{ "resourceType": "StructureDefinition", "id": "zib-MedicationUse", "url": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse", "version": "2.2.2", "name": "Zib MedicationUse", "title": "HCIM MedicationUse", "status": "active", "publisher": "Nictiz", "contact": [ { "name": "Nictiz", "telecom": [ { "system": "email", "value": "info@nictiz.nl", "use": "work" } ] } ], "description": "This profile is based on Medicatieproces V9.0.7 and the related Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) MedicationUse version 1.0.1, year 2017.\r\n\r\nMedicationUse is a statement on the historic, current or intended use of a certain medicine.", "purpose": "The goal of the medication use is to provide insight into the patient’s pattern of use.", "copyright": "CC0", "fhirVersion": "3.0.1", "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "uri": "https://zibs.nl/wiki/MedicationUse2-v1.0(2017EN)", "name": "HCIM MedicationUse2-v1.0(2017EN)" }, { "identity": "hcim-timeinterval-v1.0-2017EN", "uri": "https://zibs.nl/wiki/TimeInterval-v1.0(2017EN)", "name": "HCIM Part TimeInterval-v1.0(2017EN)" }, { "identity": "Medication-Process-v09", "uri": "https://decor.nictiz.nl/medicatieproces/mp-html-20181220T121121/ds-2.16.840.1.113883.2.4.3.11.60.20.77.1.3-2016-06-01T000000.html", "name": "Medication Process v09", "comment": "Language of Medication Process is Dutch." }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "uri": "https://zibs.nl/wiki/InstructionsForUse-v1.0(2017EN)", "name": "HCIM InstructionsForUse-v1.0(2017EN)" }, { "identity": "hcim-basicelements-v1.0-2017EN", "uri": "https://zibs.nl/wiki/BasicElements-v1.0(2017EN)", "name": "HCIM BasicElements-v1.0(2017EN)" } ], "kind": "resource", "abstract": false, "type": "MedicationStatement", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement", "derivation": "constraint", "snapshot": { "element": [ { "id": "MedicationStatement", "path": "MedicationStatement", "short": "MedicationUse", "definition": "MedicationUse is a statement on the historic, current or intended use of a certain medicine.", "comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.", "alias": [ "Medicatiegebruik" ], "min": 0, "max": "*", "base": { "path": "Resource", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "DomainResource" }, { "key": "dom-1", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative", "expression": "contained.text.empty()", "xpath": "not(parent::f:contained and f:text)", "source": "DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "DomainResource" }, { "key": "dom-3", "severity": "error", "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource", "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()", "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))", "source": "DomainResource" }, { "key": "mst-1", "severity": "error", "human": "Reason not taken is only permitted if Taken is No", "expression": "reasonNotTaken.exists().not() or (taken = 'n')", "xpath": "not(exists(f:reasonNotTaken)) or f:taken/@value='n'" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "workflow", "map": "..Event" }, { "identity": "rim", "map": "SubstanceAdministration" }, { "identity": "w5", "map": "clinical.medication" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.21338", "comment": "MedicationUse" } ] }, { "id": "MedicationStatement.id", "path": "MedicationStatement.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "code": "id" } ], "isSummary": true }, { "id": "MedicationStatement.meta", "path": "MedicationStatement.meta", "short": "Metadata about the resource", "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.", "min": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "isSummary": true }, { "id": "MedicationStatement.implicitRules", "path": "MedicationStatement.implicitRules", "short": "A set of rules under which this content was created", "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.", "comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "isModifier": true, "isSummary": true }, { "id": "MedicationStatement.language", "path": "MedicationStatement.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "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": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueReference": { "reference": "http://hl7.org/fhir/ValueSet/all-languages" } }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding", "valueBoolean": true } ], "strength": "extensible", "description": "A human language.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/languages" } } }, { "id": "MedicationStatement.text", "path": "MedicationStatement.text", "short": "Text summary of the resource, for human interpretation", "definition": "A human-readable narrative that contains a summary of the resource, and may 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 \"clinically safe\" 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": "Contained resources do not have 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 \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "condition": [ "dom-1" ], "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "MedicationStatement.contained", "path": "MedicationStatement.contained", "short": "Contained, inline Resources", "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.", "comment": "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.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.extension", "path": "MedicationStatement.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.extension:asAgreedIndicator", "path": "MedicationStatement.extension", "sliceName": "asAgreedIndicator", "short": "AsAgreedIndicator", "definition": "Is the medicine used as outlined in the medication agreement?", "comment": "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": [ "extensions", "user content", "VolgensAfspraakIndicator" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22492", "comment": "AsAgreedIndicator" } ] }, { "id": "MedicationStatement.extension:asAgreedIndicator.id", "path": "MedicationStatement.extension.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.extension:asAgreedIndicator.extension", "path": "MedicationStatement.extension.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.extension:asAgreedIndicator.url", "path": "MedicationStatement.extension.url", "representation": [ "xmlAttr" ], "short": "identifies the meaning of the extension", "definition": "Source of the definition for the extension code - a logical name or a URL.", "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.", "min": 1, "max": "1", "base": { "path": "Extension.url", "min": 1, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator", "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.extension:asAgreedIndicator.valueBoolean:valueBoolean", "path": "MedicationStatement.extension.valueBoolean", "sliceName": "valueBoolean", "short": "Value of extension", "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).", "min": 0, "max": "1", "base": { "path": "Extension.value[x]", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "example": [ { "label": "Example of asAgreed", "valueBoolean": true } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.extension:prescriber", "path": "MedicationStatement.extension", "sliceName": "prescriber", "short": "Prescriber", "definition": "The health professional that entered the medication agreement with the patient.", "comment": "The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.", "alias": [ "extensions", "user content", "Voorschrijver" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.23290", "comment": "Prescriber" } ] }, { "id": "MedicationStatement.extension:author", "path": "MedicationStatement.extension", "sliceName": "author", "short": "Author", "definition": "The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.", "comment": "A patient as author maps to the MP9 concept: mp-dataelement900-22472.\r\nA health professional as author maps to the MP9 concept: mp-dataelement900-22473.\r\nA healthcare provider as author maps to the MP9 concept: mp-dataelement900-23994.\r\n\r\nThe health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.", "alias": [ "extensions", "user content", "Auteur" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22471", "comment": "Auteur" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.7", "comment": "Author" } ] }, { "id": "MedicationStatement.extension:medicationTreatment", "path": "MedicationStatement.extension", "sliceName": "medicationTreatment", "short": "Medical Treatment", "definition": "This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.", "comment": "No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.", "alias": [ "extensions", "user content", "Medicamenteuze Behandeling" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22092", "comment": "Medicamenteuze behandeling" } ] }, { "id": "MedicationStatement.extension:copyIndicator", "path": "MedicationStatement.extension", "sliceName": "copyIndicator", "short": "copy indicator", "definition": "Indicates whether this resource is an original (false) or a copy from a different source (true).", "comment": "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": [ "extensions", "user content", "kopie indicator" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-CopyIndicator" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-23413", "comment": "Kopie Indicator" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse", "path": "MedicationStatement.extension", "sliceName": "reasonForChangeOrDiscontinuationOfUse", "short": "ReasonForChangeOrDiscontinuationOfUse", "definition": "Reason for changing or discontinuing use of medication.", "comment": "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": [ "extensions", "user content", "RedenWijzigenOfStoppenGebruik", "Reden wijzigen of stoppen gebruik" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.id", "path": "MedicationStatement.extension.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.extension", "path": "MedicationStatement.extension.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.url", "path": "MedicationStatement.extension.url", "representation": [ "xmlAttr" ], "short": "identifies the meaning of the extension", "definition": "Source of the definition for the extension code - a logical name or a URL.", "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.", "min": 1, "max": "1", "base": { "path": "Extension.url", "min": 1, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse", "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.valueCodeableConcept:valueCodeableConcept", "path": "MedicationStatement.extension.valueCodeableConcept", "sliceName": "valueCodeableConcept", "short": "ReasonForChangeOrDiscontinuationOfUse", "definition": "Reason for changing or discontinuing use of medication.", "alias": [ "Reden wijzigen of stoppen gebruik" ], "min": 0, "max": "1", "base": { "path": "Extension.value[x]", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "example": [ { "label": "Example of ReasonForChangeOrDiscontinuationOfUse", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.6.96", "code": "79899007", "display": "Drug interaction (disorder)" } ] } } ], "binding": { "strength": "extensible", "description": "ReasonForChangeOrDiscontinuationOfUseCodeList", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.37--20181218104254", "display": "RedenWijzigenOfStoppenGebruikCodelijst" } }, "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22493", "comment": "Reden wijzigen of stoppen gebruik" } ] }, { "id": "MedicationStatement.modifierExtension", "path": "MedicationStatement.modifierExtension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" }, "short": "Extensions that cannot be ignored", "definition": "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. Usually modifier elements provide negation or qualification. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule", "path": "MedicationStatement.modifierExtension", "sliceName": "repeatPeriodCyclicalSchedule", "label": "HerhaalperiodeCyclischSchema", "short": "RepeatPeriodCyclicalSchedule", "definition": "The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.\r\n\r\nExamples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days.\r\nRepeatPeriodCyclicalSchedule", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "1", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "isModifier": true, "mapping": [ { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "n/a" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.22505", "comment": "RepeatPeriodCyclicalSchedule" } ] }, { "id": "MedicationStatement.identifier", "path": "MedicationStatement.identifier", "short": "MedicationUseIdentifier", "definition": "External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.", "alias": [ "MedicatiegebruikIdentificatie" ], "min": 0, "max": "*", "base": { "path": "MedicationStatement.identifier", "min": 0, "max": "*" }, "type": [ { "code": "Identifier" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…identifer" }, { "identity": "rim", "map": ".id" }, { "identity": "w5", "map": "id" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22760", "comment": "Identificatie" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.6", "comment": "IdentificationNumber" } ] }, { "id": "MedicationStatement.basedOn", "path": "MedicationStatement.basedOn", "short": "Fulfils plan, proposal or order", "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.", "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.basedOn", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…basedOn" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]" } ] }, { "id": "MedicationStatement.partOf", "path": "MedicationStatement.partOf", "short": "Part of referenced event", "definition": "A larger event of which this particular event is a component or step.", "requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.partOf", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationDispense" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…part of" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]" } ] }, { "id": "MedicationStatement.context", "path": "MedicationStatement.context", "short": "Encounter / Episode associated with MedicationStatement", "definition": "The encounter or episode of care that establishes the context for this MedicationStatement.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.context", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…context" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]" } ] }, { "id": "MedicationStatement.status", "path": "MedicationStatement.status", "short": "MedicationUseStopType", "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally this will be active or completed.", "comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.\r\n\r\nThis element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive). A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/MedicationUseStopTypeCodeLijst-to-MedicationStatementStatus) is available that maps MedicationUseStopTypeCodeLijst to the MedicationStatementStatus valueset.", "alias": [ "MedicatieGebruikStopType" ], "min": 1, "max": "1", "base": { "path": "MedicationStatement.status", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "isModifier": true, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementStatus" } ], "strength": "required", "description": "A coded concept indicating the current status of a MedicationStatement.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-statement-status" } }, "mapping": [ { "identity": "workflow", "map": "…status" }, { "identity": "rim", "map": ".statusCode" }, { "identity": "w5", "map": "status" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.23132", "comment": "MedicationUseStopType" } ] }, { "id": "MedicationStatement.category", "path": "MedicationStatement.category", "short": "Type of medication usage", "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.", "min": 1, "max": "1", "base": { "path": "MedicationStatement.category", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementCategory" } ], "strength": "preferred", "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category" } }, "mapping": [ { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value" }, { "identity": "w5", "map": "class" } ] }, { "id": "MedicationStatement.category.id", "path": "MedicationStatement.category.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.category.extension", "path": "MedicationStatement.category.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.category.coding", "path": "MedicationStatement.category.coding", "slicing": { "discriminator": [ { "type": "value", "path": "code" } ], "rules": "open" }, "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode", "path": "MedicationStatement.category.coding", "sliceName": "medicationUseCode", "short": "MedicationUseCode", "definition": "Category code used for indexing/retrieval of the ZIB MedicationUse. The system and code are stated in the Medication Process v09.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.id", "path": "MedicationStatement.category.coding.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.extension", "path": "MedicationStatement.category.coding.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.system", "path": "MedicationStatement.category.coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 0, "max": "1", "base": { "path": "Coding.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3", "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.version", "path": "MedicationStatement.category.coding.version", "short": "Version of the system - if relevant", "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.", "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.", "min": 0, "max": "1", "base": { "path": "Coding.version", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.7" }, { "identity": "rim", "map": "./codeSystemVersion" }, { "identity": "orim", "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.code", "path": "MedicationStatement.category.coding.code", "short": "Symbol in syntax defined by the system", "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).", "requirements": "Need to refer to a particular code in the system.", "min": 0, "max": "1", "base": { "path": "Coding.code", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "fixedCode": "6", "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.category.coding.display", "short": "Representation defined by the system", "definition": "A representation of the meaning of the code in the system, following the rules of the system.", "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.", "min": 0, "max": "1", "base": { "path": "Coding.display", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.2 - but note this is not well followed" }, { "identity": "rim", "map": "CV.displayName" }, { "identity": "orim", "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" } ] }, { "id": "MedicationStatement.category.coding:medicationUseCode.userSelected", "path": "MedicationStatement.category.coding.userSelected", "short": "If this coding was chosen directly by the user", "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).", "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.", "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.", "min": 0, "max": "1", "base": { "path": "Coding.userSelected", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "Sometimes implied by being first" }, { "identity": "rim", "map": "CD.codingRationale" }, { "identity": "orim", "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]" } ] }, { "id": "MedicationStatement.category.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.category.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "MedicationStatement.medication[x]:medicationReference", "path": "MedicationStatement.medicationReference", "sliceName": "medicationReference", "short": "ProductUsed", "definition": "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": "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. .", "alias": [ "Gebruiksproduct" ], "min": 1, "max": "1", "base": { "path": "MedicationStatement.medication[x]", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-Product" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationCode" } ], "strength": "example", "description": "A coded concept identifying the substance or product being taken.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-codes" } }, "mapping": [ { "identity": "workflow", "map": "…code" }, { "identity": "rim", "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]" }, { "identity": "w5", "map": "what" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.21339", "comment": "ProductUsed" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod", "path": "MedicationStatement.effectivePeriod", "sliceName": "effectivePeriod", "short": "PeriodOfUse", "definition": "Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.\r\n\r\nStart date: This is the time at which the agreement was to take effect (or took effect or will take effect). \r\n\r\nDuration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. \r\n\r\nEnd date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.", "comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.", "alias": [ "Gebruiksperiode" ], "min": 0, "max": "1", "base": { "path": "MedicationStatement.effective[x]", "min": 0, "max": "1" }, "type": [ { "code": "Period" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…occurrence[x]" }, { "identity": "rim", "map": ".effectiveTime" }, { "identity": "w5", "map": "when.done" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22663", "comment": "PeriodOfUse" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.14", "comment": "DateTime" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.id", "path": "MedicationStatement.effectivePeriod.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension", "path": "MedicationStatement.effectivePeriod.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration", "path": "MedicationStatement.effectivePeriod.extension", "sliceName": "Duration", "short": "Duration", "definition": "The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.", "comment": "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": [ "extensions", "user content", "tijdsDuur" ], "min": 0, "max": "1", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.id", "path": "MedicationStatement.effectivePeriod.extension.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.extension", "path": "MedicationStatement.effectivePeriod.extension.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.url", "path": "MedicationStatement.effectivePeriod.extension.url", "representation": [ "xmlAttr" ], "short": "identifies the meaning of the extension", "definition": "Source of the definition for the extension code - a logical name or a URL.", "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.", "min": 1, "max": "1", "base": { "path": "Extension.url", "min": 1, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration", "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.valueDuration:valueDuration", "path": "MedicationStatement.effectivePeriod.extension.valueDuration", "sliceName": "valueDuration", "short": "UsageDuration", "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).", "alias": [ "Gebruiksduur" ], "min": 0, "max": "1", "base": { "path": "Extension.value[x]", "min": 0, "max": "1" }, "type": [ { "code": "Duration" } ], "example": [ { "label": "Example of Duration", "valueDuration": { "value": 3, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" } } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.start", "path": "MedicationStatement.effectivePeriod.start", "short": "StartDate", "definition": "This is the time at which the agreement was to take effect (or took effect or will take effect).", "comment": "If the low element is missing, the meaning is that the low boundary is not known.", "alias": [ "Ingangsdatum" ], "min": 0, "max": "1", "base": { "path": "Period.start", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "condition": [ "per-1" ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "DR.1" }, { "identity": "rim", "map": "./low" }, { "identity": "hcim-timeinterval-v1.0-2017EN", "map": "NL-CM:20.3.2", "comment": "startDateTime" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.end", "path": "MedicationStatement.effectivePeriod.end", "short": "EndDate", "definition": "The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.", "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.", "alias": [ "Einddatum" ], "min": 0, "max": "1", "base": { "path": "Period.end", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing", "condition": [ "per-1" ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "DR.2" }, { "identity": "rim", "map": "./high" }, { "identity": "hcim-timeinterval-v1.0-2017EN", "map": "NL-CM:20.3.3", "comment": "endDateTime" } ] }, { "id": "MedicationStatement.dateAsserted", "path": "MedicationStatement.dateAsserted", "short": "MedicationUseDateTime", "definition": "Date on which this use is entered.", "alias": [ "Registratiedatum" ], "min": 1, "max": "1", "base": { "path": "MedicationStatement.dateAsserted", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "example": [ { "label": "Example of MedicationUseDateTime", "valueDateTime": "2017-06-14" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".participation[typeCode=AUT].time" }, { "identity": "w5", "map": "when.recorded" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22398", "comment": "MedicationUseDateTime" } ] }, { "id": "MedicationStatement.informationSource", "path": "MedicationStatement.informationSource", "short": "Person or organization that provided the information about the taking of this medication", "definition": "The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequest.", "comment": "The informationSource can be a RelatedPerson (mp-dataelement900-22425), Patient (mp-dataelement900-22452) or a health proffesional (mp-dataelement900-22453).\r\n\r\nIf a health professional is the informationSource the missing-type-reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.informationSource", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient" }, { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" }, { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" }, { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-organization" } ], "mapping": [ { "identity": "rim", "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)" }, { "identity": "w5", "map": "who.source" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22424", "comment": "Informant" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.2", "comment": "InformationSource" } ] }, { "id": "MedicationStatement.informationSource.id", "path": "MedicationStatement.informationSource.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.informationSource.extension", "path": "MedicationStatement.informationSource.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.informationSource.extension:practitionerRole", "path": "MedicationStatement.informationSource.extension", "sliceName": "practitionerRole", "short": "Optional Extensions Element", "definition": "Optional Extension Element - found in all resources.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "1", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.informationSource.reference", "path": "MedicationStatement.informationSource.reference", "short": "Literal reference, Relative, internal or absolute URL", "definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.", "comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.", "min": 0, "max": "1", "base": { "path": "Reference.reference", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ref-1" ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.informationSource.identifier", "path": "MedicationStatement.informationSource.identifier", "short": "Logical reference, when literal reference is not known", "definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.", "comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.", "min": 0, "max": "1", "base": { "path": "Reference.identifier", "min": 0, "max": "1" }, "type": [ { "code": "Identifier" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".identifier" } ] }, { "id": "MedicationStatement.informationSource.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.informationSource.display", "short": "Text alternative for the resource", "definition": "Plain text narrative that identifies the resource in addition to the resource reference.", "comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.", "min": 0, "max": "1", "base": { "path": "Reference.display", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.subject", "path": "MedicationStatement.subject", "short": "Who is/was taking the medication", "definition": "The person, animal or group who is/was taking the medication.", "min": 1, "max": "1", "base": { "path": "MedicationStatement.subject", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…subject" }, { "identity": "v2", "map": "PID-3-Patient ID List" }, { "identity": "rim", "map": ".participation[typeCode=SBJ].role[classCode=PAT]" }, { "identity": "w5", "map": "who" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.11", "comment": "Subject" } ] }, { "id": "MedicationStatement.derivedFrom", "path": "MedicationStatement.derivedFrom", "slicing": { "discriminator": [ { "type": "profile", "path": "reference.resolve()" } ], "rules": "open" }, "short": "Additional supporting information", "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.", "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement 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 MedicationStatement from.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.derivedFrom", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ], "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" } ] }, { "id": "MedicationStatement.derivedFrom:relatedAgreement", "path": "MedicationStatement.derivedFrom", "sliceName": "relatedAgreement", "short": "Related Agreement", "definition": "A reference to a medication or dispense request that have been the medication usage has been based on.", "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement 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 MedicationStatement from.", "alias": [ "Gerelateerde afspraak" ], "min": 0, "max": "*", "base": { "path": "MedicationStatement.derivedFrom", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement" }, { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement" } ], "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22402", "comment": "Gerelateerde afspraak" } ] }, { "id": "MedicationStatement.derivedFrom:relatedDispense", "path": "MedicationStatement.derivedFrom", "sliceName": "relatedDispense", "short": "Related Dispense", "definition": "A reference to the dispense that has provided the basis for indicating use.", "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement 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 MedicationStatement from.", "alias": [ "Gerelateerde verstrekking" ], "min": 0, "max": "*", "base": { "path": "MedicationStatement.derivedFrom", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-Dispense" } ], "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" }, { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22404", "comment": "Gerelateerde verstrekking" } ] }, { "id": "MedicationStatement.taken", "path": "MedicationStatement.taken", "short": "UseIndicator", "definition": "Is this medicine used or not?", "comment": "This element is labeled as a modifier because it indicates that the medication was not taken.", "alias": [ "GebruikIndicator" ], "min": 1, "max": "1", "base": { "path": "MedicationStatement.taken", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "example": [ { "label": "Example of taken", "valueCode": "y" } ], "isModifier": true, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementTaken" } ], "strength": "required", "description": "A coded concept identifying level of certainty if patient has taken or has not taken the medication", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-statement-taken" } }, "mapping": [ { "identity": "workflow", "map": "…notDone" }, { "identity": "rim", "map": ".actionNegationInd" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22399", "comment": "UseIndicator" } ] }, { "id": "MedicationStatement.reasonNotTaken", "path": "MedicationStatement.reasonNotTaken", "short": "True if asserting medication was not given", "definition": "A code indicating why the medication was not taken.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonNotTaken", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "mst-1" ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementNotTakenReason" } ], "strength": "example", "description": "A coded concept indicating the reason why the medication was not taken", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/reason-medication-not-taken-codes" } }, "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason not taken\"].value" } ] }, { "id": "MedicationStatement.reasonCode", "path": "MedicationStatement.reasonCode", "short": "Reason for why the medication is being/was taken", "definition": "A reason for why the medication is being/was taken.", "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonCode", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationReason" } ], "strength": "example", "description": "A coded concept identifying why the medication is being taken.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/condition-code" } }, "mapping": [ { "identity": "workflow", "map": "…reasoneCodeableConcept" }, { "identity": "rim", "map": ".reasonCode" }, { "identity": "w5", "map": "why" } ] }, { "id": "MedicationStatement.reasonCode.id", "path": "MedicationStatement.reasonCode.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.reasonCode.extension", "path": "MedicationStatement.reasonCode.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.reasonCode.coding", "path": "MedicationStatement.reasonCode.coding", "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.reasonCode.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.reasonCode.text", "short": "ReasonForUse", "definition": "The reason for using the medication, particularly in self-care medicine purchased by the patient themselves.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "alias": [ "RedenGebruik" ], "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22491", "comment": "ReasonForUse" } ] }, { "id": "MedicationStatement.reasonReference", "path": "MedicationStatement.reasonReference", "short": "Condition or observation that supports why the medication is being/was taken", "definition": "Condition or observation that supports why the medication is being/was taken.", "comment": "This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonReference", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation" } ], "mapping": [ { "identity": "workflow", "map": "…reasonReference" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value" }, { "identity": "w5", "map": "why" } ] }, { "id": "MedicationStatement.note", "path": "MedicationStatement.note", "short": "Comment", "definition": "Comments on the medication use.", "alias": [ "Toelichting" ], "min": 0, "max": "*", "base": { "path": "MedicationStatement.note", "min": 0, "max": "*" }, "type": [ { "code": "Annotation" } ], "mapping": [ { "identity": "workflow", "map": "…note" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.21624", "comment": "Comment" } ] }, { "id": "MedicationStatement.dosage", "path": "MedicationStatement.dosage", "short": "InstructionsForUse", "definition": "Instructions for the use of the medication, e.g. dose and route of administration. In the event of medication use, this is the pattern of use established by the patient or which the patient followed", "comment": "The wiki page https://informatiestandaarden.nictiz.nl/wiki/mp:V9.0_Voorbeelden_doseringen provides dosage instruction examples. These examples consists of functional data and their representation in FHIR and CDA.", "alias": [ "Gebruiksinstructie" ], "min": 0, "max": "*", "base": { "path": "MedicationStatement.dosage", "min": 0, "max": "*" }, "type": [ { "code": "Dosage", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" } ], "mapping": [ { "identity": "rim", "map": "refer dosageInstruction mapping" }, { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.22504", "comment": "InstructionsForUse" }, { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22504", "comment": "InstructionsForUse" } ] }, { "id": "MedicationStatement.dosage.id", "path": "MedicationStatement.dosage.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.extension", "path": "MedicationStatement.dosage.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.sequence", "path": "MedicationStatement.dosage.sequence", "short": "SequenceNumber", "definition": "This indicates the sequence of the dosing instructions within the medication agreement.", "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.", "alias": [ "Volgnummer" ], "min": 0, "max": "1", "base": { "path": "Dosage.sequence", "min": 0, "max": "1" }, "type": [ { "code": "integer" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".text" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.22503", "comment": "SequenceNumber" } ] }, { "id": "MedicationStatement.dosage.text", "path": "MedicationStatement.dosage.text", "short": "Description", "definition": "Textual description of the complete instructions for use including the period of use.", "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.", "alias": [ "Omschrijving" ], "min": 0, "max": "1", "base": { "path": "Dosage.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".text" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.9581", "comment": "Description" } ] }, { "id": "MedicationStatement.dosage.additionalInstruction", "path": "MedicationStatement.dosage.additionalInstruction", "short": "AdditionalInstructions", "definition": "The additional instructions contain extra information on the use of or considerations for the current prescription. This can also include all instructions for use. The text can come from the original 'paper' medication prescription, but can also be generated from the coded information. This concept may contain more information than what is structurally coded in the information below, but may not conflict with it. The instructions may not conflict with other components of the request for administration. The instructions can also refer to an existing protocol. The G standard contains many texts that can support this attribute, in for example G standard table 362, which contains texts from the general practitioners’ standard WCIA table 25. If desired, these texts can be used to structure this concept.", "requirements": "Additional instruction such as \"Swallow with plenty of water\" which may or may not be coded.", "alias": [ "AanvullendeInstructie" ], "min": 0, "max": "*", "base": { "path": "Dosage.additionalInstruction", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdditionalInstruction" } ], "strength": "extensible", "description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\".", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.9--20160407000000", "display": "AanvullendeGebruiksinstructie" } }, "mapping": [ { "identity": "rim", "map": ".text" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19944", "comment": "AdditionalInstructions" } ] }, { "id": "MedicationStatement.dosage.patientInstruction", "path": "MedicationStatement.dosage.patientInstruction", "short": "Patient or consumer oriented instructions", "definition": "Instructions in terms that are understood by the patient or consumer.", "min": 0, "max": "1", "base": { "path": "Dosage.patientInstruction", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".text" } ] }, { "id": "MedicationStatement.dosage.timing", "path": "MedicationStatement.dosage.timing", "short": "AdministeringSchedule", "definition": "Specifications of the times at which the medication is to be administered. This is indicated as follows: Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. A specific number of times the medication is to be taken each day (“3x a day“), indicated with the frequency A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: The end date and time has been reached The total administration duration has been reached (14 days) A specific amount of administrations has been reached (“20 doses”, “one-time only”), to be entered in the NumberOfDoses concept.", "comment": "A timing schedule can be either a list of events - intervals on which the event occurs, or a single event with repeating criteria or just repeating criteria with no actual event. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.", "requirements": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "alias": [ "Toedieningsschema" ], "min": 0, "max": "*", "base": { "path": "Dosage.timing", "min": 0, "max": "1" }, "type": [ { "code": "Timing", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationSchedule" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".effectiveTime" }, { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "N/A" }, { "identity": "rim", "map": "QSET (GTS)" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19948", "comment": "AdministeringSchedule" } ] }, { "id": "MedicationStatement.dosage.timing.id", "path": "MedicationStatement.dosage.timing.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.extension", "path": "MedicationStatement.dosage.timing.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.event", "path": "MedicationStatement.dosage.timing.event", "short": "When the event occurs", "definition": "Identifies specific times when the event occurs.", "requirements": "In an MAR, for instance, you need to take a general specification, and turn it into a precise specification.", "min": 0, "max": "*", "base": { "path": "Timing.event", "min": 0, "max": "*" }, "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "QLIST" } ] }, { "id": "MedicationStatement.dosage.timing.repeat", "path": "MedicationStatement.dosage.timing.repeat", "short": "When the event is to occur", "definition": "A set of rules that describe when the event is scheduled.", "requirements": "Many timing schedules are determined by regular repetitions.", "min": 0, "max": "1", "base": { "path": "Timing.repeat", "min": 0, "max": "1" }, "type": [ { "code": "Element" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "tim-9", "severity": "error", "human": "If there's an offset, there must be a when (and not C, CM, CD, CV)", "expression": "offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))", "xpath": "not(exists(f:offset)) or exists(f:when)" }, { "key": "tim-5", "severity": "error", "human": "period SHALL be a non-negative value", "expression": "period.exists() implies period >= 0", "xpath": "f:period/@value >= 0 or not(f:period/@value)" }, { "key": "tim-6", "severity": "error", "human": "If there's a periodMax, there must be a period", "expression": "periodMax.empty() or period.exists()", "xpath": "not(exists(f:periodMax)) or exists(f:period)" }, { "key": "tim-7", "severity": "error", "human": "If there's a durationMax, there must be a duration", "expression": "durationMax.empty() or duration.exists()", "xpath": "not(exists(f:durationMax)) or exists(f:duration)" }, { "key": "tim-8", "severity": "error", "human": "If there's a countMax, there must be a count", "expression": "countMax.empty() or count.exists()", "xpath": "not(exists(f:countMax)) or exists(f:count)" }, { "key": "tim-1", "severity": "error", "human": "if there's a duration, there needs to be duration units", "expression": "duration.empty() or durationUnit.exists()", "xpath": "not(exists(f:duration)) or exists(f:durationUnit)" }, { "key": "tim-10", "severity": "error", "human": "If there's a timeOfDay, there cannot be be a when, or vice versa", "expression": "timeOfDay.empty() or when.empty()", "xpath": "not(exists(f:timeOfDay)) or not(exists(f:when))" }, { "key": "tim-2", "severity": "error", "human": "if there's a period, there needs to be period units", "expression": "period.empty() or periodUnit.exists()", "xpath": "not(exists(f:period)) or exists(f:periodUnit)" }, { "key": "tim-4", "severity": "error", "human": "duration SHALL be a non-negative value", "expression": "duration.exists() implies duration >= 0", "xpath": "f:duration/@value >= 0 or not(f:duration/@value)" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "Implies PIVL or EIVL" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.id", "path": "MedicationStatement.dosage.timing.repeat.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension", "path": "MedicationStatement.dosage.timing.repeat.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact", "path": "MedicationStatement.dosage.timing.repeat.extension", "sliceName": "exact", "short": "exact", "definition": "If true, indicates that the specified times, frequencies, periods are expected to be adhered to as precisely as possible. If false, indicates that a typical degree of variability based on institutional and/or patient convenience is acceptable.\r\nUse on data type: Timing.repeat", "comment": "For MP: In practice, this means that when you define a frequency (3x a day) this flag should false, but when you define an interval (every 8 hours) you set this flag to true.", "alias": [ "extensions", "user content" ], "min": 0, "max": "1", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": "http://hl7.org/fhir/StructureDefinition/timing-exact" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "N/A" }, { "identity": "rim", "map": "GTS.IsFlexible" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact.id", "path": "MedicationStatement.dosage.timing.repeat.extension.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact.extension", "path": "MedicationStatement.dosage.timing.repeat.extension.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact.url", "path": "MedicationStatement.dosage.timing.repeat.extension.url", "representation": [ "xmlAttr" ], "short": "identifies the meaning of the extension", "definition": "Source of the definition for the extension code - a logical name or a URL.", "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.", "min": 1, "max": "1", "base": { "path": "Extension.url", "min": 1, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://hl7.org/fhir/StructureDefinition/timing-exact", "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact.valueBoolean:valueBoolean", "path": "MedicationStatement.dosage.timing.repeat.extension.valueBoolean", "sliceName": "valueBoolean", "short": "Value of extension", "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).", "min": 0, "max": "1", "base": { "path": "Extension.value[x]", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.bounds[x]", "path": "MedicationStatement.dosage.timing.repeat.bounds[x]", "short": "DoseDuration", "definition": "The intended time duration for these dosing instructions.", "alias": [ "Doseerduur" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.bounds[x]", "min": 0, "max": "1" }, "type": [ { "code": "Duration" }, { "code": "Range" }, { "code": "Period" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "IVL(TS) used in a QSI" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.22506", "comment": "DoseDuration" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.count", "path": "MedicationStatement.dosage.timing.repeat.count", "short": "Number of times to repeat", "definition": "A total count of the desired number of repetitions.", "comment": "If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.", "requirements": "Repetitions may be limited by end time or total occurrences.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.count", "min": 0, "max": "1" }, "type": [ { "code": "integer" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.count" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.countMax", "path": "MedicationStatement.dosage.timing.repeat.countMax", "short": "Maximum number of times to repeat", "definition": "A maximum value for the count of the desired repetitions (e.g. do something 6-8 times).", "min": 0, "max": "1", "base": { "path": "Timing.repeat.countMax", "min": 0, "max": "1" }, "type": [ { "code": "integer" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.count" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.duration", "path": "MedicationStatement.dosage.timing.repeat.duration", "short": "Duration of administration", "definition": "Defines the amount of time during which medication is being administered. This is used especially in the context of administering liquids.", "comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).", "requirements": "Some activities are not instantaneous and need to be maintained for a period of time.", "alias": [ "Toedieninsgduur" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.duration", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.23141", "comment": "DurationOfAdministration" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.durationMax", "path": "MedicationStatement.dosage.timing.repeat.durationMax", "short": "How long when it happens (Max)", "definition": "The upper limit of how long this thing happens for when it happens.", "comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).", "requirements": "Some activities are not instantaneous and need to be maintained for a period of time.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.durationMax", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.durationUnit", "path": "MedicationStatement.dosage.timing.repeat.durationUnit", "short": "Duration unit of administration", "definition": "Defines the unit for the amount of time during which medication is being administered. This is used especially in the context of administering liquids.", "alias": [ "Toedieninsgduur" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.durationUnit", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "UnitsOfTime" } ], "strength": "required", "description": "A unit of time (units from UCUM).", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/units-of-time" } }, "mapping": [ { "identity": "rim", "map": "PIVL.phase.unit" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.23141", "comment": "DurationOfAdministration" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.frequency", "path": "MedicationStatement.dosage.timing.repeat.frequency", "short": "Frequency", "definition": "The frequency indicates the number of dose moments per time unit, usually per day. If this frequency is included, then the Interval will not have been included. Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). In that case, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). The time unit of the frequency must be the same as how it is indicated in the textual description of the dose. Example: for a '2x a day...' dose: amount = 2 time unit = 'day'. for a '3x a week...' dose: amount = 3 time unit = 'week'.", "alias": [ "frequentie", "frequentie vaste waarde", "frequentie min" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.frequency", "min": 0, "max": "1" }, "type": [ { "code": "integer" } ], "defaultValueInteger": 1, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19949", "comment": "Frequency" }, { "identity": "hcim-range-v1.0-2017EN", "map": "NL-CM:20.1.2", "comment": "Minimal frequency" }, { "identity": "hcim-range-v1.0-2017EN", "map": "NL-CM:20.1.4", "comment": "nominalValue. Nominal frequency: This element can not be used in combination with a minimum and maximum value" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.frequencyMax", "path": "MedicationStatement.dosage.timing.repeat.frequencyMax", "short": "maximumValue", "definition": "If present, indicates that the frequency is a range - so to repeat between [frequency (min)] and [frequencyMax] times within the period or period range.", "alias": [ "maximumWaarde" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.frequencyMax", "min": 0, "max": "1" }, "type": [ { "code": "integer" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" }, { "identity": "hcim-range-v1.0-2017EN", "map": "NL-CM:20.1.3", "comment": "maximumValue" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.period", "path": "MedicationStatement.dosage.timing.repeat.period", "short": "Interval", "definition": "Interval indicates the time between dose times. If this is included, then the Frequency will not have been included. \r\n \r\nExamples: every 4 hours, every 3 weeks. \r\n\r\nThe times can now be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) \r\nIn the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)", "comment": "In FHIR, the HCIM concepts Interval and Frequency are represented with the elements Timing.repeat.frequency, Timing.repeat.period and Timing.repeat.periodUnit.", "alias": [ "Interval", "Frequentie" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.period", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19949", "comment": "Frequency. When frequency is used, set \"exact\" to false" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19950", "comment": "Interval. When interval is used, set \"exact\" to true" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.periodMax", "path": "MedicationStatement.dosage.timing.repeat.periodMax", "short": "Upper limit of period (3-4 hours)", "definition": "If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as \"do this once every 3-5 days.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.periodMax", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.periodUnit", "path": "MedicationStatement.dosage.timing.repeat.periodUnit", "short": "s | min | h | d | wk | mo | a - unit of time (UCUM)", "definition": "Interval indicates the time between dose times. If this is included, then the Frequency will not have been included. \r\n \r\nExamples: every 4 hours, every 3 weeks. \r\n\r\nThe times can now be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) \r\nIn the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)", "comment": "The unit of time for the information given in Timing.repeat.period. In FHIR, the HCIM concepts Interval and Frequency are represented with the elements Timing.repeat.frequency, Timing.repeat.period and Timing.repeat.periodUnit.", "alias": [ "Interval", "Frequentie" ], "min": 0, "max": "1", "base": { "path": "Timing.repeat.periodUnit", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "UnitsOfTime" } ], "strength": "required", "description": "A unit of time (units from UCUM).", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/units-of-time" } }, "mapping": [ { "identity": "rim", "map": "PIVL.phase.unit" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19949", "comment": "Frequency. When frequency is used, set \"exact\" to false" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19950", "comment": "Interval. When interval is used, set \"exact\" to true" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.dayOfWeek", "path": "MedicationStatement.dosage.timing.repeat.dayOfWeek", "short": "WeekDay", "definition": "WeekDay indicates a pattern of doses on fixed week days.", "comment": "Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday. A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/WeekdagCodelijst-to-days-of-week) is available that maps WeekDayCodelist to the days-of-week valueset.", "alias": [ "Weekdagen" ], "min": 0, "max": "*", "base": { "path": "Timing.repeat.dayOfWeek", "min": 0, "max": "*" }, "type": [ { "code": "code" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "DayOfWeek" } ], "strength": "required", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/days-of-week" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19952", "comment": "WeekDay" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.timeOfDay", "path": "MedicationStatement.dosage.timing.repeat.timeOfDay", "short": "AdministrationTime", "definition": "The time of administration is a specific time of day (on the clock). This time usually isn’t (intended to be) exact. There can be multiple administering times in one day. The ideal time of administration can also be entered as a time of day (morning, afternoon, evening, night-time). The administration time is then to be left empty, and the time of day can be entered in the TimeOfDay concept.", "comment": "When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.", "alias": [ "Toedientijd" ], "min": 0, "max": "*", "base": { "path": "Timing.repeat.timeOfDay", "min": 0, "max": "*" }, "type": [ { "code": "time" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19951", "comment": "AdministrationTime" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.when", "path": "MedicationStatement.dosage.timing.repeat.when", "short": "TimeOfDay", "definition": "Time of day: morning, afternoon, evening, night.", "comment": "Time of day: morning, afternoon, evening, night. A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/DagdeelCodelijst-to-EventTiming) is available that maps TimeOfDayCodelist to the EventTiming valueset.", "requirements": "Timings are frequently determined by occurrences such as waking, eating and sleep.", "alias": [ "Dagdeel" ], "min": 0, "max": "*", "base": { "path": "Timing.repeat.when", "min": 0, "max": "*" }, "type": [ { "code": "code" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "EventTiming" } ], "strength": "required", "description": "Real world event relating to the schedule.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/event-timing" } }, "mapping": [ { "identity": "rim", "map": "EIVL.event" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19953", "comment": "TimeOfDay" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.offset", "path": "MedicationStatement.dosage.timing.repeat.offset", "short": "Minutes from event (before or after)", "definition": "The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.offset", "min": 0, "max": "1" }, "type": [ { "code": "unsignedInt" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "EIVL.offset" } ] }, { "id": "MedicationStatement.dosage.timing.code", "path": "MedicationStatement.dosage.timing.code", "short": "BID | TID | QID | AM | PM | QD | QOD | Q4H | Q6H +", "definition": "A code for the timing schedule. Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).", "comment": "BID etc are defined as 'at institutionally specified times'. For example, an institution may choose that BID is \"always at 7am and 6pm\". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or the a structured representation should be used (in this case, specifying the two event times).", "min": 0, "max": "1", "base": { "path": "Timing.code", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "TimingAbbreviation" } ], "strength": "preferred", "description": "Code for a known / defined timing pattern.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/timing-abbreviation" } }, "mapping": [ { "identity": "rim", "map": "QSC.code" } ] }, { "id": "MedicationStatement.dosage.asNeeded[x]:asNeededCodeableConcept", "path": "MedicationStatement.dosage.asNeededCodeableConcept", "sliceName": "asNeededCodeableConcept", "short": "AsNeeded", "definition": "As needed means that the dose is only to be administered under certain conditions.", "comment": "Using the term 'as needed' or a specific reason (eg 'in case of pain') to use medication leads to ambiguity. It is not always clear whether the whole dose is 'as needed' or only part of the dose. For example: 1x daily 1-2 tablets as needed. This can mean: 1 tablet fixed per day and 1 tablet as needed or, as needed, a maximum of 2 tablets.As needed medication is not included in GDS. In the first situation, 1 tablet comes in the GDS (drug dispensing systems) and 1 tablet is delivered separately. In the second situation there is only separate delivery.The system must make sufficiently clear whether the entire instruction or part of the dose is necessary. The HCIM supports both options described above.", "alias": [ "Zo nodig", "Criterium" ], "min": 0, "max": "1", "base": { "path": "Dosage.asNeeded[x]", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationAsNeededReason" } ], "strength": "extensible", "description": "ZonodigCriteriumCodelijst", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.4--20171231000000", "display": "ZonodigCriteriumCodelijst" } }, "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.22512", "comment": "AsNeeded" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19945", "comment": "Condition" } ] }, { "id": "MedicationStatement.dosage.site", "path": "MedicationStatement.dosage.site", "short": "Body site to administer to", "definition": "Body site to administer to.", "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html). May be a summary code, or a reference to a very precise definition of the location, or both.", "requirements": "A coded specification of the anatomic site where the medication first enters the body.", "min": 0, "max": "1", "base": { "path": "Dosage.site", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationAdministrationSite" } ], "strength": "example", "description": "A coded concept describing the site location the medicine enters into or onto the body.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/approach-site-codes" } }, "mapping": [ { "identity": "rim", "map": ".approachSiteCode" } ] }, { "id": "MedicationStatement.dosage.route", "path": "MedicationStatement.dosage.route", "short": "RouteOfAdministration", "definition": "The route through which the medication is administered (oral, nasal, intravenous, etc.)", "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.", "alias": [ "Toedieningsweg" ], "min": 0, "max": "1", "base": { "path": "Dosage.route", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "example": [ { "label": "Example of RouteOfAdministration", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.2.4.4.9", "code": "oraal", "display": "Oraal" } ] } } ], "isSummary": true, "binding": { "strength": "extensible", "description": "ToedieningswegCodelijst", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.1--20171231000000", "display": "ToedieningswegCodelijst" } }, "mapping": [ { "identity": "rim", "map": ".routeCode" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19941", "comment": "RouteOfAdministration" } ] }, { "id": "MedicationStatement.dosage.method", "path": "MedicationStatement.dosage.method", "short": "Technique for administering medication", "definition": "Technique for administering medication.", "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.", "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.", "min": 0, "max": "1", "base": { "path": "Dosage.method", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationAdministrationMethod" } ], "strength": "example", "description": "A coded concept describing the technique by which the medicine is administered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes" } }, "mapping": [ { "identity": "rim", "map": ".doseQuantity" } ] }, { "id": "MedicationStatement.dosage.dose[x]", "path": "MedicationStatement.dosage.dose[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "rules": "open" }, "short": "Dose", "definition": "The dose indicates the dose amount per administration. \n \nThe dosage is described in the unit accompanying the product; usually, this is just a number of units or doses. Liquids and other divisible products will usually include a unit of volume (preferably \"\"ml\"\"). \n \nIn many cases, the prescriber will want to indicate the dose in units of weight of the active ingredient. \n \nIf only the ingredient is included and not the product, then the amount of that ingredient will be given. Paracetamol 1000mg is equivalent to 2 Paracetamol 500mg tablets or units. \n \nThe dosage is sometimes given as a calculation, in which the patient’s body weight or body surface area is used as a parameter. The calculation is however no more than an aid in reaching a decision. \n \nIn the event of constant administration, sometimes the dose is given in addition to the administration speed (infusion rate) (e.g. 20ml in a syringe or 500ml in a bag), but it is often also omitted. \n \nA general dosage recommendation such as ‘Use according to protocol’ or ‘See instructions’ can be sufficient. In that case, no dose is given.", "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.", "requirements": "The amount of therapeutic or other substance given at one administration event.", "alias": [ "Keerdosis" ], "min": 0, "max": "1", "base": { "path": "Dosage.dose[x]", "min": 0, "max": "1" }, "type": [ { "code": "Range" }, { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".doseQuantity" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19940", "comment": "Dose" } ] }, { "id": "MedicationStatement.dosage.dose[x]:DoseQuantity", "path": "MedicationStatement.dosage.dose[x]", "sliceName": "DoseQuantity", "short": "A fixed quantity (no comparator)", "definition": "The comparator is not used on a SimpleQuantity", "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.", "requirements": "The amount of therapeutic or other substance given at one administration event.", "min": 0, "max": "*", "base": { "path": "Dosage.dose[x]", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" }, { "key": "qty-3", "severity": "error", "human": "If a code for the unit is present, the system SHALL also be present", "expression": "code.empty() or system.exists()", "xpath": "not(exists(f:code)) or exists(f:system)", "source": "Quantity" }, { "key": "sqty-1", "severity": "error", "human": "The comparator is not used on a SimpleQuantity", "expression": "comparator.empty()", "xpath": "not(exists(f:comparator))" } ], "isSummary": true, "binding": { "strength": "required", "description": "GstdTabel902", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453", "display": "GstdTabel902" } }, "mapping": [ { "identity": "rim", "map": ".doseQuantity" }, { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "SN (see also Range) or CQ" }, { "identity": "rim", "map": "PQ, IVL, MO, CO, depending on the values" } ] }, { "id": "MedicationStatement.dosage.dose[x]:DoseRange", "path": "MedicationStatement.dosage.dose[x]", "sliceName": "DoseRange", "short": "Amount of medication per dose", "definition": "Amount of medication per dose.", "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.", "requirements": "The amount of therapeutic or other substance given at one administration event.", "min": 0, "max": "1", "base": { "path": "Dosage.dose[x]", "min": 0, "max": "1" }, "type": [ { "code": "Range" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".doseQuantity" } ] }, { "id": "MedicationStatement.dosage.dose[x]:DoseRange.id", "path": "MedicationStatement.dosage.dose[x].id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.dose[x]:DoseRange.extension", "path": "MedicationStatement.dosage.dose[x].extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.dose[x]:DoseRange.low", "path": "MedicationStatement.dosage.dose[x].low", "short": "Low limit", "definition": "The low limit. The boundary is inclusive.", "comment": "If the low element is missing, the low boundary is not known.", "min": 0, "max": "1", "base": { "path": "Range.low", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "condition": [ "rng-2" ], "isSummary": true, "binding": { "strength": "required", "description": "GstdTabel902", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453", "display": "GstdTabel902" } }, "mapping": [ { "identity": "v2", "map": "NR.1" }, { "identity": "rim", "map": "./low" } ] }, { "id": "MedicationStatement.dosage.dose[x]:DoseRange.high", "path": "MedicationStatement.dosage.dose[x].high", "short": "High limit", "definition": "The high limit. The boundary is inclusive.", "comment": "If the high element is missing, the high boundary is not known.", "min": 0, "max": "1", "base": { "path": "Range.high", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "condition": [ "rng-2" ], "isSummary": true, "binding": { "strength": "required", "description": "GstdTabel902", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453", "display": "GstdTabel902" } }, "mapping": [ { "identity": "v2", "map": "NR.2" }, { "identity": "rim", "map": "./high" } ] }, { "id": "MedicationStatement.dosage.maxDosePerPeriod", "path": "MedicationStatement.dosage.maxDosePerPeriod", "short": "MaximumDose", "definition": "A maximum dose indicates the maximum duration a product can be used with an ‘as needed’ prescription.\r\n\r\nFor example:\r\n- Max 6 units per day\r\n- Max 200ml per week", "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example \"2 tablets every 4 hours to a maximum of 8/day\".", "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.", "alias": [ "Maximale dosering", "Maximale dosis (per dag enz.)" ], "min": 0, "max": "1", "base": { "path": "Dosage.maxDosePerPeriod", "min": 0, "max": "1" }, "type": [ { "code": "Ratio" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".maxDoseQuantity" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19946", "comment": "MaximumDose" } ] }, { "id": "MedicationStatement.dosage.maxDosePerPeriod.id", "path": "MedicationStatement.dosage.maxDosePerPeriod.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.maxDosePerPeriod.extension", "path": "MedicationStatement.dosage.maxDosePerPeriod.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order 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.", "comment": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.maxDosePerPeriod.numerator", "path": "MedicationStatement.dosage.maxDosePerPeriod.numerator", "short": "Numerator value", "definition": "The value of the numerator.", "min": 0, "max": "1", "base": { "path": "Ratio.numerator", "min": 0, "max": "1" }, "type": [ { "code": "Quantity" } ], "isSummary": true, "binding": { "strength": "required", "description": "GstdTabel902", "valueSetReference": { "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453", "display": "GstdTabel902" } }, "mapping": [ { "identity": "rim", "map": ".numerator" } ] }, { "id": "MedicationStatement.dosage.maxDosePerPeriod.denominator", "path": "MedicationStatement.dosage.maxDosePerPeriod.denominator", "short": "Denominator value", "definition": "The value of the denominator.", "min": 0, "max": "1", "base": { "path": "Ratio.denominator", "min": 0, "max": "1" }, "type": [ { "code": "Quantity" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".denominator" } ] }, { "id": "MedicationStatement.dosage.maxDosePerAdministration", "path": "MedicationStatement.dosage.maxDosePerAdministration", "short": "Upper limit on medication per administration", "definition": "Upper limit on medication per administration.", "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.", "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.", "min": 0, "max": "1", "base": { "path": "Dosage.maxDosePerAdministration", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "not supported" } ] }, { "id": "MedicationStatement.dosage.maxDosePerLifetime", "path": "MedicationStatement.dosage.maxDosePerLifetime", "short": "Upper limit on medication per lifetime of the patient", "definition": "Upper limit on medication per lifetime of the patient.", "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.", "min": 0, "max": "1", "base": { "path": "Dosage.maxDosePerLifetime", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "not supported" } ] }, { "id": "MedicationStatement.dosage.rate[x]", "path": "MedicationStatement.dosage.rate[x]", "short": "AdministeringSpeed", "definition": "The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: amount = 10, dose unit = ml time unit = hour", "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.", "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "alias": [ "Toedieningssnelheid", "Inloopsnelheid" ], "min": 0, "max": "1", "base": { "path": "Dosage.rate[x]", "min": 0, "max": "1" }, "type": [ { "code": "Ratio" }, { "code": "Range" }, { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": ".rateQuantity" }, { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.19942", "comment": "AdministeringSpeed" } ] } ] }, "differential": { "element": [ { "id": "MedicationStatement", "path": "MedicationStatement", "short": "MedicationUse", "definition": "MedicationUse is a statement on the historic, current or intended use of a certain medicine.", "alias": [ "Medicatiegebruik" ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.21338", "comment": "MedicationUse" } ] }, { "id": "MedicationStatement.extension", "path": "MedicationStatement.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "MedicationStatement.extension:asAgreedIndicator", "path": "MedicationStatement.extension", "sliceName": "asAgreedIndicator", "short": "AsAgreedIndicator", "definition": "Is the medicine used as outlined in the medication agreement?", "alias": [ "VolgensAfspraakIndicator" ], "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22492", "comment": "AsAgreedIndicator" } ] }, { "id": "MedicationStatement.extension:asAgreedIndicator.valueBoolean:valueBoolean", "path": "MedicationStatement.extension.valueBoolean", "sliceName": "valueBoolean", "example": [ { "label": "Example of asAgreed", "valueBoolean": true } ] }, { "id": "MedicationStatement.extension:prescriber", "path": "MedicationStatement.extension", "sliceName": "prescriber", "short": "Prescriber", "definition": "The health professional that entered the medication agreement with the patient.", "comment": "The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.", "alias": [ "Voorschrijver" ], "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.23290", "comment": "Prescriber" } ] }, { "id": "MedicationStatement.extension:author", "path": "MedicationStatement.extension", "sliceName": "author", "short": "Author", "definition": "The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.", "comment": "A patient as author maps to the MP9 concept: mp-dataelement900-22472.\r\nA health professional as author maps to the MP9 concept: mp-dataelement900-22473.\r\nA healthcare provider as author maps to the MP9 concept: mp-dataelement900-23994.\r\n\r\nThe health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.", "alias": [ "Auteur" ], "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author" } ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22471", "comment": "Auteur" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.7", "comment": "Author" } ] }, { "id": "MedicationStatement.extension:medicationTreatment", "path": "MedicationStatement.extension", "sliceName": "medicationTreatment", "short": "Medical Treatment", "definition": "This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.", "comment": "No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.", "alias": [ "Medicamenteuze Behandeling" ], "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment" } ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22092", "comment": "Medicamenteuze behandeling" } ] }, { "id": "MedicationStatement.extension:copyIndicator", "path": "MedicationStatement.extension", "sliceName": "copyIndicator", "short": "copy indicator", "alias": [ "kopie indicator" ], "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-CopyIndicator" } ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-23413", "comment": "Kopie Indicator" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse", "path": "MedicationStatement.extension", "sliceName": "reasonForChangeOrDiscontinuationOfUse", "short": "ReasonForChangeOrDiscontinuationOfUse", "definition": "Reason for changing or discontinuing use of medication.", "alias": [ "RedenWijzigenOfStoppenGebruik", "Reden wijzigen of stoppen gebruik" ], "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse" } ] }, { "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.valueCodeableConcept:valueCodeableConcept", "path": "MedicationStatement.extension.valueCodeableConcept", "sliceName": "valueCodeableConcept", "example": [ { "label": "Example of ReasonForChangeOrDiscontinuationOfUse", "valueCodeableConcept": { "coding": [ { "system": "urn:oid:2.16.840.1.113883.6.96", "code": "79899007", "display": "Drug interaction (disorder)" } ] } } ], "binding": { "strength": "extensible" }, "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22493", "comment": "Reden wijzigen of stoppen gebruik" } ] }, { "id": "MedicationStatement.modifierExtension", "path": "MedicationStatement.modifierExtension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule", "path": "MedicationStatement.modifierExtension", "sliceName": "repeatPeriodCyclicalSchedule", "label": "HerhaalperiodeCyclischSchema", "short": "RepeatPeriodCyclicalSchedule", "definition": "The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.\r\n\r\nExamples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days.\r\nRepeatPeriodCyclicalSchedule", "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule" } ], "mapping": [ { "identity": "hcim-instructionsforuse-v1.0-2017EN", "map": "NL-CM:9.12.22505", "comment": "RepeatPeriodCyclicalSchedule" } ] }, { "id": "MedicationStatement.identifier", "path": "MedicationStatement.identifier", "short": "MedicationUseIdentifier", "alias": [ "MedicatiegebruikIdentificatie" ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22760", "comment": "Identificatie" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.6", "comment": "IdentificationNumber" } ] }, { "id": "MedicationStatement.status", "path": "MedicationStatement.status", "short": "MedicationUseStopType", "comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.\r\n\r\nThis element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive). A ConceptMap (https://simplifier.net/resolve?canonical=http://nictiz.nl/fhir/ConceptMap/MedicationUseStopTypeCodeLijst-to-MedicationStatementStatus) is available that maps MedicationUseStopTypeCodeLijst to the MedicationStatementStatus valueset.", "alias": [ "MedicatieGebruikStopType" ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.23132", "comment": "MedicationUseStopType" } ] }, { "id": "MedicationStatement.category", "path": "MedicationStatement.category", "min": 1 }, { "id": "MedicationStatement.category.coding", "path": "MedicationStatement.category.coding", "slicing": { "discriminator": [ { "type": "value", "path": "code" } ], "rules": "open" } }, { "id": "MedicationStatement.category.coding:medicationUseCode", "path": "MedicationStatement.category.coding", "sliceName": "medicationUseCode", "short": "MedicationUseCode", "definition": "Category code used for indexing/retrieval of the ZIB MedicationUse. The system and code are stated in the Medication Process v09." }, { "id": "MedicationStatement.category.coding:medicationUseCode.system", "path": "MedicationStatement.category.coding.system", "fixedUri": "urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3" }, { "id": "MedicationStatement.category.coding:medicationUseCode.code", "path": "MedicationStatement.category.coding.code", "fixedCode": "6" }, { "id": "MedicationStatement.medication[x]:medicationReference", "path": "MedicationStatement.medicationReference", "sliceName": "medicationReference", "short": "ProductUsed", "alias": [ "Gebruiksproduct" ], "type": [ { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-Product" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.21339", "comment": "ProductUsed" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod", "path": "MedicationStatement.effectivePeriod", "sliceName": "effectivePeriod", "short": "PeriodOfUse", "definition": "Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.\r\n\r\nStart date: This is the time at which the agreement was to take effect (or took effect or will take effect). \r\n\r\nDuration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. \r\n\r\nEnd date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.", "alias": [ "Gebruiksperiode" ], "type": [ { "code": "Period" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22663", "comment": "PeriodOfUse" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.14", "comment": "DateTime" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension", "path": "MedicationStatement.effectivePeriod.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration", "path": "MedicationStatement.effectivePeriod.extension", "sliceName": "Duration", "short": "Duration", "definition": "The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.", "alias": [ "tijdsDuur" ], "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.valueDuration:valueDuration", "path": "MedicationStatement.effectivePeriod.extension.valueDuration", "sliceName": "valueDuration", "example": [ { "label": "Example of Duration", "valueDuration": { "value": 3, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" } } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.start", "path": "MedicationStatement.effectivePeriod.start", "short": "StartDate", "definition": "This is the time at which the agreement was to take effect (or took effect or will take effect).", "alias": [ "Ingangsdatum" ], "mapping": [ { "identity": "hcim-timeinterval-v1.0-2017EN", "map": "NL-CM:20.3.2", "comment": "startDateTime" } ] }, { "id": "MedicationStatement.effective[x]:effectivePeriod.end", "path": "MedicationStatement.effectivePeriod.end", "short": "EndDate", "definition": "The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.", "alias": [ "Einddatum" ], "mapping": [ { "identity": "hcim-timeinterval-v1.0-2017EN", "map": "NL-CM:20.3.3", "comment": "endDateTime" } ] }, { "id": "MedicationStatement.dateAsserted", "path": "MedicationStatement.dateAsserted", "short": "MedicationUseDateTime", "definition": "Date on which this use is entered.", "alias": [ "Registratiedatum" ], "min": 1, "example": [ { "label": "Example of MedicationUseDateTime", "valueDateTime": "2017-06-14" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22398", "comment": "MedicationUseDateTime" } ] }, { "id": "MedicationStatement.informationSource", "path": "MedicationStatement.informationSource", "comment": "The informationSource can be a RelatedPerson (mp-dataelement900-22425), Patient (mp-dataelement900-22452) or a health proffesional (mp-dataelement900-22453).\r\n\r\nIf a health professional is the informationSource the missing-type-reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.", "type": [ { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient" }, { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" }, { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" }, { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-organization" } ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22424", "comment": "Informant" }, { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.2", "comment": "InformationSource" } ] }, { "id": "MedicationStatement.informationSource.extension", "path": "MedicationStatement.informationSource.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "MedicationStatement.informationSource.extension:practitionerRole", "path": "MedicationStatement.informationSource.extension", "sliceName": "practitionerRole", "max": "1", "type": [ { "code": "Extension", "profile": "http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" } ] }, { "id": "MedicationStatement.subject", "path": "MedicationStatement.subject", "type": [ { "code": "Reference", "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient" } ], "mapping": [ { "identity": "hcim-basicelements-v1.0-2017EN", "map": "NL-CM:0.0.11", "comment": "Subject" } ] }, { "id": "MedicationStatement.derivedFrom", "path": "MedicationStatement.derivedFrom", "slicing": { "discriminator": [ { "type": "profile", "path": "reference.resolve()" } ], "rules": "open" } }, { "id": "MedicationStatement.derivedFrom:relatedAgreement", "path": "MedicationStatement.derivedFrom", "sliceName": "relatedAgreement", "short": "Related Agreement", "definition": "A reference to a medication or dispense request that have been the medication usage has been based on.", "alias": [ "Gerelateerde afspraak" ], "type": [ { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationAgreement" }, { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAgreement" } ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22402", "comment": "Gerelateerde afspraak" } ] }, { "id": "MedicationStatement.derivedFrom:relatedDispense", "path": "MedicationStatement.derivedFrom", "sliceName": "relatedDispense", "short": "Related Dispense", "definition": "A reference to the dispense that has provided the basis for indicating use.", "alias": [ "Gerelateerde verstrekking" ], "type": [ { "code": "Reference", "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-Dispense" } ], "mapping": [ { "identity": "Medication-Process-v09", "map": "mp-dataelement900-22404", "comment": "Gerelateerde verstrekking" } ] }, { "id": "MedicationStatement.taken", "path": "MedicationStatement.taken", "short": "UseIndicator", "definition": "Is this medicine used or not?", "alias": [ "GebruikIndicator" ], "example": [ { "label": "Example of taken", "valueCode": "y" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22399", "comment": "UseIndicator" } ] }, { "id": "MedicationStatement.reasonCode.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.reasonCode.text", "short": "ReasonForUse", "definition": "The reason for using the medication, particularly in self-care medicine purchased by the patient themselves.", "alias": [ "RedenGebruik" ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22491", "comment": "ReasonForUse" } ] }, { "id": "MedicationStatement.note", "path": "MedicationStatement.note", "short": "Comment", "definition": "Comments on the medication use.", "alias": [ "Toelichting" ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.21624", "comment": "Comment" } ] }, { "id": "MedicationStatement.dosage", "path": "MedicationStatement.dosage", "type": [ { "code": "Dosage", "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse" } ], "mapping": [ { "identity": "hcim-medicationuse2-v1.0-2017EN", "map": "NL-CM:9.11.22504", "comment": "InstructionsForUse" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact", "path": "MedicationStatement.dosage.timing.repeat.extension", "sliceName": "exact" }, { "id": "MedicationStatement.dosage.timing.repeat.extension:exact.valueBoolean:valueBoolean", "path": "MedicationStatement.dosage.timing.repeat.extension.valueBoolean", "sliceName": "valueBoolean" }, { "id": "MedicationStatement.dosage.dose[x]", "path": "MedicationStatement.dosage.dose[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "rules": "open" } } ] } }