": [ { "identity": "CACDI", "map": "Drug English Description" }, { "identity": "CACDI", "map": "Drug French Description" } ] }, { "id": "MedicationStatement.subject", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "SHALL:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.subject", "type": [ { "code": "Reference", "targetProfile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core", "http://hl7.org/fhir/StructureDefinition/Group" ] } ], "mustSupport": true }, { "id": "MedicationStatement.effective[x]", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "SHALL:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.effective[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "mustSupport": true }, { "id": "MedicationStatement.effective[x]:effectivePeriod", "path": "MedicationStatement.effective[x]", "sliceName": "effectivePeriod", "min": 0, "max": "1", "type": [ { "code": "Period" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.end", "path": "MedicationStatement.effective[x].end", "mapping": [ { "identity": "CACDI", "map": "Medication End Date and Time" } ] }, { "id": "MedicationStatement.reasonCode", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "MAY:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.reasonCode", "type": [ { "code": "CodeableConcept", "profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ] } ], "binding": { "strength": "preferred", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding", "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse" }, { "url": "documentation", "valueMarkdown": " Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)" } ] }, { "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode" }, { "url": "documentation", "valueMarkdown": "A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment" } ], "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding" } ] }, "mapping": [ { "identity": "CACDI", "map": "Medication Reason" } ] }, { "id": "MedicationStatement.reasonReference", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "MAY:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.reasonReference", "mapping": [ { "identity": "CACDI", "map": "Medication Reason" } ] }, { "id": "MedicationStatement.dosage", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "SHALL:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.dosage" }, { "id": "MedicationStatement.dosage.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/obligation", "extension": [ { "url": "code", "valueCode": "SHALL:populate-if-known" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" } ] }, { "extension": [ { "url": "code", "valueCode": "SHALL:no-error" }, { "url": "actor", "valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" } ], "url": "http://hl7.org/fhir/StructureDefinition/obligation" } ], "path": "MedicationStatement.dosage.text" }, { "id": "MedicationStatement.dosage.timing", "path": "MedicationStatement.dosage.timing", "mapping": [ { "identity": "CACDI", "map": "Medication Timing" } ] }, { "id": "MedicationStatement.dosage.route", "path": "MedicationStatement.dosage.route", "type": [ { "code": "CodeableConcept", "profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ] } ], "binding": { "strength": "preferred", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding", "extension": [ { "url": "purpose", "valueCode": "candidate" }, { "url": "valueSet", "valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration" }, { "url": "documentation", "valueMarkdown": "Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." } ] } ], "description": "SCTCA Route of Administration" }, "mapping": [ { "identity": "CACDI", "map": "Medication Route of Administration" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.dose[x]", "path": "MedicationStatement.dosage.doseAndRate.dose[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "comment": "Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range", "binding": { "strength": "preferred", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit", "description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set" } }, { "id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity", "path": "MedicationStatement.dosage.doseAndRate.dose[x]", "sliceName": "doseQuantity", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ] } ] }, { "id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value", "path": "MedicationStatement.dosage.doseAndRate.dose[x].value", "mapping": [ { "identity": "CACDI", "map": "Medication Dose Value" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit", "path": "MedicationStatement.dosage.doseAndRate.dose[x].unit", "mapping": [ { "identity": "CACDI", "map": "Medication Dose Unit of Measure" } ] } ] } }