Copy of 'GP Connect Data Model | FHIR STU3 Representation'

Profile: CareConnect-GPC-MedicationStatement-1

CareConnect-GPC-MedicationStatement-1 (MedicationStatement)

There are no (further) constraints on this element

Element id

MedicationStatement

Short description

Record of medication being taken by a patient

Definition

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 sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

The primary difference between a 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.

Comments

When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

Data type

MedicationStatement

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: SubstanceAdministration

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

MedicationStatement.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.meta.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.meta.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

versionId

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.meta.versionId

Short description

Version specific identifier

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

lastUpdated

0..1

instant

There are no (further) constraints on this element

Element id

MedicationStatement.meta.lastUpdated

Short description

When the resource version last changed

Definition

When the resource last changed - e.g. when the version changed.

Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Data type

instant

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

source

0..1

uri

There are no (further) constraints on this element

Element id

MedicationStatement.meta.source

Short description

Identifies where the resource comes from

Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

profile

1..*

canonical(StructureDefinition)

There are no (further) constraints on this element

Element id

MedicationStatement.meta.profile

Short description

Profiles this resource claims to conform to

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Data type

canonical(StructureDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

security

0..*

CodingBinding

There are no (further) constraints on this element

Element id

MedicationStatement.meta.security

Short description

Security Labels applied to this resource

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

Coding

Binding

Security Labels from the Healthcare Privacy and Security Classification System.

AllSecurityLabels (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

tag

0..*

Coding

There are no (further) constraints on this element

Element id

MedicationStatement.meta.tag

Short description

Tags applied to this resource

Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

Coding

Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationStatement.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationStatement.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

MaxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationStatement.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationStatement.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

1..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

lastIssueDate

S C

0..1

Extension(dateTime)

Element id

MedicationStatement.extension:lastIssueDate

Short description

The date a prescription was last issued

Alternate names

extensions, user content

Definition

The date a prescription was last issued.

Comments

Data type

Extension(dateTime)

Extension URL

Extension-CareConnect-GPC-MedicationStatementLastIssueDate-1

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

changeSummary

0..1

Extension(Complex)

Element id

MedicationStatement.extension:changeSummary

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

Extension(Complex)

Extension URL

Extension-CareConnect-GPC-MedicationChangeSummary-1

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

prescribingAgency

1..1

Extension(CodeableConcept)

Element id

MedicationStatement.extension:prescribingAgency

Short description

The type of organisation/setting responsible for authorising and issuing the medication

Alternate names

extensions, user content

Definition

The type of organisation/setting responsible for authorising and issuing the medication.

Comments

Data type

Extension(CodeableConcept)

Extension URL

Extension-CareConnect-GPC-PrescribingAgency-1

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

dosageLastChanged

0..1

Extension

Element id

MedicationStatement.extension:dosageLastChanged

Short description

The date when the dosage instructions were last changed

Alternate names

extensions, user content

Definition

Only populate where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan. Set to the date when the dosage instructions were last changed.

Comments

Data type

Extension

Extension URL

https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.extension:dosageLastChanged.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.extension:dosageLastChanged.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

url

1..1

uriFixed Value

Element id

MedicationStatement.extension:dosageLastChanged.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value

https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1

Mappings

rim: N/A

value[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.extension:dosageLastChanged.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueAddress

Address

There are no (further) constraints on this element

Data type

Address

valueAge

Age

There are no (further) constraints on this element

Data type

Age

valueAnnotation

Annotation

There are no (further) constraints on this element

Data type

Annotation

valueAttachment

Attachment

There are no (further) constraints on this element

Data type

Attachment

valueBase64Binary

base64Binary

There are no (further) constraints on this element

Data type

base64Binary

valueBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

valueCanonical

canonical

There are no (further) constraints on this element

Data type

canonical

valueCode

code

There are no (further) constraints on this element

Data type

code

valueCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

valueCoding

Coding

There are no (further) constraints on this element

Data type

Coding

valueContactDetail

ContactDetail

There are no (further) constraints on this element

Data type

ContactDetail

valueContactPoint

ContactPoint

There are no (further) constraints on this element

Data type

ContactPoint

valueContributor

Contributor

There are no (further) constraints on this element

Data type

Contributor

valueCount

Count

There are no (further) constraints on this element

Data type

Count

valueDataRequirement

DataRequirement

There are no (further) constraints on this element

Data type

DataRequirement

valueDate

date

There are no (further) constraints on this element

Data type

date

valueDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

valueDecimal

decimal

There are no (further) constraints on this element

Data type

decimal

valueDistance

Distance

There are no (further) constraints on this element

Data type

Distance

valueDosage

Dosage

There are no (further) constraints on this element

Data type

Dosage

valueDuration

Duration

There are no (further) constraints on this element

Data type

Duration

valueExpression

Expression

There are no (further) constraints on this element

Data type

Expression

valueHumanName

HumanName

There are no (further) constraints on this element

Data type

HumanName

valueId

There are no (further) constraints on this element

Data type

valueIdentifier

Identifier

There are no (further) constraints on this element

Data type

Identifier

valueInstant

instant

There are no (further) constraints on this element

Data type

instant

valueInteger

integer

There are no (further) constraints on this element

Data type

integer

valueMarkdown

markdown

There are no (further) constraints on this element

Data type

markdown

valueMeta

Meta

There are no (further) constraints on this element

Data type

Meta

valueMoney

Money

There are no (further) constraints on this element

Data type

Money

valueOid

oid

There are no (further) constraints on this element

Data type

oid

valueParameterDefinition

ParameterDefinition

There are no (further) constraints on this element

Data type

ParameterDefinition

valuePeriod

Period

There are no (further) constraints on this element

Data type

Period

valuePositiveInt

positiveInt

There are no (further) constraints on this element

Data type

positiveInt

valueQuantity

Quantity

There are no (further) constraints on this element

Data type

Quantity

valueRange

Range

There are no (further) constraints on this element

Data type

Range

valueRatio

Ratio

There are no (further) constraints on this element

Data type

Ratio

valueReference

Reference

There are no (further) constraints on this element

Data type

Reference

valueRelatedArtifact

RelatedArtifact

There are no (further) constraints on this element

Data type

RelatedArtifact

valueSampledData

SampledData

There are no (further) constraints on this element

Data type

SampledData

valueSignature

Signature

There are no (further) constraints on this element

Data type

Signature

valueString

string

There are no (further) constraints on this element

Data type

string

valueTime

time

There are no (further) constraints on this element

Data type

time

valueTiming

Timing

There are no (further) constraints on this element

Data type

Timing

valueTriggerDefinition

TriggerDefinition

There are no (further) constraints on this element

Data type

TriggerDefinition

valueUnsignedInt

unsignedInt

There are no (further) constraints on this element

Data type

unsignedInt

valueUri

uri

There are no (further) constraints on this element

Data type

uri

valueUrl

url

There are no (further) constraints on this element

Data type

url

valueUsageContext

UsageContext

There are no (further) constraints on this element

Data type

UsageContext

valueUuid

uuid

There are no (further) constraints on this element

Data type

uuid

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

1..*

Identifier

There are no (further) constraints on this element

Element id

MedicationStatement.identifier

Short description

External identifier

Definition

Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

Comments

This is a business identifier, not a resource identifier.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Event.identifier
w5: FiveWs.identifier
rim: .id

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

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.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

1..1

uri

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(Organization)

There are no (further) constraints on this element

Element id

MedicationStatement.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

basedOn

Σ C

0..1

Reference(CarePlan) | Reference(http://hl7.org/fhir/StructureDefinition/ProcedureRequest) | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest) | Reference(CareConnect-GPC-MedicationRequest-1)

Element id

MedicationStatement.basedOn

Short description

Fulfils plan, proposal or order

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event.

Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

partOf

Σ C

0..*

Reference(MedicationAdministration) | Reference(MedicationDispense) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1) | Reference(CareConnect-GPC-MedicationStatement-1)

Element id

MedicationStatement.partOf

Short description

Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Requirements

This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationStatement.status

Short description

Definition

A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

Comments

MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Data type

code

Binding

A coded concept indicating the current status of a MedicationStatement.

Medication Status Codes (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
w5: FiveWs.status
rim: .statusCode

statusReason

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.statusReason

Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationStatement.

Comments

This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

Data type

CodeableConcept

Binding

A coded concept indicating the reason for the status of the statement.

SNOMEDCTDrugTherapyStatusCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.statusReason
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

category

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationStatement.category

Short description

Type of medication usage

Definition

Indicates where the medication is expected to be consumed or administered.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConcept

Binding

A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

Medication usage category codes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
w5: FiveWs.class
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

medication[x]

1..1

There are no (further) constraints on this element

Element id

MedicationStatement.medication[x]

Short description

What medication was taken

Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

Binding

A coded concept identifying the substance or product being taken.

SNOMEDCTMedicationCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.code
w5: FiveWs.what[x]
rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]

medicationCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

medicationReference

Reference(Medication)

There are no (further) constraints on this element

Data type

Reference(Medication)

subject

Σ C

1..1

Reference(Group | Patient)

There are no (further) constraints on this element

Element id

MedicationStatement.subject

Short description

Who is/was taking the medication

Definition

The person, animal or group who is/was taking the medication.

Comments

Data type

Reference(Group | Patient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

context

S Σ C

0..1

Reference(EpisodeOfCare) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)

Element id

MedicationStatement.context

Short description

Encounter / Episode associated with MedicationStatement

Definition

The encounter or episode of care that establishes the context for this MedicationStatement.

Comments

Data type

Reference(EpisodeOfCare) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

effective[x]

S Σ

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.effective[x]

Short description

The date/time or interval when the medication is/was/will be taken

Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.occurrence[x]
w5: FiveWs.done[x]
rim: .effectiveTime

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

dateAsserted

1..1

dateTime

There are no (further) constraints on this element

Element id

MedicationStatement.dateAsserted

Short description

When the statement was asserted?

Definition

The date when the medication statement was asserted by the information source.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
w5: FiveWs.recorded
rim: .participation[typeCode=AUT].time

informationSource

0..1

Element id

MedicationStatement.informationSource

Short description

Person or organization that provided the information about the taking of this medication

Definition

The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.source
rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)

derivedFrom

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationStatement.derivedFrom

Short description

Additional supporting information

Definition

Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

Comments

Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.reasonCode

Short description

Reason for why the medication is being/was taken

Definition

A reason for why the medication is being/was taken.

Comments

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

Data type

CodeableConcept

Binding

A coded concept identifying why the medication is being taken.

ConditionProblemDiagnosisCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
rim: .reasonCode

reasonReference

0..*

Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1)

Element id

MedicationStatement.reasonReference

Short description

Condition or observation that supports why the medication is being/was taken

Definition

Condition or observation that supports why the medication is being/was taken.

Comments

This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

Data type

Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationStatement.note

Short description

Further information about the statement

Definition

Provides extra information about the medication statement that is not conveyed by the other attributes.

Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: Event.note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.note.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.note.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

author[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.participant[typeCode=AUT].role

authorReference

Data type

authorString

string

Data type

string

time

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationStatement.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.effectiveTime

text

1..1

markdown

There are no (further) constraints on this element

Element id

MedicationStatement.note.text

Short description

The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

Data type

markdown

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.text

dosage

1..*

Dosage

There are no (further) constraints on this element

Element id

MedicationStatement.dosage

Short description

Details of how medication is/was taken or should be taken

Definition

Indicates how the medication is/was or should be taken by the patient.

Comments

The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

Data type

Dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: refer dosageInstruction mapping

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

sequence

0..1

integer

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.sequence

Short description

The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Requirements

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

32 bit number; for values larger than this, use decimal

Data type

integer

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: TQ1-1
rim: .text

text

1..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXO-6; RXE-21
rim: .text

additionalInstruction

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.additionalInstruction

Short description

Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Data type

CodeableConcept

Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXO-7
rim: .text

patientInstruction

S Σ

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.patientInstruction

Short description

Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXO-7
rim: .text

timing

0..1

Timing

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.timing

Short description

When medication should be administered

Definition

When medication should be administered.

Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Data type

Timing

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: QSET<TS> (GTS)
rim: .effectiveTime

asNeeded[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.asNeeded[x]

Short description

Take "as needed" (for x)

Definition

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).

Comments

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

SNOMEDCTMedicationAsNeededReasonCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept

asNeededBoolean

boolean

There are no (further) constraints on this element

Data type

boolean

asNeededCodeableConcept

CodeableConcept

There are no (further) constraints on this element

Data type

CodeableConcept

site

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.site

Short description

Body site to administer to

Definition

Body site to administer to.

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Data type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureAdministrationSites (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-2
rim: .approachSiteCode

route

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route

Short description

How drug should enter body

Definition

How drug should enter body.

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

Data type

CodeableConcept

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMEDCTRouteCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-1
rim: .routeCode

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

MedicationStatement.dosage.route.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by system(Value)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..1

Coding

Element id

MedicationStatement.dosage.route.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

(unbound) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

1..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

descriptionId

1..1

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId

Short description

The SNOMED CT Description ID

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..0

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Fixed value

descriptionId

Mappings

rim: N/A

value[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]

Short description

The SNOMED CT Description ID

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueId

There are no (further) constraints on this element

Data type

descriptionDisplay

0..1

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay

Short description

The SNOMED CT display for the description ID

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..0

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Fixed value

descriptionDisplay

Mappings

rim: N/A

value[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]

Short description

The SNOMED CT display for the description ID

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

valueString

string

There are no (further) constraints on this element

Data type

string

url

1..1

uriFixed Value

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

Data type

uri

Fixed value

https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Mappings

rim: N/A

value[x]

0..0

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

MedicationStatement.dosage.route.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

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 reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..0

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

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.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

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.

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.route.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

method

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.method

Short description

Technique for administering medication

Definition

Technique for administering medication.

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Data type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-4
rim: .doseQuantity

doseAndRate

0..*

Element

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.doseAndRate

Short description

Amount of medication administered

Definition

The amount of medication administered.

Data type

Element

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: TQ1-2

0..1

string

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.doseAndRate.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.doseAndRate.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

type

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.doseAndRate.type

Short description

The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Requirements

If the type is not populated, assume to be "ordered".

Comments

Data type

CodeableConcept

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXO-21; RXE-23

dose[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.doseAndRate.dose[x]

Short description

Amount of medication per dose

Definition

Amount of medication per dose.

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXO-2, RXE-3
rim: .doseQuantity

doseQuantity

SimpleQuantity

There are no (further) constraints on this element

Data type

SimpleQuantity

doseRange

Range

There are no (further) constraints on this element

Data type

Range

rate[x]

0..1

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.doseAndRate.rate[x]

Short description

Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXE22, RXE23, RXE-24
rim: .rateQuantity

rateQuantity

SimpleQuantity

There are no (further) constraints on this element

Data type

SimpleQuantity

rateRange

Range

There are no (further) constraints on this element

Data type

Range

rateRatio

Ratio

There are no (further) constraints on this element

Data type

Ratio

maxDosePerPeriod

Σ C

0..1

Ratio

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.maxDosePerPeriod

Short description

Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Data type

Ratio

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Mappings

rim: n/a
v2: N/A
rim: RTO
v2: RXO-23, RXE-19
rim: .maxDoseQuantity

maxDosePerAdministration

Σ C

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.maxDosePerAdministration

Short description

Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: not supported

maxDosePerLifetime

Σ C

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationStatement.dosage.maxDosePerLifetime

Short description

Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: not supported

medication[x]

0..*

Element id

MedicationStatement.medication[x]

Short description

Base for all elements

Definition

Base definition for all elements in a resource.

Binding

(unbound) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

medicationCodeableConcept

CodeableConcept

Data type

CodeableConcept

medicationReference

Reference(CareConnect-GPC-Medication-1)

Data type

Reference(CareConnect-GPC-Medication-1)

subject

0..*

Reference(Group) | Reference(CareConnect-GPC-Patient-1)

Element id

MedicationStatement.subject

Short description

A reference from one resource to another

Definition

A reference from one resource to another.

Comments

Data type

Reference(Group) | Reference(CareConnect-GPC-Patient-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

MedicationStatement C

Short Record of medication being taken by a patient

Definition

Cardinality 0..*

Comments

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: SubstanceAdministration

MedicationStatement.id Σ

Short Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Cardinality 0..1

Type

Summary True

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.meta Σ

Short Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Cardinality 0..1

Type

Meta

Summary True

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

MedicationStatement.meta.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.meta.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.meta.versionId Σ

Short Version specific identifier

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Cardinality 0..1

Type

Summary True

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.meta.lastUpdated Σ

Short When the resource version last changed

Definition

When the resource last changed - e.g. when the version changed.

Cardinality 0..1

Type

instant

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.meta.source Σ

Short Identifies where the resource comes from

Definition

Cardinality 0..1

Type

uri

Summary True

Comments

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.meta.profile Σ

Short Profiles this resource claims to conform to

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Cardinality 1..*

Type canonical(StructureDefinition)

Summary True

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.meta.security Σ

Short Security Labels applied to this resource

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Cardinality 0..*

Type

Coding

Binding

Security Labels from the Healthcare Privacy and Security Classification System.

AllSecurityLabels (extensible)

Summary True

Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

MedicationStatement.meta.tag Σ

Short Tags applied to this resource

Definition

Cardinality 0..*

Type

Coding

Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

Summary True

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

MedicationStatement.implicitRules Σ ?!

Short A set of rules under which this content was created

Definition

Cardinality 0..1

Type

uri

Modifier True

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.language

Short Language of the resource content

Definition

The base language in which the resource is written.

Cardinality 0..1

Type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

MaxValueSet	AllLanguages

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.text

Short Text summary of the resource, for human interpretation

Definition

Cardinality 0..1

Type

Narrative

Alias narrative, html, xhtml, display

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

MedicationStatement.contained

Short Contained, inline Resources

Definition

Cardinality 0..*

Type

Resource

Alias inline resources, anonymous resources, contained resources

Comments

Mappings

rim: Entity. Role, or Act
rim: N/A

MedicationStatement.extension C

Short Additional content defined by implementations

Definition

Cardinality 1..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.extension:lastIssueDate S C

Short The date a prescription was last issued

Definition

The date a prescription was last issued.

Cardinality 0..1

Type Extension(dateTime)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.extension:changeSummary C

Short Optional Extensions Element

Definition

Optional Extension Element - found in all resources.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.extension:prescribingAgency C

Short The type of organisation/setting responsible for authorising and issuing the medication

Definition

The type of organisation/setting responsible for authorising and issuing the medication.

Cardinality 1..1

Type Extension(CodeableConcept)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.extension:dosageLastChanged C

Short The date when the dosage instructions were last changed

Definition

Only populate where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan. Set to the date when the dosage instructions were last changed.

Cardinality 0..1

Type

Extension

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.extension:dosageLastChanged.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.extension:dosageLastChanged.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.extension:dosageLastChanged.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Type

uri

Comments

Fixed Value

https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1

Mappings

rim: N/A

MedicationStatement.extension:dosageLastChanged.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 0..1

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

MedicationStatement.modifierExtension ?! C

Short Extensions that cannot be ignored

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Type

Extension

Modifier True

Alias extensions, user content

Requirements

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.identifier Σ

Short External identifier

Definition

Cardinality 1..*

Type

Identifier

Summary True

Comments

This is a business identifier, not a resource identifier.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Event.identifier
w5: FiveWs.identifier
rim: .id

MedicationStatement.identifier.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.identifier.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.identifier.use Σ ?!

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

MedicationStatement.identifier.type Σ

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

Type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

MedicationStatement.identifier.system Σ

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 1..1

Type

uri

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationStatement.identifier.value Σ

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 1..1

Type

string

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationStatement.identifier.period Σ C

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Type

Period

Summary True

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationStatement.identifier.assigner Σ C

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference(Organization)

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationStatement.basedOn Σ C

Short Fulfils plan, proposal or order

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event.

Cardinality 0..1

Type Reference(CarePlan) | Reference(http://hl7.org/fhir/StructureDefinition/ProcedureRequest) | Reference(http://hl7.org/fhir/StructureDefinition/ReferralRequest) | Reference(CareConnect-GPC-MedicationRequest-1)

Summary True

Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]

MedicationStatement.partOf Σ C

Short Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Cardinality 0..*

Type Reference(MedicationAdministration) | Reference(MedicationDispense) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1) | Reference(CareConnect-GPC-MedicationStatement-1)

Summary True

Requirements

This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]

MedicationStatement.status Σ ?!

Definition

A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

Cardinality 1..1

Type

code

Binding

A coded concept indicating the current status of a MedicationStatement.

Medication Status Codes (required)

Modifier True

Summary True

Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
w5: FiveWs.status
rim: .statusCode

MedicationStatement.statusReason

Short Reason for current status

Definition

Captures the reason for the current state of the MedicationStatement.

Cardinality 0..*

Type

CodeableConcept

Binding

A coded concept indicating the reason for the status of the statement.

SNOMEDCTDrugTherapyStatusCodes (example)

Comments

This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.statusReason
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde

MedicationStatement.category Σ

Short Type of medication usage

Definition

Indicates where the medication is expected to be consumed or administered.

Cardinality 0..1

Type

CodeableConcept

Binding

A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

Medication usage category codes (preferred)

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
w5: FiveWs.class
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

MedicationStatement.medication[x] Σ

Short What medication was taken

Definition

Cardinality 1..1

Type CodeableConcept | Reference(Medication)

Binding

A coded concept identifying the substance or product being taken.

SNOMEDCTMedicationCodes (example)

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.code
w5: FiveWs.what[x]
rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]

MedicationStatement.subject Σ C

Short Who is/was taking the medication

Definition

The person, animal or group who is/was taking the medication.

Cardinality 1..1

Type Reference(Group | Patient)

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

MedicationStatement.context S Σ C

Short Encounter / Episode associated with MedicationStatement

Definition

The encounter or episode of care that establishes the context for this MedicationStatement.

Cardinality 0..1

Type Reference(EpisodeOfCare) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1)

Must Support True

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

MedicationStatement.effective[x] S Σ

Short The date/time or interval when the medication is/was/will be taken

Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

Cardinality 0..1

Type dateTime | Period

Must Support True

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.occurrence[x]
w5: FiveWs.done[x]
rim: .effectiveTime

MedicationStatement.dateAsserted Σ

Short When the statement was asserted?

Definition

The date when the medication statement was asserted by the information source.

Cardinality 1..1

Type

dateTime

Summary True

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
w5: FiveWs.recorded
rim: .participation[typeCode=AUT].time

MedicationStatement.informationSource C

Short Person or organization that provided the information about the taking of this medication

Definition

Cardinality 0..1

Type Reference(RelatedPerson) | Reference(CareConnect-GPC-Organization-1) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.source
rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)

MedicationStatement.derivedFrom C

Short Additional supporting information

Definition

Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

Cardinality 0..*

Type Reference(Resource)

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]

MedicationStatement.reasonCode

Short Reason for why the medication is being/was taken

Definition

A reason for why the medication is being/was taken.

Cardinality 0..*

Type

CodeableConcept

Binding

A coded concept identifying why the medication is being taken.

ConditionProblemDiagnosisCodes (example)

Comments

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
rim: .reasonCode

MedicationStatement.reasonReference C

Short Condition or observation that supports why the medication is being/was taken

Definition

Condition or observation that supports why the medication is being/was taken.

Cardinality 0..*

Type Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1) | Reference(https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1)

Comments

This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value

MedicationStatement.note S

Short Further information about the statement

Definition

Provides extra information about the medication statement that is not conveyed by the other attributes.

Cardinality 0..*

Type

Annotation

Must Support True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: Event.note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

MedicationStatement.note.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.note.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.note.author[x] Σ

Short Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Cardinality 0..1

Type Reference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1) | string

Summary True

Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.participant[typeCode=AUT].role

MedicationStatement.note.time Σ

Short When the annotation was made

Definition

Indicates when this particular annotation was made.

Cardinality 0..1

Type

dateTime

Summary True

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.effectiveTime

MedicationStatement.note.text Σ

Short The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Cardinality 1..1

Type

markdown

Summary True

Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.text

MedicationStatement.dosage

Short Details of how medication is/was taken or should be taken

Definition

Indicates how the medication is/was or should be taken by the patient.

Cardinality 1..*

Type

Dosage

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: refer dosageInstruction mapping

MedicationStatement.dosage.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.modifierExtension Σ ?! C

Short Extensions that cannot be ignored even if unrecognized

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Type

Extension

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.sequence Σ

Short The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Cardinality 0..1

Type

integer

Summary True

Requirements

Comments

32 bit number; for values larger than this, use decimal

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: TQ1-1
rim: .text

MedicationStatement.dosage.text Σ

Short Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Cardinality 1..1

Type

string

Summary True

Requirements

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXO-6; RXE-21
rim: .text

MedicationStatement.dosage.additionalInstruction Σ

Short Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Cardinality 0..*

Type

CodeableConcept

Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)

Summary True

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXO-7
rim: .text

MedicationStatement.dosage.patientInstruction S Σ

Short Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Cardinality 0..1

Type

string

Must Support True

Summary True

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXO-7
rim: .text

MedicationStatement.dosage.timing Σ

Short When medication should be administered

Definition

When medication should be administered.

Cardinality 0..1

Type

Timing

Summary True

Requirements

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: QSET<TS> (GTS)
rim: .effectiveTime

MedicationStatement.dosage.asNeeded[x] Σ

Short Take "as needed" (for x)

Definition

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).

Cardinality 0..1

Type boolean | CodeableConcept

Binding

SNOMEDCTMedicationAsNeededReasonCodes (example)

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept

MedicationStatement.dosage.site Σ

Short Body site to administer to

Definition

Body site to administer to.

Cardinality 0..1

Type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureAdministrationSites (example)

Summary True

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-2
rim: .approachSiteCode

MedicationStatement.dosage.route Σ

Short How drug should enter body

Definition

How drug should enter body.

Cardinality 0..1

Type

CodeableConcept

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMEDCTRouteCodes (example)

Summary True

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-1
rim: .routeCode

MedicationStatement.dosage.route.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.route.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding Σ

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Type

Coding

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Slicing

Unordered, Open, by system(Value)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationStatement.dosage.route.coding:snomedCT Σ

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

Type

Coding

Binding

A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

(unbound) (example)

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationStatement.dosage.route.coding:snomedCT.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.route.coding:snomedCT.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID C

Short The SNOMED CT Description ID for the display

Definition

The SNOMED CT Description ID for the display.

Cardinality 0..1

Type Extension(Complex)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension C

Short Additional content defined by implementations

Definition

Cardinality 1..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId C

Short The SNOMED CT Description ID

Definition

Cardinality 1..1

Type

Extension

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..0

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Type

uri

Comments

Fixed Value

descriptionId

Mappings

rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]

Short The SNOMED CT Description ID

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 0..1

Type

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay C

Short The SNOMED CT display for the description ID

Definition

Cardinality 0..1

Type

Extension

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..0

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Type

uri

Comments

Fixed Value

descriptionDisplay

Mappings

rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]

Short The SNOMED CT display for the description ID

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 0..1

Type

string

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Type

uri

Comments

Fixed Value

https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Mappings

rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 0..0

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.route.coding:snomedCT.system Σ

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Type

uri

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Fixed Value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationStatement.dosage.route.coding:snomedCT.version Σ

Short Version of the system - if relevant

Definition

Cardinality 0..0

Type

string

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationStatement.dosage.route.coding:snomedCT.code Σ

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Type

code

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationStatement.dosage.route.coding:snomedCT.display Σ

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 1..1

Type

string

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationStatement.dosage.route.coding:snomedCT.userSelected Σ

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality 0..1

Type

boolean

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationStatement.dosage.route.text Σ

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Type

string

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

MedicationStatement.dosage.method Σ

Short Technique for administering medication

Definition

Technique for administering medication.

Cardinality 0..1

Type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)

Summary True

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-4
rim: .doseQuantity

MedicationStatement.dosage.doseAndRate Σ

Short Amount of medication administered

Definition

The amount of medication administered.

Cardinality 0..*

Type

Element

Summary True

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: TQ1-2

MedicationStatement.dosage.doseAndRate.id

Short Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Cardinality 0..1

Type

string

Mappings

rim: n/a

MedicationStatement.dosage.doseAndRate.extension C

Short Additional content defined by implementations

Definition

Cardinality 0..*

Type

Extension

Alias extensions, user content

Comments

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

MedicationStatement.dosage.doseAndRate.type Σ

Short The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Cardinality 0..1

Type

CodeableConcept

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Summary True

Requirements

If the type is not populated, assume to be "ordered".

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXO-21; RXE-23

MedicationStatement.dosage.doseAndRate.dose[x] Σ

Short Amount of medication per dose

Definition

Amount of medication per dose.

Cardinality 0..1

Type SimpleQuantity | Range

Summary True

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXO-2, RXE-3
rim: .doseQuantity

MedicationStatement.dosage.doseAndRate.rate[x] Σ

Short Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Cardinality 0..1

Type SimpleQuantity | Range | Ratio

Summary True

Requirements

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: RXE22, RXE23, RXE-24
rim: .rateQuantity

MedicationStatement.dosage.maxDosePerPeriod Σ C

Short Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Cardinality 0..1

Type

Ratio

Summary True

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())

Mappings

rim: n/a
v2: N/A
rim: RTO
v2: RXO-23, RXE-19
rim: .maxDoseQuantity

MedicationStatement.dosage.maxDosePerAdministration Σ C

Short Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Cardinality 0..1

Type

SimpleQuantity

Summary True

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: not supported

MedicationStatement.dosage.maxDosePerLifetime Σ C

Short Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Cardinality 0..1

Type

SimpleQuantity

Summary True

Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: not supported

MedicationStatement.medication[x]

Short Base for all elements

Definition

Base definition for all elements in a resource.

Cardinality 0..*

Type CodeableConcept | Reference(CareConnect-GPC-Medication-1)

Binding

(unbound) (example)

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

MedicationStatement.subject C

Short A reference from one resource to another

Definition

A reference from one resource to another.

Cardinality 0..*

Type Reference(Group) | Reference(CareConnect-GPC-Patient-1)

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

<meta>
<lastUpdated value="2026-10-29T16:52:47.7002541+00:00" />
</meta>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="phx" />
</extension>
<url value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1" />
<version value="1.9.0" />
<name value="CareConnect-GPC-MedicationStatement-1" />
<title value="CareConnect GPC MedicationStatement1" />
<status value="active" />
<date value="2023-10-04" />
<publisher value="HL7 UK" />
<description value="This MedicationStatement Resource is a record of a medication that is being consumed by a patient." />
<purpose value="CURATED BY INTEROPen see: http://www.interopen.org/careconnect-curation-methodology/ on the 12th September 2019." />
<copyright value="Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" 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.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html" />
<fhirVersion value="3.0.2" />
<kind value="resource" />
<abstract value="false" />
<type value="MedicationStatement" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
<derivation value="constraint" />
<differential>
<element id="MedicationStatement.meta">
<path value="MedicationStatement.meta" />
</element>
<element id="MedicationStatement.meta.profile">
<path value="MedicationStatement.meta.profile" />
<min value="1" />
</element>
<element id="MedicationStatement.extension">
<path value="MedicationStatement.extension" />
<min value="1" />
</element>
<element id="MedicationStatement.extension:lastIssueDate">
<path value="MedicationStatement.extension" />
<sliceName value="lastIssueDate" />
<max value="1" />
<type>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatementLastIssueDate-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationStatement.extension:changeSummary">
<path value="MedicationStatement.extension" />
<sliceName value="changeSummary" />
<short value="Optional Extensions Element" />
<definition value="Optional Extension Element - found in all resources." />
<type>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationChangeSummary-1" />
</type>
</element>
<element id="MedicationStatement.extension:prescribingAgency">
<path value="MedicationStatement.extension" />
<sliceName value="prescribingAgency" />
<short value="The type of organisation/setting responsible for authorising and issuing the medication" />
<definition value="The type of organisation/setting responsible for authorising and issuing the medication." />
<min value="1" />
<type>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescribingAgency-1" />
</type>
</element>
<element id="MedicationStatement.extension:dosageLastChanged">
<path value="MedicationStatement.extension" />
<sliceName value="dosageLastChanged" />
<short value="The date when the dosage instructions were last changed" />
<definition value="Only populate where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan.\nSet to the date when the dosage instructions were last changed." />
<max value="1" />
<type>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1" />
</type>
</element>
<element id="MedicationStatement.extension:dosageLastChanged.url">
<path value="MedicationStatement.extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1" />
</element>
<element id="MedicationStatement.identifier">
<path value="MedicationStatement.identifier" />
<min value="1" />
</element>
<element id="MedicationStatement.identifier.system">
<path value="MedicationStatement.identifier.system" />
<min value="1" />
</element>
<element id="MedicationStatement.identifier.value">
<path value="MedicationStatement.identifier.value" />
<min value="1" />
</element>
<element id="MedicationStatement.basedOn">
<path value="MedicationStatement.basedOn" />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
</type>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest" />
</type>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1" />
</type>
</element>
<element id="MedicationStatement.partOf">
<path value="MedicationStatement.partOf" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
</type>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1" />
</type>
</element>
<element id="MedicationStatement.context">
<path value="MedicationStatement.context" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationStatement.medication[x]">
<path value="MedicationStatement.medication[x]" />
<type>
<code value="CodeableConcept" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Medication-1" />
</type>
<binding>
<strength value="example" />
</binding>
</element>
<element id="MedicationStatement.effective[x]">
<path value="MedicationStatement.effective[x]" />
<mustSupport value="true" />
</element>
<element id="MedicationStatement.dateAsserted">
<path value="MedicationStatement.dateAsserted" />
<min value="1" />
</element>
<element id="MedicationStatement.informationSource">
<path value="MedicationStatement.informationSource" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="MedicationStatement.subject">
<path value="MedicationStatement.subject" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
</element>
<element id="MedicationStatement.reasonReference">
<path value="MedicationStatement.reasonReference" />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1" />
</type>
</element>
<element id="MedicationStatement.note">
<path value="MedicationStatement.note" />
<mustSupport value="true" />
</element>
<element id="MedicationStatement.note.author[x]">
<path value="MedicationStatement.note.author[x]" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<type>
<code value="string" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="MedicationStatement.dosage">
<path value="MedicationStatement.dosage" />
<min value="1" />
</element>
<element id="MedicationStatement.dosage.text">
<path value="MedicationStatement.dosage.text" />
<min value="1" />
</element>
<element id="MedicationStatement.dosage.patientInstruction">
<path value="MedicationStatement.dosage.patientInstruction" />
<mustSupport value="true" />
</element>
<element id="MedicationStatement.dosage.route.coding">
<path value="MedicationStatement.dosage.route.coding" />
<slicing>
<discriminator>
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT">
<path value="MedicationStatement.dosage.route.coding" />
<sliceName value="snomedCT" />
<max value="1" />
<binding>
<strength value="example" />
<description value="A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration." />
</binding>
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID">
<path value="MedicationStatement.dosage.route.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<type>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension">
<path value="MedicationStatement.dosage.route.coding.extension.extension" />
<min value="1" />
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT.system">
<path value="MedicationStatement.dosage.route.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT.version">
<path value="MedicationStatement.dosage.route.coding.version" />
<max value="0" />
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT.code">
<path value="MedicationStatement.dosage.route.coding.code" />
<min value="1" />
</element>
<element id="MedicationStatement.dosage.route.coding:snomedCT.display">
<path value="MedicationStatement.dosage.route.coding.display" />
<min value="1" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"meta": {
"lastUpdated": "2026-10-29T16:52:47.7002541+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "phx"
}
],
"url": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1",
"version": "1.9.0",
"name": "CareConnect-GPC-MedicationStatement-1",
"title": "CareConnect GPC MedicationStatement1",
"status": "active",
"date": "2023-10-04",
"publisher": "HL7 UK",
"description": "This MedicationStatement Resource is a record of a medication that is being consumed by a patient.",
"purpose": "CURATED BY INTEROPen see: http://www.interopen.org/careconnect-curation-methodology/ on the 12th September 2019.",
"copyright": "Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" 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.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html",
"fhirVersion": "3.0.2",
"kind": "resource",
"abstract": false,
"type": "MedicationStatement",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "MedicationStatement.meta",
"path": "MedicationStatement.meta"
},
{
"id": "MedicationStatement.meta.profile",
"path": "MedicationStatement.meta.profile",
"min": 1
},
{
"id": "MedicationStatement.extension",
"path": "MedicationStatement.extension",
"min": 1
},
{
"id": "MedicationStatement.extension:lastIssueDate",
"path": "MedicationStatement.extension",
"sliceName": "lastIssueDate",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatementLastIssueDate-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationStatement.extension:changeSummary",
"path": "MedicationStatement.extension",
"sliceName": "changeSummary",
"short": "Optional Extensions Element",
"definition": "Optional Extension Element - found in all resources.",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationChangeSummary-1"
]
}
]
},
{
"id": "MedicationStatement.extension:prescribingAgency",
"path": "MedicationStatement.extension",
"sliceName": "prescribingAgency",
"short": "The type of organisation/setting responsible for authorising and issuing the medication",
"definition": "The type of organisation/setting responsible for authorising and issuing the medication.",
"min": 1,
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescribingAgency-1"
]
}
]
},
{
"id": "MedicationStatement.extension:dosageLastChanged",
"path": "MedicationStatement.extension",
"sliceName": "dosageLastChanged",
"short": "The date when the dosage instructions were last changed",
"definition": "Only populate where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan.\nSet to the date when the dosage instructions were last changed.",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1"
]
}
]
},
{
"id": "MedicationStatement.extension:dosageLastChanged.url",
"path": "MedicationStatement.extension.url",
"fixedUri": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1"
},
{
"id": "MedicationStatement.identifier",
"path": "MedicationStatement.identifier",
"min": 1
},
{
"id": "MedicationStatement.identifier.system",
"path": "MedicationStatement.identifier.system",
"min": 1
},
{
"id": "MedicationStatement.identifier.value",
"path": "MedicationStatement.identifier.value",
"min": 1
},
{
"id": "MedicationStatement.basedOn",
"path": "MedicationStatement.basedOn",
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/CarePlan"
]
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
]
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ReferralRequest"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationRequest-1"
]
}
]
},
{
"id": "MedicationStatement.partOf",
"path": "MedicationStatement.partOf",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
]
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationDispense"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1"
]
}
]
},
{
"id": "MedicationStatement.context",
"path": "MedicationStatement.context",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1"
]
}
],
"mustSupport": true
},
{
"id": "MedicationStatement.medication[x]",
"path": "MedicationStatement.medication[x]",
"type": [
{
"code": "CodeableConcept"
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Medication-1"
]
}
],
"binding": {
"valueSetUri": "http://hl7.org/fhir/ValueSet/medication-codes",
"strength": "example"
}
},
{
"id": "MedicationStatement.effective[x]",
"path": "MedicationStatement.effective[x]",
"mustSupport": true
},
{
"id": "MedicationStatement.dateAsserted",
"path": "MedicationStatement.dateAsserted",
"min": 1
},
{
"id": "MedicationStatement.informationSource",
"path": "MedicationStatement.informationSource",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Organization-1"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "MedicationStatement.subject",
"path": "MedicationStatement.subject",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Group"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
}
]
},
{
"id": "MedicationStatement.reasonReference",
"path": "MedicationStatement.reasonReference",
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Observation-1"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1"
]
}
]
},
{
"id": "MedicationStatement.note",
"path": "MedicationStatement.note",
"mustSupport": true
},
{
"id": "MedicationStatement.note.author[x]",
"path": "MedicationStatement.note.author[x]",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "string"
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "MedicationStatement.dosage",
"path": "MedicationStatement.dosage",
"min": 1
},
{
"id": "MedicationStatement.dosage.text",
"path": "MedicationStatement.dosage.text",
"min": 1
},
{
"id": "MedicationStatement.dosage.patientInstruction",
"path": "MedicationStatement.dosage.patientInstruction",
"mustSupport": true
},
{
"id": "MedicationStatement.dosage.route.coding",
"path": "MedicationStatement.dosage.route.coding",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT",
"path": "MedicationStatement.dosage.route.coding",
"sliceName": "snomedCT",
"max": "1",
"binding": {
"valueSetReference": {
"reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-MedicationDosageRoute-1"
},
"strength": "example",
"description": "A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration."
}
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID",
"path": "MedicationStatement.dosage.route.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID.extension",
"path": "MedicationStatement.dosage.route.coding.extension.extension",
"min": 1
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT.system",
"path": "MedicationStatement.dosage.route.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT.version",
"path": "MedicationStatement.dosage.route.coding.version",
"max": "0"
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT.code",
"path": "MedicationStatement.dosage.route.coding.code",
"min": 1
},
{
"id": "MedicationStatement.dosage.route.coding:snomedCT.display",
"path": "MedicationStatement.dosage.route.coding.display",
"min": 1
}
]
}

}

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Reference

Canonical URI: https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1

The canonical URI is the stable FHIR identifier for this profile and is not currently available as a browsable web page.

Background

What is a MedicationStatement?

A MedicationStatement (despite the potentially confusing name) is not a statement in the traditional sense of a list of items (such as bank statement), and in FHIR R5 it is going to be renamed to MedicationUsage.

The definition of a MedicationStatement from hl7.org is as follows:

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.

A MedicationStatement resource will contain a single line-item of medication, and may contain information from the original MedicationRequest, MedicationDispense or MedicationAdministration if the system populating the resource knows about them.

It is possible; however, to create the resource without this information.

Example

In the diagram below there are three active medications, one completed medication, and a stopped medication.

Note that all of medications are derived from a MedicationStatement - each with varying data-sources.

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Potential data-sources for the `MedicationStatement` resource

Pharmacy System - MedicationRequest
Dispensing System - MedicationDispense
Patient self-declared - MedicationAdministration
ICS Shared Record - MedicationStatement

Data model element usage

Element	Use	CareConnect (STU3)	UK Core (R4)
id
meta.versionId
meta.lastUpdated
meta.profile
meta.security
meta.tag
extension(lastIssueDate)
extension(changeSummary)
extension(prescribingAgency)
extension(dosageLastChanged)
extension(medicationTradeFamily)
identifier
basedOn
partOf
context
status
category
medicationR
effective[x]
dateAsserted
informationSource
subject
derivedFrom
taken
reasonNotTaken
reasonCode
reasonReference
note
dosage

id

Usage

Optional

Guidance

The id is the logical identifier for the CareConnect-GPC-Observation-1 profile.

Example

<id value="bfa6215a-e433-4729-9e41-510730df6423" />

meta.profile

Usage

Mandatory

Guidance

The meta.profile contains a fixed value of the URL for the CareConnect-GPC-MedicationStatement-1 profile.

Example

<meta>
    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1" />
</meta>

meta.security

Usage

Optional

Guidance

The security label(s) applicable to the resource.

See Resources not to be disclosed to a patient for more details on how to populate the element.

Example

<meta>
    <security>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="NOPAT"/>
        <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/>
    </security>
</meta>

meta.tag

Usage

Optional

Guidance

A use-case for the meta.tag element within GP Connect has not been defined.

Example

<meta>
    <tag>
        <coding>
            <system value="http://hl7.org/fhir/common-tags" />
            <code value="actionable" />
            <display value="Actionable" />
        </coding>
    </tag>
</meta>

extension(lastIssueDate)

Usage

Required

Guidance

The date when the latest prescription under this plan was issued (signed).

Note: The issue information may not be recorded in the GP system if the medication or medical device is a repeat dispense, or has been prescribed elsewhere.

Example

<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatementLastIssueDate-1" />
    <valueDateTime value="2022-07-07T14:07:48+00:00Z" />
</extension>

extension(prescribingAgency)

Usage

Mandatory

Guidance

This details the care setting in which the medication or medical device was prescribed taken from the CareConnect Prescribing Agency ValueSet.

Currently this field will only support two coded entries, indicating whether the medication / medical device was prescribed by the GP practice or by another organisation. If the providing organisation has more details about the type of prescribing organisation (for example, that it was a dental practice or hospital), this MUST be included in the CodeableConcept.text field.

In the future, the coded valueset will be built on to be more specific about where a medication / medical device was prescribed. For instance, if the patient was prescribed a medication by a hospital or bought a medication over the counter then this would be coded as well as in the text.

For repeat and repeat dispensed medications / medical devices, the value identifies the care setting where the medication plan (rather than any specific issue in the plan) was authorised.

Example

<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescribingAgency-1" />
    <valueCodeableConcept>
        <system value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescribingAgency-1" />
        <coding value="prescribed-at-gp-practice">
        <text value="Prescribed at GP practice" />
    </valueCodeableConcept>
</extension>

extension(dosageLastChanged)

Usage

Optional

Guidance

The extension.dosageLastChanged does not need to be populated.

Example

<extension>
    <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1" />
    <valueDateTime value="2022-10-28T10:57:00+00:00Z" />
</extension>

identifier

Usage

Mandatory

Guidance

The identifier element MUST be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data). This MUST be scoped by a provider specific namespace for the identifier.

Where consuming systems are integrating data from this resource to their local system, they MUST also persist this identifier at the same time.

Example

<identifier>
    <system value="https://tools.ietf.org/html/rfc4122" />
    <value value="653c0790-a509-4eed-99f3-f42f3683cf2e" />
</identifier>

basedOn

Usage

Required

Guidance

This element should normally be used to link to a MedicationRequest which authorised the medication.

This element could also potentially reference all medication requests relating to the medication or relevant instances of CarePlan or ServiceRequest.

This should not be confused with MedicationStatement.derivedFrom which should only be used to reference information that can’t be referenced here.

Note: For GP Connect, each `MedicationStatement` MUST be based on a MedicationRequest with intent set to plan.

Example

<basedOn>
    <reference value="medication-request-5485984" />
</basedOn>

context

Usage

Required

Guidance

A reference (if known) to either a CareConnect:

Example

<context>
    <reference value="encounter-0012345" />
</context>

status

Usage

Mandatory

Guidance

The status of the authorisation.

Use one of active, completed or stopped:

active represents an active authorisation - used for active repeat medications/medical devices
stopped represents an authorisation which has been discontinued, cancelled or stopped
completed represents an authorisation which has run its course

For repeat and repeat dispensed the status refers to the status of the plan (the entire cycle of prescriptions).

For acute, the status refers to the status of the prescription issue.

Example

<status value="active" />

medication

Usage

Mandatory

Guidance

Important: Determining the value of this element when constructing the resource.

When the `MedicationRequest` and `MedicationDispense` are known

If the basedOn (medication request) and partOf (medication dispense) elements are known, and defined within the MedicationStatement, then care should be taken as to how the medication[x] element is populated.

If substitution is allowed within the MedicationRequest resource then the medicine dispensed may differ to the request. In this case, this element must reflect the dispensed medication in the MedicationDispense resource.

Also note that the dosageInstruction may differ from what was originally requested.

Even if substution is not allowed, it may be prudent to check that medication requested is equal to what was dispensed.

When the `MedicataionRequest` or `MedicationDispsnese` are not known

The medication component should be constructed by the information provided from the source.

Example

<medication>
    <coding>
        <system value="http://snomed.info/sct" />
        <code value="195967001" />
        <display value="Penicillin" />
    </coding>
</medication>

effective[x]

Usage (Conditional)

Required

Guidance

The period the medication or medical device is authorised under this medication/medical device plan. For items that are repeats and repeat dispensed this refers to the entire cycle of prescriptions made under the authorisation. For acutes, this refers to the period of the prescription issue.

This element is especially required when the status is intended.

Either:

effectiveDateTime a date time at which the medication started or should start
effectivePeriod the period over which the patient has taken or should take the medication

The use of effectivePeriod is to be preferred, and should start when the medication started in any preceding episode of care.

The date / time format allows various degrees of date resolution; year, year/month and exact date so an approximate date can be used when the exact date is not known.

This could be either backdated or future dated.

Note: Where the end date is unknown it may be omitted.

Examples

<effectiveDateTime value="2022-09-23T09:04:00Z" />

<effectivePeriod>
    <start value="2022-09-23T09:04:00Z" />
    <end value="2022-09-30T23:59:59Z" />
</effectivePeriod>

dateAsserted

Usage

Mandatory

Guidance

This is the audit trail date/time for when the authorisation was entered onto the record.

Example

<dateAsserted value="2022-09-23T09:11:00Z" />

informationSource

Usage

Required

Guidance

Referencing an `Organization resource is likely to be more useful than a person, as a Practitioner resource, as people’s work patterns and employers may be variable while the care setting organisation will be constantly available.

When referencing an organisation - the following must be provided:

Oraganization.contact.name
Organization.contact.telecom
Organisation.identifier.odsOrganizationCode or Organization.identifier.odsSiteCode

Where the organisation is an Acute Trust, an ODS Site Code may be more useful than the parent Trust-wide ODS organisation code.

Example

<informationSource>
    <reference value="oraganization-1234" />
</informationSource>

subject

Usage

Mandatory

Guidance

A refernce to the patient that the medication statement relates to.

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Example

<subject>
    <reference value="patient-7890" />
</subject>

derivedFrom

Usage

Optional

Guidance

A use-case for populating the derivedFrom element within GP Connect has not been defined, as it is expected that the the basedOn element will suffice.

Warning: Population of both derivedFrom and baseOn elements should be avoided as potentially confusing.

Example

<derivedFrom>
    <reference value="resource-any-11ks8f" />
</derivedFrom>

note

Usage

Required

Guidance

All notes that are associated with this medication / medical device record.

Note: All patient notes and prescriber notes at authorisation(plan) and issue(order) level MUST be included in this field. They MUST be concatenated and indicate the level the notes come from (for example, First Issue) and be prefixed with either "Patient Notes:" or "Prescriber Notes:" as appropriate.

Example

<note>
    <author>
        <reference value="practitioner-00134" />
    </author>
    <time value="2022-10-19T10:12:00Z" />
    <text>
        First Issue | Prescriber notes: Lorem ipsum dolor sit amet, consectetur adipiscing... | Patient notes: Ut enim ad minim veniam, quis nostrud exercitation...
    </text>
</note>

dosage

Usage

Mandatory

Guidance

Complete dosage instructions as text.

Where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan append the following warning text to end of the dosage instructions:

WARNING – Dosage has changed during the effective period. The latest change was made on DD-Mmm-YYYY - where DD-Mmm-YYYY is the date the dosage was last changed.

In exceptional cases where for legacy data there is no dosage recorded in the system then this MUST be populated with the text: No information available.

The patientInstruction elemement MAY provide additional instructions to the patient, this is, RHS of the prescription label.

Important: The information standards notice (ISN): DAPB4013: Medicine and Allergy/Intolerance Data Transfer stipulates that structured dosage instructions should be sent.

GP Connect providers may uplift to the Information Standards Notice outlined above at different times so please account for both textual and structured representations.

See Medication and Medical Device interoperability for additional information.

Example

Legacy (free text):

<dosageInstruction>
    <text value="2 tablet - every 4 hours - up to a maximum of 6 dose in 24 hours - when migraine recurs" />
    <patientInstruction value="when migraine recurs" />
</dosageInstruction>

Structured dose syntax:

<dosageInstruction>
    <text value="2 tablet - every 4 hours - up to a maximum of 6 dose in 24 hours - when migraine recurs" />
    <patientInstruction value="when migraine recurs" />
    <timing>
        <repeat>
            <frequency value="1" />
            <period value="4" />
            <periodUnit value="h" />
        </repeat>
    </timing>
    <doseQuantity>
        <value value="2" />
        <unit value="tablet" />
        <system value="http://snomed.info/sct" />
        <code value="428673006" />
    </doseQuantity>
    <maxDosePerPeriod>
        <numerator>
            <value value="6" />
            <unit value="dose" />
            <system value="http://snomed.info/sct" />
            <code value="3317411000001100" />
        </numerator>
        <denominator>
            <value value="24" />
            <unit value="hour" />
            <system value="http://unitsofmeasure.org/" />
            <code value="h" />
        </denominator>
    </maxDosePerPeriod>
</dosageInstruction>

MedicationStatement elements not in use

The following elements SHALL NOT be populated:

meta.versionId

meta.lastUpdated

extension[ChangeSummary]

This is not in scope for this version of GP Connect.

partOf

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

derivedFrom

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

taken

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

reasonNotTaken

This is not in scope for this version of Care Connect and therefore not available for use in GP Connect.

reasonCode

This information is available via linking to a Problem record.

reasonReference

This information is available via linking to a Problem record.

Copy of 'GP Connect Data Model | FHIR STU3 Representation'

Profile: CareConnect-GPC-MedicationStatement-1

Reference

Related links

Background

What is a MedicationStatement?

Example

Potential data-sources for the MedicationStatement resource

Data model element usage

id

Usage

Guidance

Example

meta.profile

Usage

Guidance

Example

meta.security

Usage

Guidance

Example

meta.tag

Usage

Guidance

Example

extension(lastIssueDate)

Usage

Guidance

Example

extension(prescribingAgency)

Usage

Guidance

Example

extension(dosageLastChanged)

Usage

Guidance

Example

identifier

Usage

Guidance

Example

basedOn

Usage

Guidance

Example

context

Usage

Guidance

Example

status

Usage

Guidance

Example

medication

Usage

Guidance

When the MedicationRequest and MedicationDispense are known

When the MedicataionRequest or MedicationDispsnese are not known

Example

effective[x]

Usage (Conditional)

Guidance

Examples

dateAsserted

Usage

Guidance

Example

informationSource

Usage

Guidance

Example

subject

Usage

Guidance

Example

derivedFrom

Usage

Guidance

Example

note

Potential data-sources for the `MedicationStatement` resource

When the `MedicationRequest` and `MedicationDispense` are known

When the `MedicataionRequest` or `MedicationDispsnese` are not known