<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="447bcab1-12c9-486e-a308-4909d531510a" />
  <meta>
    <versionId value="1" />
    <lastUpdated value="2016-11-24T20:29:31.928+00:00" />
    <tag>
      <system value="urn:hscic:examples" />
      <code value="MedicationStatement" />
      <display value="Medication Statement" />
    </tag>
    <tag>
      <system value="urn:hscic:publishOrder" />
      <code value="10" />
    </tag>
  </meta>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1" />
  </extension>
  <url value="http://fhir.nhs.net/StructureDefinition/careconnect-gpc-medicationstatement-1" />
  <name value="CareConnect-GPC-MedicationStatement-1" />
  <status value="draft" />
  <publisher value="HL7 UK" />
  <description value="CareConnect MedicationStatement profile, with further constraints applied to support the GP Connect requirements." />
  <copyright value="Copyright © 2016 HL7 UK&#xD;&#xA;&#xD;&#xA;Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at&#xD;&#xA;&#xD;&#xA;http://www.apache.org/licenses/LICENSE-2.0&#xD;&#xA;&#xD;&#xA;Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.&#xD;&#xA;&#xD;&#xA;HL7® FHIR® standard Copyright © 2011+ HL7&#xD;&#xA;&#xD;&#xA;The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at&#xD;&#xA;&#xD;&#xA;https://www.hl7.org/fhir/license.html" />
  <fhirVersion value="1.0.2" />
  <kind value="resource" />
  <constrainedType value="MedicationStatement" />
  <abstract value="false" />
  <base value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
  <snapshot>
    <element>
      <path value="MedicationStatement" />
      <short value="Record of medication being taken by a patient" />
      <definition value="A record of a medication that is being consumed by a patient.   A MedicationStatement may indicate that the patient may be taking the medication now, or has taken the medication in the past or will be taking the medication in the future.  The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician.  A common scenario where this information is captured is during the history taking process during a patient visit or stay.   The medication information may come from e.g. the patient's memory, from a prescription bottle,  or from a list of medications the patient, clinician or other party maintains   The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication.  A medication statement is often, if not always, less specific.  There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise.  As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains.  Medication administration is more formal and is not missing detailed information." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="MedicationStatement" />
      </type>
      <constraint>
        <key value="mst-1" />
        <severity value="error" />
        <human value="Reason not taken is only permitted if wasNotTaken is true" />
        <xpath value="not(exists(f:reasonNotTaken) and f:wasNotTaken/@value=false())" />
      </constraint>
      <constraint>
        <key value="mst-2" />
        <severity value="error" />
        <human value="Reason for use is only permitted if wasNotTaken is false" />
        <xpath value="not(exists(*[starts-with(local-name(.), 'reasonForUse')]) and f:wasNotTaken/@value=true())" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.medication" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <slicing>
        <discriminator value="url" />
        <rules value="openAtEnd" />
      </slicing>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="reasonEnded" />
      <short value="Why prescription was stopped" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationstatementreasonended-1" />
      </type>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="lastIssueDate" />
      <short value="Indicates the date a prescription was last issued" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationstatementlastissuedate-1" />
      </type>
      <mustSupport value="true" />
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="quantityDispensed" />
      <short value="Amount of medication to supply per dispense" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationstatementquantity-1" />
      </type>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="repeatInformation" />
      <short value="Medication repeat information" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationrepeatinformation-1" />
      </type>
      <mustSupport value="true" />
    </element>
    <element>
      <path value="MedicationStatement.identifier" />
      <short value="External identifier" />
      <definition value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration.id" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.use" />
      <short value="usual | official | temp | secondary (If known)" />
      <definition value="The purpose of this identifier." />
      <comments value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.use" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/identifier-use" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type" />
      <short value="Description of identifier" />
      <definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
      <comments value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
      <requirements value="Allows users to make use of identifiers when the identifier system is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="extensible" />
        <description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/identifier-type" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="CX.5" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.coding" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.type.text" />
      <short value="Plain text representation of the concept" />
      <definition value="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." />
      <comments value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="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 value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.system" />
      <short value="The namespace for the identifier" />
      <definition value="Establishes the namespace in which set of possible id values is unique." />
      <requirements value="There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically displayed to the user and which is unique within the context of the system." />
      <comments value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <exampleString value="123456" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.period" />
      <short value="Time period when id is/was valid for use" />
      <definition value="Time period during which identifier is/was valid for use." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.7 + CX.8" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.effectiveTime or implied by context" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./StartDate and ./EndDate" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.period.start" />
      <short value="Starting time with inclusive boundary" />
      <definition value="The start of the period. The boundary is inclusive." />
      <comments value="If the low element is missing, the meaning is that the low boundary is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Period.start" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="per-1" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="DR.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./low" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.period.end" />
      <short value="End time with inclusive boundary, if not ongoing" />
      <definition value="The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
      <comments value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Period.end" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
      <condition value="per-1" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="DR.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./high" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comments value="The reference may be just a text description of the assigner." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-organization-1" />
        <aggregation value="referenced" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.assigner.reference" />
      <short value="Relative, internal or absolute URL reference" />
      <definition value="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." />
      <comments value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-1" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.assigner.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.patient" />
      <short value="Who is/was taking  the medication" />
      <definition value="The person or animal who is/was taking the medication." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.patient" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-patient-1" />
        <aggregation value="referenced" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="PID-3-Patient ID List" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration-&gt;subject-&gt;Patient" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.focus" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.patient.reference" />
      <short value="Relative, internal or absolute URL reference" />
      <definition value="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." />
      <comments value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-1" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.patient.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.informationSource" />
      <definition value="The person who provided the information about the medication." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.informationSource" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <aggregation value="referenced" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-patient-1" />
        <aggregation value="referenced" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-practitioner-1" />
        <aggregation value="referenced" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="w5" />
        <map value="who.source" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dateAsserted" />
      <short value="When the statement was asserted?" />
      <definition value="The date when the medication statement was asserted by the information source." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dateAsserted" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.status" />
      <short value="active | completed | entered-in-error | intended" />
      <definition value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="A set of codes indicating the current status of a MedicationStatement." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-statement-status" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="MedicationStatement.wasNotTaken" />
      <short value="True if medication is/was not being taken" />
      <definition value="Set this to true if the record is saying that the medication was NOT taken." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.wasNotTaken" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <meaningWhenMissing value="If this is missing, then the medication was taken" />
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration.actionNegationInd" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken" />
      <short value="True if asserting medication was not given" />
      <definition value="A code indicating why the medication was not taken." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.reasonNotTaken" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="mst-1" />
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="A set of codes indicating the reason why the MedicationAdministration is negated." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration-&gt;Reason-&gt;Observation-&gt;Value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding" />
      <slicing>
        <discriminator value="system" />
        <ordered value="false" />
        <rules value="openAtEnd" />
      </slicing>
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding" />
      <name value="SNOMED CT" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://snomed.info/sct" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.text" />
      <short value="Plain text representation of the concept" />
      <definition value="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." />
      <comments value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="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 value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonForUse[x]" />
      <definition value="A reason for why the medication is being/was taken." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.reasonForUse[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Condition" />
        <aggregation value="referenced" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="Codes identifying why the medication is being taken." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="MedicationStatement.effective[x]" />
      <short value="Over what period was medication consumed?" />
      <definition value="The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true)." />
      <comments value="If the medication is still being taken at the time the statement is recorded, the &quot;end&quot; date will be omitted." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.effective[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration.effectiveTime" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.done" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.note" />
      <short value="Further information about the statement" />
      <definition value="Provides extra information about the medication statement that is not conveyed by the other attributes." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.note" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.supportingInformation" />
      <short value="Additional supporting information" />
      <definition value="Allows linking the MedicationStatement to the underlying MedicationOrder, or to other information that supports the MedicationStatement." />
      <comments value="Likely references would be to MedicationOrder, MedicationDispense, Claim, Observation or QuestionnaireAnswers." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.supportingInformation" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Resource" />
        <aggregation value="referenced" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.supportingInformation.reference" />
      <short value="Relative, internal or absolute URL reference" />
      <definition value="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." />
      <comments value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ref-1" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.supportingInformation.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.medication[x]" />
      <short value="What medication was taken" />
      <definition value="Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications." />
      <comments value="If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the medication this statement concerns. When the only available information is a text description of the medication, Medication.code.text should be used." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.medication[x]" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/careconnect-medication-1" />
        <aggregation value="bundled" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="Codes identifying medication item" />
        <valueSetReference>
          <reference value="http://fhir.nhs.net/ValueSet/careconnect-manufacturedmaterialsnct-1" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration&gt;Component&gt;SubstanceAdministrationRequest.consumable" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage" />
      <short value="Details of how medication was taken" />
      <definition value="Indicates how the medication is/was used by the patient." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration&gt;Component&gt;SubstanceAdministrationRequest" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element, 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." />
      <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.text" />
      <short value="A text representation of the dosage instructions given to the patient" />
      <definition value="Free text dosage information as reported about a patient's medication use. When coded dosage information is present, the free text may still be present for display to humans." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing" />
      <short value="When/how often was medication taken" />
      <definition value="The timing schedule for giving the medication to the patient.  The Schedule data type allows many different expressions, for example.  &quot;Every  8 hours&quot;; &quot;Three times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;;  &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.timing" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Timing" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".effectiveTime" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.event" />
      <short value="When the event occurs" />
      <definition value="Identifies specific times when the event occurs." />
      <requirements value="In an MAR, for instance, you need to take a general specification, and turn it into a precise specification." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.event" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="QLIST&lt;TS&gt;" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat" />
      <short value="When the event is to occur" />
      <definition value="A set of rules that describe when the event should occur." />
      <requirements value="Many timing schedules are determined by regular repetitions." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Element" />
      </type>
      <constraint>
        <key value="tim-6" />
        <severity value="error" />
        <human value="If there's a periodMax, there must be a period" />
        <xpath value="not(exists(f:periodMax)) or exists(f:period)" />
      </constraint>
      <constraint>
        <key value="tim-7" />
        <severity value="error" />
        <human value="If there's a durationMax, there must be a duration" />
        <xpath value="not(exists(f:durationMax)) or exists(f:duration)" />
      </constraint>
      <constraint>
        <key value="tim-1" />
        <severity value="error" />
        <human value="if there's a duration, there needs to be duration units" />
        <xpath value="not(exists(f:duration)) or exists(f:durationUnits)" />
      </constraint>
      <constraint>
        <key value="tim-2" />
        <severity value="error" />
        <human value="if there's a period, there needs to be period units" />
        <xpath value="not(exists(f:period)) or exists(f:periodUnits)" />
      </constraint>
      <constraint>
        <key value="tim-3" />
        <severity value="error" />
        <human value="Either frequency or when can exist, not both" />
        <xpath value="not(exists(f:frequency)) or not(exists(f:when))" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="Implies PIVL or EIVL" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.extension" />
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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." />
      <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.bounds[x]" />
      <short value="Length/Range of lengths, or (Start and/or end) limits" />
      <definition value="Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.bounds[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Duration" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="IVL(TS) used in a QSI" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.count" />
      <short value="Number of times to repeat" />
      <definition value="A total count of the desired number of repetitions." />
      <comments value="If you have both bounds and count, then this should be understood as within the bounds period, until count times happens." />
      <requirements value="Repetitions may be limited by end time or total occurrences." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.count" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.count" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.duration" />
      <short value="How long when it happens" />
      <definition value="How long this thing happens for when it happens." />
      <comments value="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 value="Some activities are not instantaneous and need to be maintained for a period of time." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.duration" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <constraint>
        <key value="tim-4" />
        <severity value="error" />
        <human value="duration SHALL be a non-negative value" />
        <xpath value="@value &gt;= 0 or not(@value)" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase / EIVL.offset" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.durationMax" />
      <short value="How long when it happens (Max)" />
      <definition value="The upper limit of how long this thing happens for when it happens." />
      <comments value="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 value="Some activities are not instantaneous and need to be maintained for a period of time." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.durationMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase / EIVL.offset" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.durationUnits" />
      <short value="s | min | h | d | wk | mo | a - unit of time (UCUM)" />
      <definition value="The units of time for the duration, in UCUM units." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.durationUnits" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="A unit of time (units from UCUM)." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/units-of-time" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase.unit" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.frequency" />
      <short value="Event occurs frequency times per period" />
      <definition value="The number of times to repeat the action within the specified period / period range (i.e. both period and periodMax provided)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.frequency" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <defaultValueInteger value="1" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase / EIVL.offset" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.frequencyMax" />
      <short value="Event occurs up to frequencyMax times per period" />
      <definition value="If present, indicates that the frequency is a range - so repeat between [frequency] and [frequencyMax] times within the period or period range." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.frequencyMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.period" />
      <short value="Event occurs frequency times per period" />
      <definition value="Indicates the duration of time over which repetitions are to occur; e.g. to express &quot;3 times per day&quot;, 3 would be the frequency and &quot;1 day&quot; would be the period." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <constraint>
        <key value="tim-5" />
        <severity value="error" />
        <human value="period SHALL be a non-negative value" />
        <xpath value="@value &gt;= 0 or not(@value)" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.periodMax" />
      <short value="Upper limit of period (3-4 hours)" />
      <definition value="If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as &quot;do this once every 3-5 days." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.periodMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.periodUnits" />
      <short value="s | min | h | d | wk | mo | a - unit of time (UCUM)" />
      <definition value="The units of time for the period in UCUM units." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.periodUnits" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="A unit of time (units from UCUM)." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/units-of-time" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase.unit" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.repeat.when" />
      <short value="Regular life events the event is tied to" />
      <definition value="A real world event that the occurrence of the event should be tied to." />
      <requirements value="Timings are frequently determined by occurrences such as waking, eating and sleep." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.when" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="Real world event that the relating to the schedule." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/event-timing" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="EIVL.event" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code" />
      <short value="QD | QOD | Q4H | Q6H | BID | TID | QID | AM | PM +" />
      <definition value="A code for the timing pattern. Some codes such as BID are ubiquitous, but many institutions define their own additional codes." />
      <comments value="A repeat should always be defined except for the common codes BID, TID, QID, AM and PM, which all systems are required to understand." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="Code for a known / defined timing pattern." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/timing-abbreviation" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="QSC.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.coding" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.code.text" />
      <short value="Plain text representation of the concept" />
      <definition value="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." />
      <comments value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="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 value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.asNeeded[x]" />
      <short value="Take &quot;as needed&quot; (for x)" />
      <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).    Specifically if 'boolean' datatype is selected, then the following logic applies:  If set to True, this indicates that the medication is only taken when needed, within the specified schedule." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.asNeeded[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30 minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc." />
        <valueSetUri value="http://snomed.info/sct" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="boolean: .outboundRelationship[typeCode=PRCN].negationInd (inversed - so negationInd = true means asNeeded=false  CodeableConcept: .outboundRelationship[typCode=PRCN].target[classCode=OBS, moodCode=EVN, isCriterionInd=true, code=&quot;Assertion&quot;].value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.site[x]" />
      <short value="Where (on body) medication is/was administered" />
      <definition value="A coded specification of or a reference to the anatomic site where the medication first enters the body." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.site[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/BodySite" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept describing the site location the medicine enters into or onto the body." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/approach-site-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".approachSiteCode" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route" />
      <short value="How the medication entered the body" />
      <definition value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.route" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/route-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".routeCode" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding" />
      <slicing>
        <discriminator value="system" />
        <ordered value="false" />
        <rules value="openAtEnd" />
      </slicing>
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding" />
      <name value="SNOMED CT" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept describing the route" />
        <valueSetReference>
          <reference value="http://fhir.nhs.net/ValueSet/careconnect-medicationdosageroute-1" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://snomed.info/sct" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.text" />
      <short value="Plain text representation of the concept" />
      <definition value="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." />
      <comments value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="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 value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method" />
      <short value="Technique used to administer medication" />
      <definition value="A coded value indicating the method by which the medication is intended to be or was introduced into or on the body.  This attribute will most often NOT be populated.  It is most commonly used for injections.  For example, Slow Push, Deep IV." />
      <comments value="One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration.  This means the codes used in route or form may pre-coordinate the method in the route code or the form code.  The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may  be used frequently." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.method" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="A coded concept describing the technique by which the medicine is administered." />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".methodCode" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding" />
      <slicing>
        <discriminator value="system" />
        <ordered value="false" />
        <rules value="openAtEnd" />
      </slicing>
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding" />
      <name value="SNOMED CT" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept describing the technique by which the medicine is administered." />
        <valueSetReference>
          <reference value="http://fhir.nhs.net/ValueSet/careconnect-medicationdosagemethod-1" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://snomed.info/sct" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.userSelected" />
      <short value="If this coding was chosen directly by the user" />
      <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)." />
      <comments value="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 value="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 value="0" />
      <max value="1" />
      <base>
        <path value="Coding.userSelected" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="Sometimes implied by being first" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD.codingRationale" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="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 &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.text" />
      <short value="Plain text representation of the concept" />
      <definition value="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." />
      <comments value="Very often the text is the same as a displayName of one of the codings." />
      <requirements value="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 value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.quantityQuantity" />
      <short value="Amount administered in one dose" />
      <definition value="The amount of therapeutic or other substance given at one administration event." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.quantity[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.rate[x]" />
      <short value="Dose quantity per unit of time" />
      <definition value="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.   Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.rate[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".rateQuantity" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod" />
      <short value="Maximum dose that was consumed per unit of time" />
      <definition value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.maxDosePerPeriod" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Ratio" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".maxDoseQuantity" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.numerator" />
      <short value="Numerator value" />
      <definition value="The value of the numerator." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Ratio.numerator" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".numerator" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.numerator.value" />
      <short value="Numerical value (with implicit precision)" />
      <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
      <comments value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
      <requirements value="Precision is handled implicitly in almost all cases of measurement." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="SN.2  / CQ - N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.numerator.comparator" />
      <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value" />
      <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is &quot;&lt;&quot; , then the real value is &lt; stated value." />
      <comments value="This is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." />
      <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.comparator" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="How the Quantity should be understood and represented." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="SN.1  / CQ.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL properties" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.numerator.unit" />
      <short value="Unit representation" />
      <definition value="A human-readable form of the unit." />
      <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.unit" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.unit" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.numerator.system" />
      <short value="System that defines coded unit form" />
      <definition value="The identification of the system that provides the coded form of the unit." />
      <requirements value="Need to know the system that defines the coded form of the unit." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="qty-3" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CO.codeSystem, PQ.translation.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.numerator.code" />
      <short value="Coded form of the unit" />
      <definition value="A computer processable form of the unit in some unit representation system." />
      <comments value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system." />
      <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.code, MO.currency, PQ.translation.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.denominator" />
      <short value="Denominator value" />
      <definition value="The value of the denominator." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Ratio.denominator" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".denominator" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.denominator.value" />
      <short value="Numerical value (with implicit precision)" />
      <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
      <comments value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
      <requirements value="Precision is handled implicitly in almost all cases of measurement." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="SN.2  / CQ - N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.denominator.comparator" />
      <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value" />
      <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is &quot;&lt;&quot; , then the real value is &lt; stated value." />
      <comments value="This is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value." />
      <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.comparator" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="How the Quantity should be understood and represented." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/quantity-comparator" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="SN.1  / CQ.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL properties" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.denominator.unit" />
      <short value="Unit representation" />
      <definition value="A human-readable form of the unit." />
      <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.unit" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.unit" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.denominator.system" />
      <short value="System that defines coded unit form" />
      <definition value="The identification of the system that provides the coded form of the unit." />
      <requirements value="Need to know the system that defines the coded form of the unit." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="qty-3" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CO.codeSystem, PQ.translation.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.maxDosePerPeriod.denominator.code" />
      <short value="Coded form of the unit" />
      <definition value="A computer processable form of the unit in some unit representation system." />
      <comments value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system." />
      <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Quantity.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="(see OBX.6 etc.) / CQ.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ.code, MO.currency, PQ.translation.code" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="MedicationStatement" />
      <short value="Record of medication being taken by a patient" />
      <definition value="A record of a medication that is being consumed by a patient.   A MedicationStatement may indicate that the patient may be taking the medication now, or has taken the medication in the past or will be taking the medication in the future.  The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician.  A common scenario where this information is captured is during the history taking process during a patient visit or stay.   The medication information may come from e.g. the patient's memory, from a prescription bottle,  or from a list of medications the patient, clinician or other party maintains   The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication.  A medication statement is often, if not always, less specific.  There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise.  As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains.  Medication administration is more formal and is not missing detailed information." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="MedicationStatement" />
      </type>
      <constraint>
        <key value="mst-1" />
        <severity value="error" />
        <human value="Reason not taken is only permitted if wasNotTaken is true" />
        <xpath value="not(exists(f:reasonNotTaken) and f:wasNotTaken/@value=false())" />
      </constraint>
      <constraint>
        <key value="mst-2" />
        <severity value="error" />
        <human value="Reason for use is only permitted if wasNotTaken is false" />
        <xpath value="not(exists(*[starts-with(local-name(.), 'reasonForUse')]) and f:wasNotTaken/@value=true())" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.medication" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <slicing>
        <discriminator value="url" />
        <rules value="openAtEnd" />
      </slicing>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="reasonEnded" />
      <short value="Why prescription was stopped" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationstatementreasonended-1" />
      </type>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="lastIssueDate" />
      <short value="Indicates the date a prescription was last issued" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationstatementlastissuedate-1" />
      </type>
      <mustSupport value="true" />
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="quantityDispensed" />
      <short value="Amount of medication to supply per dispense" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationstatementquantity-1" />
      </type>
    </element>
    <element>
      <path value="MedicationStatement.extension" />
      <name value="repeatInformation" />
      <short value="Medication repeat information" />
      <definition value="Optional Extensions Element - found in all resources." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://fhir.nhs.net/StructureDefinition/extension-careconnect-medicationrepeatinformation-1" />
      </type>
      <mustSupport value="true" />
    </element>
    <element>
      <path value="MedicationStatement.identifier" />
      <short value="External identifier" />
      <definition value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration.id" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.system" />
      <short value="The namespace for the identifier" />
      <definition value="Establishes the namespace in which set of possible id values is unique." />
      <requirements value="There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically displayed to the user and which is unique within the context of the system." />
      <comments value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Identifier.value" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <exampleString value="123456" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.identifier.assigner" />
      <short value="Organization that issued id (may be just text)" />
      <definition value="Organization that issued/manages the identifier." />
      <comments value="The reference may be just a text description of the assigner." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Identifier.assigner" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-organization-1" />
        <aggregation value="referenced" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / (CX.4,CX.9,CX.10)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierIssuingAuthority" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.patient" />
      <short value="Who is/was taking  the medication" />
      <definition value="The person or animal who is/was taking the medication." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.patient" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-patient-1" />
        <aggregation value="referenced" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="PID-3-Patient ID List" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration-&gt;subject-&gt;Patient" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.focus" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.informationSource" />
      <definition value="The person who provided the information about the medication." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.informationSource" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <aggregation value="referenced" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-patient-1" />
        <aggregation value="referenced" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/gpconnect-practitioner-1" />
        <aggregation value="referenced" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="w5" />
        <map value="who.source" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken" />
      <short value="True if asserting medication was not given" />
      <definition value="A code indicating why the medication was not taken." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.reasonNotTaken" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="mst-1" />
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="A set of codes indicating the reason why the MedicationAdministration is negated." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration-&gt;Reason-&gt;Observation-&gt;Value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding" />
      <slicing>
        <discriminator value="system" />
        <ordered value="false" />
        <rules value="openAtEnd" />
      </slicing>
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding" />
      <name value="SNOMED CT" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://snomed.info/sct" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonNotTaken.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.reasonForUse[x]" />
      <definition value="A reason for why the medication is being/was taken." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.reasonForUse[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Condition" />
        <aggregation value="referenced" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="Codes identifying why the medication is being taken." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code" />
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="MedicationStatement.effective[x]" />
      <short value="Over what period was medication consumed?" />
      <definition value="The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true)." />
      <comments value="If the medication is still being taken at the time the statement is recorded, the &quot;end&quot; date will be omitted." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.effective[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration.effectiveTime" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.done" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.note" />
      <short value="Further information about the statement" />
      <definition value="Provides extra information about the medication statement that is not conveyed by the other attributes." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.note" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.supportingInformation" />
      <short value="Additional supporting information" />
      <definition value="Allows linking the MedicationStatement to the underlying MedicationOrder, or to other information that supports the MedicationStatement." />
      <comments value="Likely references would be to MedicationOrder, MedicationDispense, Claim, Observation or QuestionnaireAnswers." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.supportingInformation" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Resource" />
        <aggregation value="referenced" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.medication[x]" />
      <short value="What medication was taken" />
      <definition value="Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications." />
      <comments value="If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the medication this statement concerns. When the only available information is a text description of the medication, Medication.code.text should be used." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.medication[x]" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://fhir.nhs.net/StructureDefinition/careconnect-medication-1" />
        <aggregation value="bundled" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="Codes identifying medication item" />
        <valueSetReference>
          <reference value="http://fhir.nhs.net/ValueSet/careconnect-manufacturedmaterialsnct-1" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration&gt;Component&gt;SubstanceAdministrationRequest.consumable" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage" />
      <short value="Details of how medication was taken" />
      <definition value="Indicates how the medication is/was used by the patient." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration&gt;Component&gt;SubstanceAdministrationRequest" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.text" />
      <short value="A text representation of the dosage instructions given to the patient" />
      <definition value="Free text dosage information as reported about a patient's medication use. When coded dosage information is present, the free text may still be present for display to humans." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
    </element>
    <element>
      <path value="MedicationStatement.dosage.timing.event" />
      <short value="When the event occurs" />
      <definition value="Identifies specific times when the event occurs." />
      <requirements value="In an MAR, for instance, you need to take a general specification, and turn it into a precise specification." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.event" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="QLIST&lt;TS&gt;" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.asNeeded[x]" />
      <short value="Take &quot;as needed&quot; (for x)" />
      <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).    Specifically if 'boolean' datatype is selected, then the following logic applies:  If set to True, this indicates that the medication is only taken when needed, within the specified schedule." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.asNeeded[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30 minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc." />
        <valueSetUri value="http://snomed.info/sct" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="boolean: .outboundRelationship[typeCode=PRCN].negationInd (inversed - so negationInd = true means asNeeded=false  CodeableConcept: .outboundRelationship[typCode=PRCN].target[classCode=OBS, moodCode=EVN, isCriterionInd=true, code=&quot;Assertion&quot;].value" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.site[x]" />
      <short value="Where (on body) medication is/was administered" />
      <definition value="A coded specification of or a reference to the anatomic site where the medication first enters the body." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.site[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/BodySite" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept describing the site location the medicine enters into or onto the body." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/approach-site-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value=".approachSiteCode" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding" />
      <slicing>
        <discriminator value="system" />
        <ordered value="false" />
        <rules value="openAtEnd" />
      </slicing>
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding" />
      <name value="SNOMED CT" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept describing the route" />
        <valueSetReference>
          <reference value="http://fhir.nhs.net/ValueSet/careconnect-medicationdosageroute-1" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://snomed.info/sct" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.route.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding" />
      <slicing>
        <discriminator value="system" />
        <ordered value="false" />
        <rules value="openAtEnd" />
      </slicing>
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding" />
      <name value="SNOMED CT" />
      <short value="Code defined by a terminology system" />
      <definition value="A reference to a code defined by a terminology system." />
      <comments value="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 labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="CodeableConcept.coding" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="A coded concept describing the technique by which the medicine is administered." />
        <valueSetReference>
          <reference value="http://fhir.nhs.net/ValueSet/careconnect-medicationdosagemethod-1" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="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 value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.system" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="http://snomed.info/sct" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.version" />
      <short value="Version of the system - if relevant" />
      <definition value="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." />
      <comments value="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 value="0" />
      <max value="0" />
      <base>
        <path value="Coding.version" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystemVersion" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="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 value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.method.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Coding.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="MedicationStatement.dosage.quantityQuantity" />
      <short value="Amount administered in one dose" />
      <definition value="The amount of therapeutic or other substance given at one administration event." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dosage.quantity[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>