NVD FHIR API integrācijas apraksts Onko

Ķīmijterapija

Apraksts

Informācija par ķīmijterapijas ārstēšanu.

Ķīmijterapijas datu apmaiņas nodrošināšanai tiek izmantots FHIR R4B bāzes resurss MedicationStatement, uz kura pamata izveidots FHIR profils Chemotherapy.

Apstrāde

Iesūtot ķīmijterapijas datus, ir nepieciešams norādīt slimības pamatdatu karti (FHIR profils OncologyBasicDataOfDisease). To norāda caur MedicationStatement.reasonReference lauku.
Iesūtot datus, ir nepieciešams norādīt references uz administratīvajiem profiliem: pacients (MedicationStatement.subject.reference), ārējās sistēmas piešķirtā ieraksta identifikatora organizācija (MedicationStatement.identifier.assigner.reference), Ārstniecības iestāde, kurā saņemta ārstēšana (MedicationStatement.informationSource.reference).
Iesūtot jaunu karti, kartei ir jānorāda statuss 2-Iesniegta (Extension: CardStatusExtension).
Gadījumā, ja karti ir nepieciešams anulēt, tai ir nepieciešams uzstādīt statusu 3-Anulēta (Extension: CardStatusExtension).
Statusa izmaiņu datumu (Extension: CardStatusDateExtension) automātiski piešķir Vēža pacientu reģistra IS. Vienīgais izņēmums ir anulēšanas darbība. Gadījumā, ja anulēšanas datums nav tekošās dienas datums (piemēram, karte anulēta pirms tekošās dienas), tad to var norādīt pie iesūtīšanas laukā Extension: CardStatusDateExtension un Vēža pacientu reģistra IS izmantos šo datumu.

Datu lauki

Nr.	Datu lauks	FHIR Lauks	Kard.	FHIR lauka apraksts	Detaļas
1	Ārstēšanas veids	Standard: MedicationStatement.category	1..1	Type of medication usage	Ārstēšanas veidu klasifikators: 1.3.6.1.4.1.38760.2.628
2	Ārstniecības iestāde, kurā saņemta ārstēšana	Standard: MedicationStatement.informationSource	0..1	Person or organization that provided the information about the taking of this medication	Obligāti ir jāaizpilda vai nu ārstniecības iestāde, vai nu ārvalstu ārstniecības iestāde Atsauce uz VVIS Medicīnas iestādes profilu: https://vvis.gov.lv/fhir/StructureDefinition/Organization/MedicalInstitution
3	Ārvalstu ārstniecības iestāde, kurā saņemta ārstēšana	Extension: MedicationStatement.foreignMedicalInstitution	0..1		Teksts līdz 500 simboliem
4	Ķīmijterapijas veids	Standard: MedicationStatement.category	1..1	Type of medication usage	Ķīmijterapijas veids: 1.3.6.1.4.1.38760.2.634
5	Ķīmijterapijas līnija	Extension: TherapyLineExtension	0..1		Ķīmijterapijas līnija: 1.3.6.1.4.1.38760.2.635
6	Zāļu vispārīgā nosaukuma ATK kods	Standard: MedicationStatement.Medication	1..*	What medication was taken	Zāļu anatomiski terapeitiski ķīmiskā klasifikācija (ATĶ): 1.3.6.1.4.1.38760.2.141
7	Saņemto kursu skaits	Extension: CourseCountReceived	0..1		Nav klasifikators
8	Ķīmijterapijas sākuma datums	Standard: MedicationStatement.effective.start	1..1	When the procedure was performed Time range defined by start and end date/time
9	Ķīmijterapijas beigu datums	Standard: MedicationStatement.effective.end	0..1	When the procedure was performed Time range defined by start and end date/time
10	Norāde par pacientu tālāko ārstēšanu/ uzraudzību	Extension: FollowUpExtension Slice: followUp	0..1		Pacienta tālāka ārstēšana vai uzraudzība: 1.3.6.1.4.1.38760.2.629
11	Turpmākā ārstēšana/ novērošana (tikai vēsturiskām kartēm)	Extension: FollowUpExtension Slice: folowUpOld	0..1		Onkoloģijas pacienta plūsma: 1.3.6.1.4.1.38760.2.204
12	Pārtraukšanas datums	Extension: TerminationDateExtension	0..1
13	Pārtraukšanas iemesls	Extension: TerminationReasonExtension	0..1		Terapijas pārtraukšanas iemesls: 1.3.6.1.4.1.38760.2.877
14	Pārtraukšanas papildus informācija	Extension: TerminationReasonExtension	0..1		Teksts līdz 250 simboliem

Citi profila obligātie datu lauki:

Nr.	Datu lauks	FHIR Lauks	Kard.	FHIR lauka apraksts	Detaļas
15	Ārējās sistēmas ieraksta ID	Standard: MedicationStatement.identifier	1..1	External identifier	Tiek izmantots identifikatora tips “EXTERNAL_SYSTEM_IDENTIFIER”
16	MedicationStatement statuss	Standard: MedicationStatement.status	1..1	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.	FHIR obligātais lauks. Pieejamās vērtības: active, completed, entered-in-error, intended, stopped, on-hold, unknown, not-taken Iesūtot vienmēr tiek aizpildīts ar “completed”
17	Ārstēšanas kartes statuss	Extension: CardStatusExtension	1..1		Ārstēšanas karte var būt statusā 2-Iesniegta vai 3-Anulēta
18	Ārstēšanas kartes statusa datums	Extension: CardStatusDateExtension	0..1		Datums, kad attiecīgais statuss kartei ir piešķirts. Datumu nav nepieciešams iesūtīt, to automātiski piešķir Vēža pacientu reģistra IS
19	Atsauce uz pacientu	Standard: MedicationStatement.subject	1..1	Who is/was taking the medication	Atsauce uz VVIS LV pacienta profilu: https://vvis.gov.lv/fhir/StructureDefinition/Patient/LVPatient
20	Ārstētā slimība. Sasaiste ar slimības pamatdatiem (FHIR: OncologyBasicDataOfDisease)	Standard: MedicationStatement.reasonReference	1..*	The justification of why the procedure was performed.	Ārstētā slimība - Norāde uz vienu vai vairākām onkoloģiskā pacienta slimības kartēm (numuriem), ar kuru ir saistīta attiecīgā ārstēšana

Profila struktūra

Chemotherapy (MedicationStatement)	I		MedicationStatement	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.exists() and ('#'+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(uri) = '#').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()` Chemotherapy-con-1: At least one institution is mandatory - either Latvian (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.informationSource.reference) or foreign (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.informationSource.extension:foreignMedicalInstitution) `informationSource.reference.exists() or informationSource.extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/ForeignMedicalInstitutionExtension-v1').value.exists()` Chemotherapy-con-2: Therapy start date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.effective.start) is mandatory and cannot be greater than sysdate `iif(effective.start.exists(), effective.start.toDateTime() <= now(), false)` Chemotherapy-con-3: End date of therapy (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.effective.end) must not be greater than sysdate & must not be less than the start date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.effective.start) `iif(effective.end.exists(), effective.end.toDateTime() <= now() and effective.end.toDateTime() >= effective.start.toDateTime(), true)` Chemotherapy-con-5: If the TherapyLine extension (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:chemotherapyLine) is used, then its value coding system (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:chemotherapyLine.value[x].coding:chemotherapyLine.system) should match https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.635 `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TherapyLineExtension-v1').value.coding.code.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TherapyLineExtension-v1').value.coding.system='https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.635', true)` Chemotherapy-con-6: Chemotherapy medicine (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.medication[x].coding.code) can only be fifth level entry (active substance level entry eg: L01AA02 chlorambucil) from the classifier `medicationCodeableConcept.coding.all(code.matches('^.{7}$'))` Chemotherapy-con-7: Only one medical institution can be submitted at a time - Latvian from the classifier (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.informationSource.reference) or foreign in the text field (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.informationSource.extension:foreignMedicalInstitution.value[x]) `(informationSource.reference.exists() implies informationSource.extension.value.exists().not()) and (informationSource.extension.value.exists() implies informationSource.reference.exists().not())` Chemotherapy-con-8: Chemotherapy card status (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:cardStatusExtension.value[x].coding.code) must be 2-Submitted or 3-Revoked `extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusExtension-v1').value.coding.code.matches('^2$\|^3$')` Chemotherapy-con-9: If treatment card status is 3-Revoked, (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:cardStatusExtension.value[x].coding.code), then card revoke reason (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:cardStatusReasonExtension.value[x].coding:cardRevokeReason.code) is mandatory `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusExtension-v1').value.coding.code.matches('^3$'), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusReasonExtension-v1').value.exists(), true)` Chemotherapy-con-10: Therapy termination date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationDateExtension.value[x]) is not allowed if the therapy end date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.effective[x].end) is submitted `iif(effectivePeriod.end.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').valueDateTime.exists().not(), true)` Chemotherapy-con-11: Therapy termination date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationDateExtension.value[x]) must be greater than or equal to the therapy start date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.effective[x].start) `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').valueDateTime.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').valueDateTime >= effectivePeriod.start, true)` Chemotherapy-con-12: If the therapy termination date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationDateExtension.value[x]) is provided, then therapy termination reason (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationReasonExtension.value[x].coding.code) must be provided and vice versa iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').valueDateTime.exists() or extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.coding.code.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').valueDateTime.exists() and extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.coding.code.exists(), true) Chemotherapy-con-13: If the therapy termination information (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationReasonExtension.value[x].text) is provided, then the therapy termination date (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationDateExtension.value[x]) and the therapy termination reason (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.extension:terminationReasonExtension.value[x].coding.code) must be provided `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.text.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').valueDateTime.exists() and extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.coding.code.exists(), true)` Mappings rim: Entity. Role, or Act workflow: Event rim: SubstanceAdministration w5: clinical.medication
id	Σ	0..1	id	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 id
meta	Σ I	0..1	OncologyMeta	Element id MedicationStatement.meta Short description Metadata about a resource Definition The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type OncologyMeta Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Meta-con-1: Data enterer medical person role (Profile: Meta/OnkoMeta, Field: Meta.tag with id "entererMedicalPersonRole") or data enterer person iId (Profile: Meta/OnkoMeta, Field: Meta.tag with id "entererPersonId") must be provided `tag.where(id='entererMedicalPersonRole').exists() or tag.where(id='entererPersonId').exists()` Mappings rim: n/a rim: N/A
id		0..0	id	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 id Mappings rim: n/a
extension	I	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 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
versionId	Σ	0..1	id	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. ©NHS: Value SHALL NOT be provided in CREATE and UPDATE requests. It is only available in READ response. 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 id Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
lastUpdated	Σ	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. ©NHS: Value SHALL NOT be provided in CREATE and UPDATE requests. It is only available in READ response. 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
source	Σ	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. ©NHS: Value SHALL NOT be provided in CREATE and UPDATE requests. It is only available in READ response. 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
profile	Σ I	1..1	canonical(StructureDefinition)	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) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Chemotherapy-con-4: If the Profile on MedicationStatement is Chemotherapy (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.meta.profile), then treatment type (Profile: MedicationStatement/Chemotherapy, Field: MedicationStatement.category.coding:typeOfTreatment.code) should be 3 - Chemotherapy `$this='https://onko.vvis.gov.lv/fhir/StructureDefinition/MedicationStatement/Chemotherapy-v1' implies (%resource.category.ofType(CodeableConcept).coding.where(system='https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.628').code = '3')` Mappings rim: n/a
security	Σ	0..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 All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	Σ	1..*	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. ©NHS: Tags are requiered to identify who is responsible for the information in the resource, i.e who typed it in. 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 Sliced: Unordered, Open, by system(Value) Binding CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
authorMedicalInstitution	Σ	1..1	Coding	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution 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. ©NHS: Values SHALL be provided in CREATE and UPDATE requests of Medical Institutions. When provided will be validated against JWT. 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 CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		1..1	idFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 id Fixed value authorMedicalInstitution Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value urn:oid:1.3.6.1.4.1.38760.2.23 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:authorMedicalInstitution.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ]
entererMedicalPerson	Σ	0..1	Coding	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson 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. ©NHS: Values SHOULD be provided in CREATE and UPDATE requests of Medical Personal. When provided will be validated against JWT. 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 CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		1..1	idFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 id Fixed value entererMedicalPerson Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value urn:oid:1.3.6.1.4.1.38760.2.1 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPerson.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ]
entererPersonId	Σ	0..1	Coding	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId 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. ©NHS: Values SHALL be provided in CREATE and UPDATE requests of any human actor. When provided will be validated against JWT. 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 CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		1..1	idFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.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 id Fixed value entererPersonId Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value urn:oid:1.3.6.1.4.1.38760.3.1.1 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.code Short description Symbol in syntax defined by the system Definition Doctor or patient personal identity number is expected. 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererPersonId.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ]
entererSystem	Σ	1..1	Coding	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem 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. ©NHS: Values SHALL be provided in CREATE and UPDATE requests. When provided will be validated against JWT. 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 CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		1..1	idFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 id Fixed value entererSystem Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://vvis.gov.lv/fhir/CodeSystem/1.3.6.1.4.1.38760.2.3 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererSystem.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ]
entererMedicalPersonRole	Σ	0..1	Coding	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole 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 CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		1..1	idFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 id Fixed value entererMedicalPersonRole Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value urn:oid:1.3.6.1.4.1.38760.2.37 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id MedicationStatement.meta.tag:entererMedicalPersonRole.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ]
implicitRules	Σ ?!	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
language		0..0	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 IETF language tag CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
text		0..0	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A rim: Act.text?
contained	I	0..0	Resource	There are no (further) constraints on this element Element id MedicationStatement.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Constraints dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic) Mappings rim: Entity. Role, or Act rim: N/A
extension	I	1..*	Extension	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 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, Closed, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
courseCountReceived	I	0..1	Extension(integer)	Element id MedicationStatement.extension:courseCountReceived Short description Course Count Received \| Saņemto kursu skaits Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(integer) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/CourseCountReceivedExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
chemotherapyLine	I	0..1	Extension(CodeableConcept)	Element id MedicationStatement.extension:chemotherapyLine Short description Therapy Line \| Terapijas līnija Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(CodeableConcept) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/TherapyLineExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
followUpExtension	I	0..*	Extension(CodeableConcept)	Element id MedicationStatement.extension:followUpExtension Short description Indication of further treatment/monitoring of patients \| Norāde par pacientu tālāko ārstēšanu/uzraudzību Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(CodeableConcept) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/FollowUpExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
cardStatusExtension	I	1..1	Extension(CodeableConcept)	Element id MedicationStatement.extension:cardStatusExtension Short description Status of the Oncology card in the register \| Kartes statuss reģistrā Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(CodeableConcept) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
cardStatusDateExtension	I	0..1	Extension(dateTime)	Element id MedicationStatement.extension:cardStatusDateExtension Short description Card status date \| Datums, kad kartei uzstādīts statuss Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(dateTime) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusDateExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
cardStatusReasonExtension	I	0..1	Extension(CodeableConcept)	Element id MedicationStatement.extension:cardStatusReasonExtension Short description Card status reason \| Kartes statusa maiņas iemesls Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(CodeableConcept) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusReasonExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
terminationDateExtension	I	0..1	Extension(dateTime)	Element id MedicationStatement.extension:terminationDateExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(dateTime) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
terminationReasonExtension	I	0..1	Extension(CodeableConcept)	Element id MedicationStatement.extension:terminationReasonExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(CodeableConcept) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	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 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	1..1	OncologyIdentifier	Element id MedicationStatement.identifier Short description External Identifier \| Ārējās sistēmas ieraksta ID Definition An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. Comments This is a business identifier, not a resource identifier. Data type OncologyIdentifier Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		0..0	id	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 id Mappings rim: n/a
extension	I	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 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: N/A rim: Role.code or implied by context
type	Σ	1..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 Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.system Short description FHIR OncologyCardData Profile Identifier Classifier \| FHIR OncologyCardData profila identifikatoru klasifikators 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.646 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.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 Binding FHIR OncologyCardData Profile Identifier Classifier code \| FHIR OncologyCardData profila identifikatoru klasifikatora kods https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.646 (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.coding.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.identifier.type.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
system	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	Σ	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Examples General 123456 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 I	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 I	1..1	Reference(MedicalInstitution)	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(MedicalInstitution) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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 I	0..0	Reference(MedicationRequest \| CarePlan \| ServiceRequest)	There are no (further) constraints on this element 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 Reference(MedicationRequest \| CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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 I	0..0	Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation)	There are no (further) constraints on this element 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 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 Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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 active \| completed \| entered-in-error \| intended \| stopped \| on-hold \| unknown \| not-taken 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. MedicationStatement Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a workflow: Event.status w5: FiveWs.status rim: .statusCode
statusReason		0..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) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	Σ	1..1	CodeableConceptBinding	Element id MedicationStatement.category Short description Type of treatment and Type of chemotherapy \| Ārstēšanas veids un Ķīmijterapijas veids 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) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.category.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.category.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	1..2	Coding	Element id MedicationStatement.category.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 Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
typeOfTreatment	Σ	1..1	Coding	Element id MedicationStatement.category.coding:typeOfTreatment Short description Type of treatment \| Ārstēšanas veids 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.category.coding:typeOfTreatment.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.category.coding:typeOfTreatment.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id MedicationStatement.category.coding:typeOfTreatment.system Short description Classifier of types of treatment \| Ārstēšanas veidu klasifikators 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.628 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.category.coding:typeOfTreatment.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	Element id MedicationStatement.category.coding:typeOfTreatment.code Short description Classifier of types of treatment code \| Ārstēšanas veidu klasifikators kods 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.category.coding:typeOfTreatment.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationStatement.category.coding:typeOfTreatment.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ]
chemotherapyType	Σ	1..1	Coding	Element id MedicationStatement.category.coding:chemotherapyType Short description Type of chemotherapy \| Ķīmijterapijas veids 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.category.coding:chemotherapyType.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.category.coding:chemotherapyType.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id MedicationStatement.category.coding:chemotherapyType.system Short description Type of chemotherapy classifier \| Ķīmijterapijas veida klasifikators 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.634 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.category.coding:chemotherapyType.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	Element id MedicationStatement.category.coding:chemotherapyType.code Short description Type of chemotherapy classifier code \| Ķīmijterapijas veida klasifikatora kods 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.category.coding:chemotherapyType.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationStatement.category.coding:chemotherapyType.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.category.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
medication[x]	Σ	1..1		Element id MedicationStatement.medication[x] Short description ATK code of the generic name of the drug \| Zāļu vispārīgā nosaukuma ATK kods 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) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a workflow: Event.code w5: FiveWs.what[x] rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.medication[x].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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.medication[x].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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id MedicationStatement.medication[x].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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id MedicationStatement.medication[x].coding.system Short description Anatomical therapeutic chemical classification of drugs classifier \| Zāļu anatomiski terapeitiski ķīmiskā klasifikācija (ATĶ) klasifikators 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.141 Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	Element id MedicationStatement.medication[x].coding.code Short description Anatomical therapeutic chemical classification of drugs classifier code \| Zāļu anatomiski terapeitiski ķīmiskā klasifikācija (ATĶ) klasifikatora kods 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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ I	1..1	Reference(LVPatient)	Element id MedicationStatement.subject Short description Reference to Patient profile \| Saite uz Patient profilu Definition The person, animal or group who is/was taking the medication. 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 Reference(LVPatient) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.subject.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.subject.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reference	Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationStatement.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
type	Σ	1..1	uriBinding	There are no (further) constraints on this element Element id MedicationStatement.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationStatement.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
context	Σ I	0..0	Reference(Encounter \| EpisodeOfCare)	There are no (further) constraints on this element 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 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 Reference(Encounter \| EpisodeOfCare) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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]	Σ	0..1		Element id MedicationStatement.effective[x] Short description Chemotherapy start date / Chemotherapy end date \| Ķīmijterapijas sākuma datums / Ķīmijterapijas beigu datums 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. Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.done[x] rim: .effectiveTime
effectivePeriod			Period	Data type Period
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.effective[x].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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.effective[x].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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
start	S Σ I	1..1	dateTime	Element id MedicationStatement.effective[x].start Short description Chemotherapy start date \| Ķīmijterapijas sākuma datums Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: DR.1 rim: ./low
end	Σ I	0..1	dateTime	Element id MedicationStatement.effective[x].end Short description End date of chemotherapy \| Ķīmijterapijas beigu datums Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: DR.2 rim: ./high
dateAsserted	Σ	0..0	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
informationSource	I	1..1	Reference(MedicalInstitution)	Element id MedicationStatement.informationSource Short description Medical institution where the treatment was received \| Ārstniecības iestāde, kurā saņemta ārstēšana 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 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 Reference(MedicalInstitution) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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)
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.informationSource.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.informationSource.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
foreignMedicalInstitution	I	0..1	Extension(string)	Element id MedicationStatement.informationSource.extension:foreignMedicalInstitution Short description Foreign medical institution where the treatment was received \| Ārvalstu ārstniecības iestāde, kurā saņemta ārstēšana Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://onko.vvis.gov.lv/fhir/StructureDefinition/ForeignMedicalInstitutionExtension-v1 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reference	Σ I	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.informationSource.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationStatement.informationSource.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationStatement.informationSource.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.informationSource.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
derivedFrom	I	0..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) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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..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. Condition/Problem/DiagnosisCodes (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	I	1..*	Reference(OncologyBasicDataOfDisease)	Element id MedicationStatement.reasonReference Short description Treated disease \| Ārstētā slimība 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(OncologyBasicDataOfDisease) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `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
id		0..1	id	There are no (further) constraints on this element Element id MedicationStatement.reasonReference.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 id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.reasonReference.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reference	Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationStatement.reasonReference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
type	Σ	1..1	uriBinding	There are no (further) constraints on this element Element id MedicationStatement.reasonReference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationStatement.reasonReference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.reasonReference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
note		0..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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: N/A rim: Act workflow: Event.note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosage		0..0	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 Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT] rim: refer dosageInstruction mapping

Profila validācijas

Nr.	Nosacījums	Tips	Validācija FHIR
1.	Vai ir norādīta vismaz viena saistītā slimības karte	Kardinalitāte	MedicationStatement.reasonReference kardinalitāte ir uzstādīta 1..*
2	Vai ir norādīta ārstniecības iestāde (Latvijas – no klasifikatora, vai ārvalstu – ievadot informāciju teksta laukā)	FHIRPath	ID: Chemotherapy-con-1 `informationSource.reference.exists() or informationSource.extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/ForeignMedicalInstitutionExtension-v1').value.exists()`
3	Vai ir norādīts ķīmijterapijas veids	Kardinalitāte	MedicationStatement.category.coding:chemotherapyType kardinalitāte ir uzstādīta 1..1
4	Vai ir norādīts sākuma datums	Kardinalitāte	MedicationStatement.effective[x].start kardinalitāte ir uzstādīta 1..1
5	Vai ir norādīts vismaz viens medikaments	Kardinalitāte	MedicationStatement.medication[x].coding kardinalitāte ir uzstādīta 1..*
6	Ķīmijterapijas sākuma datums – obligāts, datums nedrīkst būt nākotnē	FHIRPath	ID: Chemotherapy-con-2 `iif(effective.start.exists(), effective.start.toDateTime() <= now(), false)`
7	Ķīmijterapijas sākuma datums – obligāts, datums nedrīkst būt agrāks par diagnozes noteikšanas datumu	FHIRPath	Validācija tiek definēta Bundle resursa ietvaros ar ID: OncologyBundle-con-40
8	Ķīmijterapijas sākuma datums – obligāts, datumam ir jābūt lielākam par pacienta dzimšanas datumu	-	Validācija netiek nodrošināta FHIR līmenī, tā kā pacienta dzimšanas datums netiek iesūtīts datu kopā (tiek iesūtīta tikai reference uz pacientu)
9	Ķīmijterpaijas beigu datums (neobligāts), Datums nedrīkst būt nākotnē & nedrīkst būt mazāks par sākuma datumu (var būt vienāds vai lielāks)	FHIRPath	ID: Chemotherapy-con-3 `iif(effective.end.exists(), effective.end.toDateTime() <= now() and effective.end.toDateTime() >= effective.start.toDateTime(), true)`
10	Ķīmijterpaijas gadījumā jānorāda ārstēšanas veids 3—Ķīmijterpaija	FHIRPath	ID: Chemotherapy-con-4 `$this='https://onko.vvis.gov.lv/fhir/StructureDefinition/MedicationStatement/Chemotherapy-v1' implies (%resource.category.ofType(CodeableConcept).coding.where(system='https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.628').code = '3')`
11	Kā medikamentu var iesūtīt tikai piektā līmeņa ierakstu (aktīvas vielas līmeņa ierakstu, piemēram: L01AA02 chlorambucil).	FHIRPath	ID: Chemotherapy-con-6 `medicationCodeableConcept.coding.all(code.matches('^.{7}$'))`
12	Vienlaikus var norādīt tikai vienu ārstniecības iestādi – Latvijas no klasifikatora, vai ārvalstu teksta laukā	FHIRPath	ID: Chemotherapy-con-7 `(informationSource.reference.exists() implies informationSource.extension.value.exists().not()) and (informationSource.extension.value.exists() implies informationSource.reference.exists().not())`
13	Ārstēšanas kartes statuss var būt tikai 2-Iesniegta vai 3-Anulēta	FHIRPath	ID: Chemotherapy-con-8 `extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusExtension-v1').value.coding.code.matches('^2$\|^3$')`
14	Ja ārstēšanas kartei tiek uzstādīts statuss "3-Anulēta", tad obligāti ir jānorāda anulēšanas iemesls	FHIRPath	ID: Chemotherapy-con-9 `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusExtension-v1').value.coding.code.matches('^3$'), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusReasonExtension-v1').value.exists(), true)`
15	Pārtraukšanas datums nav atļauts, ja ir aizpildīts terapijas beigu datums	FHIRPath	ID: Chemotherapy-con-10 `iif(effective.end.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').value.exists().not(), true)`
16	Terapijas pārtraukšanas datumam ir jābūt lielākam vai vienādam ar terapijas sākuma datumu	FHIRPath	ID: Chemotherapy-con-11 `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').value.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').value.toDate() >= effective.start.toDateTime(), true)`
17	Ja ir norādīts terapijas pārtraukšanas datums, tad ir obligāti jābūt norādītam terapijas pārtraukšanas iemeslam no klasifikatora (un otrādi: ja ir norādīts pārtraukšanas iemesls, tad ir noteikti jābūt pārtraukšanas datumam)	FHIRPath	ID: Chemotherapy-con-12 iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').value.exists() or extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.coding.code.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').value.exists() and extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.coding.code.exists(), true)
18	Ja ir norādīts teksts sadaļā “Papildus informācija” tad ir obligāti jābūt norādītam pārtraukšanas datumam un iemeslam no klasifikatora (bet pats “papildus informācijas” lauks nav obligāts)	FHIRPath	ID: Chemotherapy-con-13 `iif(extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.text.exists(), extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1').value.exists() and extension.where(url='https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1').value.coding.code.exists(), true)`

Datu iesūtīšanas piemēri

Skatīt Postman kolekcijas struktūru Chemotherapy:

Darbība	Nosaukums	Apraksts
POST	Create Chemotherapy	Jaunas ārstēšanas – ķīmijterapija iesūtīšana
POST	Create Chemotherapy (historical cards)	Jaunas ārstēšanas - ķīmijterapija iesūtīšana, iekļaujot arī vēsturiskos datu laukus
GET	Get Chemotherapy	Esošas ārstēšanas - ķīmijterapija izgūšana pēc ID
PUT	Update Chemotherapy	Esošas ārstēšanas - ķīmijterapija datu labošana
GET	Search for Chemotherapy entry by OncologyBasicDataOfDisease reference	Ķīmijterapijas kartes meklēšana pēc Slimības pamatdatu references