CA Core+
cibuild 
1.2.0-DFT - The specification is version 1.2.0-DFT of CA Core+ For a full list of available versions, see the Directory of published versions
MedicationStatement (CA-Core)
Many ValueSet and CodeSystem bindings in this guide link to resources hosted on the Canada Health Infoway Terminology Service (Ontoserver). If you are redirected to a login page: This is expected and you are being directed to Infoway’s secure environment. To access these resources: You’ll need an InfoCentral Account.
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/MedicationStatement
Examples
example-medicationstatement-ca-core
Description
This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context.
References to this resource
CFMM: 2
Resource Content
| MedicationStatementCACore (MedicationStatement) | C | MedicationStatement | |
| id | Σ | 0..1 | id |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| RenderedDosageInstruction | C | 0..1 | Extension(string) |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| basedOn | Σ C | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest) |
| partOf | Σ C | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Observation | Procedure) |
| status | SO Σ ?! | 1..1 | codeBinding |
| statusReason | 0..* | CodeableConcept | |
| category | Σ | 0..1 | CodeableConceptBinding |
| medication[x] | SO Σ | 1..1 | |
| medicationReference | Σ | 0..1 | Reference(MedicationCACore) |
| medicationCodeableConcept | Σ | 0..1 | CodeableConceptCACoreBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 0..* | CodingCACore |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | Σ | 0..1 | uri |
| version | Σ | 0..1 | string |
| code | Σ | 0..1 | code |
| display | Σ | 0..1 | string |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| translation | C | 0..* | Extension(Complex) |
| value | 0..1 | System.String | |
| userSelected | Σ | 0..1 | boolean |
| text | Σ | 0..1 | string |
| subject | SO Σ C | 1..1 | Reference(PatientCACore | Group) |
| context | Σ C | 0..1 | Reference(Encounter | EpisodeOfCare) |
| effective[x] | SO Σ | 0..1 | |
| effectiveDateTime | dateTime | ||
| effectivePeriod | Σ | 0..1 | Period |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| start | Σ C | 0..1 | dateTime |
| end | Σ C | 0..1 | dateTime |
| dateAsserted | Σ | 0..1 | dateTime |
| informationSource | C | 0..1 | Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) |
| derivedFrom | C | 0..* | Reference(Resource) |
| reasonCode | O | 0..* | CodeableConceptCACoreBinding |
| reasonReference | O C | 0..* | Reference(Condition | DiagnosticReport | Observation) |
| note | 0..* | Annotation | |
| dosage | O | 0..* | Dosage |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| sequence | Σ | 0..1 | integer |
| text | O Σ | 0..1 | string |
| additionalInstruction | Σ | 0..* | CodeableConcept |
| patientInstruction | Σ | 0..1 | string |
| timing | Σ | 0..1 | Timing |
| asNeeded[x] | Σ | 0..1 | |
| asNeededBoolean | boolean | ||
| asNeededCodeableConcept | CodeableConcept | ||
| site | Σ | 0..1 | CodeableConcept |
| route | Σ | 0..1 | CodeableConceptCACoreBinding |
| method | Σ | 0..1 | CodeableConcept |
| doseAndRate | Σ | 0..* | Element |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| type | Σ | 0..1 | CodeableConcept |
| dose[x] | Σ | 0..1 | Binding |
| doseRange | Range | ||
| doseQuantity | Σ C | 0..1 | SimpleQuantity |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| value | Σ | 0..1 | decimal |
| comparator | Σ ?! | 0..0 | codeBinding |
| unit | Σ | 0..1 | string |
| system | Σ C | 0..1 | uri |
| code | Σ | 0..1 | code |
| rate[x] | Σ | 0..1 | |
| rateQuantity | SimpleQuantity | ||
| rateRange | Range | ||
| rateRatio | Ratio | ||
| maxDosePerPeriod | Σ C | 0..1 | Ratio |
| maxDosePerAdministration | Σ C | 0..1 | SimpleQuantity |
| maxDosePerLifetime | Σ C | 0..1 | SimpleQuantity |
| MedicationStatementCACore (MedicationStatement) | MedicationStatement | ||
| extension | |||
| RenderedDosageInstruction | 0..1 | Extension(string) | |
| status | SO | ||
| medication[x] | SO | ||
| medicationReference | 0..1 | Reference(MedicationCACore) | |
| medicationCodeableConcept | 0..1 | CodeableConceptCACoreBinding | |
| coding | |||
| system | |||
| display | |||
| subject | SO | Reference(PatientCACore | Group) | |
| effective[x] | SO | ||
| effectivePeriod | 0..1 | Period | |
| end | |||
| reasonCode | O | CodeableConceptCACoreBinding | |
| reasonReference | O | ||
| dosage | O | ||
| text | O | ||
| timing | |||
| route | CodeableConceptCACoreBinding | ||
| doseAndRate | |||
| dose[x] | Binding | ||
| doseQuantity | 0..1 | SimpleQuantity | |
| value | |||
| unit |
</extension>
<url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medicationstatement-ca-core" />
</telecom>
</telecom>
</contact>
<description value="This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context." />
</jurisdiction>
<copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<comment value="Mapping for MedicationStatementCACore to Canadian Core Data for Interoperability (CACDI)." />
</mapping>
</discriminator>
</slicing>
</element>
<definition value="A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider." />
<comment value="Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use." />
</type>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</discriminator>
</slicing>
<comment value="The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides." />
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core" />
</type>
</element>
<comment value="The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet." />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis" />
</extension>
</extension>
</extension>
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" />
</extension>
<valueMarkdown value="per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets" />
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada" />
</extension>
</extension>
</binding>
</mapping>
</element>
</mapping>
</element>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</discriminator>
</slicing>
</element>
</type>
</element>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
</extension>
<valueMarkdown value=" Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)" />
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment" />
</extension>
</extension>
</binding>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</mapping>
</element>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration" />
</extension>
<valueMarkdown value="Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." />
</extension>
</extension>
</binding>
</mapping>
</element>
</discriminator>
</slicing>
<comment value="Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range" />
<description value="Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set" />
</binding>
</element>
</type>
</element>
</mapping>
</element>
</mapping>
</element>
</differential>
</StructureDefinition>
{
],
{
{
},
{
}
]
}
],
"description": "This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context.",
],
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
"comment": "Mapping for MedicationStatementCACore to Canadian Core Data for Interoperability (CACDI)."
}
],
{
}
},
{
"definition": "A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.",
"comment": "Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.",
{
"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
]
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
"comment": "The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.",
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core"
]
}
]
},
{
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet.",
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
"valueMarkdown": "per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis"
}
],
},
{
{
},
{
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
},
{
"valueMarkdown": "per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
}
],
},
{
{
},
{
},
{
"valueMarkdown": "A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada"
}
],
}
],
},
]
},
{
]
},
{
{
},
{
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
},
{
]
},
{
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
"valueMarkdown": " Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)"
}
],
},
{
{
},
{
},
{
"valueMarkdown": "A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment"
}
],
}
],
},
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
"valueMarkdown": "Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
}
],
}
],
},
]
},
{
},
"comment": "Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range",
"description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set",
}
},
{
]
},
{
]
},
{
]
}
]
}
}
Terminology bindings
| Path | Conformance | ValueSet |
|---|---|---|
| MedicationStatement.medication[x]:medicationCodeableConcept | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct |
| MedicationStatement.reasonCode | preferred | https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode |
| MedicationStatement.dosage.route | preferred | https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration |
| MedicationStatement.dosage.doseAndRate.dose[x] | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit |
Additional Terminology Bindings
These bindings may be used in lieu of the primary bindings in the table above.
| Path | Conformance | AdditionalValueSet |
|---|---|---|
| MedicationStatement.medication[x]:medicationCodeableConcept | candidate | https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts |
| MedicationStatement.reasonCode | candidate | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse |
| MedicationStatement.dosage.route | candidate | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration |
Mappings to CACDI
The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.
| FHIR Profile Element | CACDI Element(s) |
|---|---|
| MedicationStatement.medication[x]:medicationCodeableConcept | Medication |
| MedicationStatement.medication[x]:medicationCodeableConcept.coding.system | Drug Code System URI |
| MedicationStatement.medication[x]:medicationCodeableConcept.coding.display | Drug English Description, Drug French Description |
| MedicationStatement.effective[x]:effectivePeriod.end | Medication End Date and Time |
| MedicationStatement.reasonCode | Medication Reason |
| MedicationStatement.reasonReference | Medication Reason |
| MedicationStatement.dosage.timing | Medication Timing |
| MedicationStatement.dosage.route | Medication Route of Administration |
| MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value | Medication Dose Value |
| MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit | Medication Dose Unit of Measure |
Constraints
The following table lists constraints (from differential).