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HdBe-DrugUse

CBB	Description	Status
HdBe-DrugUse	Drugs (or: narcotics, amphetamines, intoxicants, highs, hallucinogenics, illegal substances or dope) is a collective term for drugs and chemical substances with a more or less ‘drugging' (anesthetic, boosting and/or hallucinogenic) effect and which can lead to addiction. Drug [Online] Available at: nl.Wikipedia.org/wiki/drug [Accessed: 11 February 2015]. This information model describes the information asked of the patient about their drug use. Purpose Documenting and sharing registration of the drug use, as described in the concept. Evidence Base Though this information model can also be used to abuse (the patient’s own) medication, the project group eventually decided to focus on information on drug use, as described in the concept. Seeing as there is a large variety of ways to record the amount of drugs used, we decided that this part is to be entered as free text. Instructions The 'DrugOrMedicationTypeCodelist is extensible. If the drug in question is not on the codelist, the list can be extended with a code from the SNOMED CT hierarchy 'Substance; <105590001' or if necessary from the hierarchy 'Pharmaceutical/biologic product; < 373873005'.	active

CBB

Description

Status

HdBe-DrugUse

Drugs (or: narcotics, amphetamines, intoxicants, highs, hallucinogenics, illegal substances or dope) is a collective term for drugs and chemical substances with a more or less ‘drugging' (anesthetic, boosting and/or hallucinogenic) effect and which can lead to addiction. Drug [Online] Available at: nl.Wikipedia.org/wiki/drug [Accessed: 11 February 2015].

This information model describes the information asked of the patient about their drug use.

Purpose

Documenting and sharing registration of the drug use, as described in the concept.

Evidence Base

Though this information model can also be used to abuse (the patient’s own) medication, the project group eventually decided to focus on information on drug use, as described in the concept. Seeing as there is a large variety of ways to record the amount of drugs used, we decided that this part is to be entered as free text.

Instructions

The 'DrugOrMedicationTypeCodelist is extensible. If the drug in question is not on the codelist, the list can be extended with a code from the SNOMED CT hierarchy 'Substance; <105590001' or if necessary from the hierarchy 'Pharmaceutical/biologic product; < 373873005'.

active

DrugUse			DrugUse	Element id DrugUse Short description DrugUse Definition Root concept of the DrugUse information model. This concept contains all data elements of the DrugUse information model. Data type DrugUse Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id DrugUse.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	I	0..*	Extension	There are no (further) constraints on this element Element id DrugUse.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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
ObservationOfUse		0..1	BackboneElement	Element id DrugUse.ObservationOfUse Short description ObservationOfUse Definition Container for ObservationOfUse. This container contains all data elements of the ObservationOfUse container. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id DrugUse.ObservationOfUse.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	I	0..*	Extension	There are no (further) constraints on this element Element id DrugUse.ObservationOfUse.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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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 ?! I	0..*	Extension	There are no (further) constraints on this element Element id DrugUse.ObservationOfUse.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 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 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 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
StartDate		0..1	dateTime	Element id DrugUse.ObservationOfUse.StartDate Short description StartDate Definition The date on which the patient started using. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
StopDate		0..1	dateTime	Element id DrugUse.ObservationOfUse.StopDate Short description StopDate Definition The date on which the patient quit using. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Amount		0..1	string	Element id DrugUse.ObservationOfUse.Amount Short description Amount Definition The number of units (pills, joints, shots etc.) per day, week, month, or year; or the frequency of use. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Comment		0..1	string	Element id DrugUse.Comment Short description Comment Definition Relevant comments on the drug use. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
DrugOrMedicationType		0..1	CodeableConceptBinding	Element id DrugUse.DrugOrMedicationType Short description DrugOrMedicationType Definition Type of drug used by the patient. 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 DrugOrMedicationType codes TypeOfDrugOrMedication (extensible) 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
DrugUseStatus		1..1	CodeableConceptBinding	Element id DrugUse.DrugUseStatus Short description DrugUseStatus Definition Indication stating whether there was any drug use in the past or present. 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 DrugUseStatus codes DrugUseStatus (extensible) 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
RouteOfAdministration		0..*	CodeableConceptBinding	Element id DrugUse.RouteOfAdministration Short description RouteOfAdministration Definition The way the drugs are used. 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 RouteOfAdministration codes RouteOfAdministration (extensible) 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

DrugUse		0..*
DrugUse.ObservationOfUse	BackboneElement	0..1
DrugUse.ObservationOfUse.StartDate	dateTime	0..1
DrugUse.ObservationOfUse.StopDate	dateTime	0..1
DrugUse.ObservationOfUse.Amount	string	0..1
DrugUse.Comment	string	0..1
DrugUse.DrugOrMedicationType	CodeableConcept	0..1
DrugUse.DrugUseStatus	CodeableConcept	1..1
DrugUse.RouteOfAdministration	CodeableConcept	0..*

DrugUse
Definition	Root concept of the DrugUse information model. This concept contains all data elements of the DrugUse information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DrugUse.id
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
DrugUse.extension
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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Slicing	Unordered, Open, by url(Value)
Invariants	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
DrugUse.ObservationOfUse
Definition	Container for ObservationOfUse. This container contains all data elements of the ObservationOfUse container.
Cardinality	0...1
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DrugUse.ObservationOfUse.id
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
DrugUse.ObservationOfUse.extension
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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Slicing	Unordered, Open, by url(Value)
Invariants	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
DrugUse.ObservationOfUse.modifierExtension
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).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
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	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.
Invariants	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
DrugUse.ObservationOfUse.StartDate
Definition	The date on which the patient started using.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DrugUse.ObservationOfUse.StopDate
Definition	The date on which the patient quit using.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DrugUse.ObservationOfUse.Amount
Definition	The number of units (pills, joints, shots etc.) per day, week, month, or year; or the frequency of use.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DrugUse.Comment
Definition	Relevant comments on the drug use.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
DrugUse.DrugOrMedicationType
Definition	Type of drug used by the patient.
Cardinality	0...1
Type	CodeableConcept
Binding	DrugOrMedicationType codes TypeOfDrugOrMedication (extensible)
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.
Invariants	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
DrugUse.DrugUseStatus
Definition	Indication stating whether there was any drug use in the past or present.
Cardinality	1...1
Type	CodeableConcept
Binding	DrugUseStatus codes DrugUseStatus (extensible)
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.
Invariants	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
DrugUse.RouteOfAdministration
Definition	The way the drugs are used.
Cardinality	0...*
Type	CodeableConcept
Binding	RouteOfAdministration codes RouteOfAdministration (extensible)
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.
Invariants	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

Example instances

DrugUse
ObservationOfUse.StartDate	1985-01-01
ObservationOfUse.StopDate
ObservationOfUse.Amount	2x per month
Comment	Uses at parties and on weekends. The patient used more in the past than the present.
DrugOrMedicationType	288459003 - Methylenedioxymethamphetamine (code by SNOMED CT)
DrugUseStatus	417284009 - Current drug user (code by SNOMED CT)
RouteOfAdministration	26643006 - Oral route (code by SNOMED CT), 46713006 - Nasal route (code by SNOMED CT)

zib DrugUse-v3.3 difference

Concept	Category	Description
`DrugUseStatus`	terminology	Replaced 'Other' from HL7 NullFlavor CodeSystem with equivalent SNOMED code.
`DrugOrMedicationType`	terminology	Replaced 'Other' from HL7 NullFlavor CodeSystem with equivalent SNOMED code.
`RouteOfAdministration`	terminology	Replaced ValueSet content of RouteOfAdministration with SNOMED codes.
`StopDate`	textual	Added a period at the end of the sentence.
`Amount`	textual	Replaced 'week, month or year or' with 'week, month, or year; or'

Terminology Bindings

Path	Name	Strength	URL
DrugOrMedicationType	TypeOfDrugOrMedication	extensible	https://fhir.healthdata.be/ValueSet/TypeOfDrugOrMedication
DrugUseStatus	DrugUseStatus	extensible	https://fhir.healthdata.be/ValueSet/DrugUseStatus
RouteOfAdministration	RouteOfAdministration	extensible	https://fhir.healthdata.be/ValueSet/RouteOfAdministration