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 laukāExtension: 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 idMedicationStatement Record of medication being taken by a patient DefinitionA 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. 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.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ I | 0..1 | OncologyMeta | Element idMedicationStatement.meta Metadata about a resource DefinitionThe 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.
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id | 0..0 | id | There are no (further) constraints on this element Element idMedicationStatement.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.meta.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.meta.versionId Version specific identifier DefinitionThe 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. 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.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element idMedicationStatement.meta.lastUpdated When the resource version last changed DefinitionWhen 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. 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.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ I | 1..1 | canonical(StructureDefinition) | Element idMedicationStatement.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..0 | CodingBinding | There are no (further) constraints on this element Element idMedicationStatement.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. All Security Labels (extensible) Constraints
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tag | Σ | 1..* | Coding | There are no (further) constraints on this element Element idMedicationStatement.meta.tag Tags applied to this resource DefinitionTags 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. 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. Unordered, Open, by system(Value) Binding Constraints
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authorMedicalInstitution | Σ | 1..1 | Coding | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution Tags applied to this resource DefinitionTags 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. 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.
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id | 1..1 | idFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. authorMedicalInstitution
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
urn:oid:1.3.6.1.4.1.38760.2.23
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version | Σ | 0..0 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:authorMedicalInstitution.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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entererMedicalPerson | Σ | 0..1 | Coding | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson Tags applied to this resource DefinitionTags 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. 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.
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id | 1..1 | idFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. entererMedicalPerson
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
urn:oid:1.3.6.1.4.1.38760.2.1
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version | Σ | 0..0 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPerson.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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entererPersonId | Σ | 0..1 | Coding | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId Tags applied to this resource DefinitionTags 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. 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.
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id | 1..1 | idFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. entererPersonId
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
urn:oid:1.3.6.1.4.1.38760.3.1.1
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version | Σ | 0..0 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.code Symbol in syntax defined by the system DefinitionDoctor or patient personal identity number is expected. Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererPersonId.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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entererSystem | Σ | 1..1 | Coding | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem Tags applied to this resource DefinitionTags 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. 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.
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id | 1..1 | idFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. entererSystem
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
https://vvis.gov.lv/fhir/CodeSystem/1.3.6.1.4.1.38760.2.3
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version | Σ | 0..0 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererSystem.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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entererMedicalPersonRole | Σ | 0..1 | Coding | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole Tags applied to this resource DefinitionTags 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. 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.
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id | 1..1 | idFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. entererMedicalPersonRole
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
urn:oid:1.3.6.1.4.1.38760.2.37
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version | Σ | 0..0 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..0 | boolean | There are no (further) constraints on this element Element idMedicationStatement.meta.tag:entererMedicalPersonRole.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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implicitRules | Σ ?! | 0..0 | uri | There are no (further) constraints on this element Element idMedicationStatement.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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language | 0..0 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.language Language of the resource content DefinitionThe base language in which the resource is written. 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). IETF language tag
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text | 0..0 | Narrative | There are no (further) constraints on this element Element idMedicationStatement.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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contained | I | 0..0 | Resource | There are no (further) constraints on this element Element idMedicationStatement.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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extension | I | 1..* | Extension | Element idMedicationStatement.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Closed, by url(Value) Extensions are always sliced by (at least) url Constraints
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courseCountReceived | I | 0..1 | Extension(integer) | Element idMedicationStatement.extension:courseCountReceived Course Count Received | Saņemto kursu skaits Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/CourseCountReceivedExtension-v1 Constraints
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chemotherapyLine | I | 0..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:chemotherapyLine Therapy Line | Terapijas līnija Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/TherapyLineExtension-v1 Constraints
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followUpExtension | I | 0..* | Extension(CodeableConcept) | Element idMedicationStatement.extension:followUpExtension Indication of further treatment/monitoring of patients | Norāde par pacientu tālāko ārstēšanu/uzraudzību Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/FollowUpExtension-v1 Constraints
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cardStatusExtension | I | 1..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:cardStatusExtension Status of the Oncology card in the register | Kartes statuss reģistrā Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusExtension-v1 Constraints
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cardStatusDateExtension | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:cardStatusDateExtension Card status date | Datums, kad kartei uzstādīts statuss Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusDateExtension-v1 Constraints
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cardStatusReasonExtension | I | 0..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:cardStatusReasonExtension Card status reason | Kartes statusa maiņas iemesls Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/CardStatusReasonExtension-v1 Constraints
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terminationDateExtension | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:terminationDateExtension Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationDateExtension-v1 Constraints
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terminationReasonExtension | I | 0..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:terminationReasonExtension Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/TerminationReasonExtension-v1 Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 1..1 | OncologyIdentifier | Element idMedicationStatement.identifier External Identifier | Ārējās sistēmas ieraksta ID DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. This is a business identifier, not a resource identifier.
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id | 0..0 | id | There are no (further) constraints on this element Element idMedicationStatement.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. Identifier Type Codes (extensible) Constraints
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 1..1 | Coding | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.system FHIR OncologyCardData Profile Identifier Classifier | FHIR OncologyCardData profila identifikatoru klasifikators DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.646
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size FHIR OncologyCardData Profile Identifier Classifier code | FHIR OncologyCardData profila identifikatoru klasifikatora kods
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.type.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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system | Σ | 0..0 | uri | There are no (further) constraints on this element Element idMedicationStatement.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ I | 0..0 | Period | There are no (further) constraints on this element Element idMedicationStatement.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 1..1 | Reference(MedicalInstitution) | There are no (further) constraints on this element Element idMedicationStatement.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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basedOn | Σ I | 0..0 | Reference(MedicationRequest | CarePlan | ServiceRequest) | There are no (further) constraints on this element Element idMedicationStatement.basedOn Fulfils plan, proposal or order DefinitionA plan, proposal or order that is fulfilled in whole or in part by this event. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. 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. Reference(MedicationRequest | CarePlan | ServiceRequest) Constraints
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partOf | Σ I | 0..0 | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | There are no (further) constraints on this element Element idMedicationStatement.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. 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. 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. Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.status active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken DefinitionA 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. 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. A coded concept indicating the current status of a MedicationStatement.
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statusReason | 0..0 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.statusReason Reason for current status DefinitionCaptures the reason for the current state of the MedicationStatement. 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. A coded concept indicating the reason for the status of the statement.
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category | Σ | 1..1 | CodeableConceptBinding | Element idMedicationStatement.category Type of treatment and Type of chemotherapy | Ārstēšanas veids un Ķīmijterapijas veids DefinitionIndicates where the medication is expected to be consumed or administered. 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. A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.category.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.category.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 1..2 | Coding | Element idMedicationStatement.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by system(Value) Constraints
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typeOfTreatment | Σ | 1..1 | Coding | Element idMedicationStatement.category.coding:typeOfTreatment Type of treatment | Ārstēšanas veids DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.category.coding:typeOfTreatment.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.category.coding:typeOfTreatment.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedicationStatement.category.coding:typeOfTreatment.system Classifier of types of treatment | Ārstēšanas veidu klasifikators DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.628
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.category.coding:typeOfTreatment.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | Element idMedicationStatement.category.coding:typeOfTreatment.code Classifier of types of treatment code | Ārstēšanas veidu klasifikators kods DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.category.coding:typeOfTreatment.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.category.coding:typeOfTreatment.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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chemotherapyType | Σ | 1..1 | Coding | Element idMedicationStatement.category.coding:chemotherapyType Type of chemotherapy | Ķīmijterapijas veids DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.category.coding:chemotherapyType.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.category.coding:chemotherapyType.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedicationStatement.category.coding:chemotherapyType.system Type of chemotherapy classifier | Ķīmijterapijas veida klasifikators DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.634
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.category.coding:chemotherapyType.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | Element idMedicationStatement.category.coding:chemotherapyType.code Type of chemotherapy classifier code | Ķīmijterapijas veida klasifikatora kods DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.category.coding:chemotherapyType.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.category.coding:chemotherapyType.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.category.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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medication[x] | Σ | 1..1 | Element idMedicationStatement.medication[x] ATK code of the generic name of the drug | Zāļu vispārīgā nosaukuma ATK kods DefinitionIdentifies 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. 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. A coded concept identifying the substance or product being taken.
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medicationCodeableConcept | CodeableConcept | Data type | ||
id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.medication[x].id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.medication[x].extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 1..* | Coding | There are no (further) constraints on this element Element idMedicationStatement.medication[x].coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.medication[x].coding.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.medication[x].coding.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedicationStatement.medication[x].coding.system Anatomical therapeutic chemical classification of drugs classifier | Zāļu anatomiski terapeitiski ķīmiskā klasifikācija (ATĶ) klasifikators DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
https://vvis.gov.lv/fhir/ValueSet/1.3.6.1.4.1.38760.2.141
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.medication[x].coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | Element idMedicationStatement.medication[x].coding.code Anatomical therapeutic chemical classification of drugs classifier code | Zāļu anatomiski terapeitiski ķīmiskā klasifikācija (ATĶ) klasifikatora kods DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.medication[x].coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.medication[x].coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.medication[x].text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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subject | Σ I | 1..1 | Reference(LVPatient) | Element idMedicationStatement.subject Reference to Patient profile | Saite uz Patient profilu DefinitionThe person, animal or group who is/was taking the medication. 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.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.subject.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.subject.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 1..1 | uriBinding | There are no (further) constraints on this element Element idMedicationStatement.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). 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.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationStatement.subject.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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context | Σ I | 0..0 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationStatement.context Encounter / Episode associated with MedicationStatement DefinitionThe encounter or episode of care that establishes the context for this MedicationStatement. 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. Reference(Encounter | EpisodeOfCare) Constraints
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effective[x] | Σ | 0..1 | Element idMedicationStatement.effective[x] Chemotherapy start date / Chemotherapy end date | Ķīmijterapijas sākuma datums / Ķīmijterapijas beigu datums DefinitionThe 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). 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.
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effectivePeriod | Period | Data type | ||
id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.effective[x].id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.effective[x].extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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start | S Σ I | 1..1 | dateTime | Element idMedicationStatement.effective[x].start Chemotherapy start date | Ķīmijterapijas sākuma datums DefinitionThe start of the period. The boundary is inclusive. If the low element is missing, the meaning is that the low boundary is not known.
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end | Σ I | 0..1 | dateTime | Element idMedicationStatement.effective[x].end End date of chemotherapy | Ķīmijterapijas beigu datums DefinitionThe 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. 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. If the end of the period is missing, it means that the period is ongoing
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dateAsserted | Σ | 0..0 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.dateAsserted When the statement was asserted? DefinitionThe date when the medication statement was asserted by the information source.
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informationSource | I | 1..1 | Reference(MedicalInstitution) | Element idMedicationStatement.informationSource Medical institution where the treatment was received | Ārstniecības iestāde, kurā saņemta ārstēšana DefinitionThe 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. 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.
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.informationSource.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.informationSource.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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foreignMedicalInstitution | I | 0..1 | Extension(string) | Element idMedicationStatement.informationSource.extension:foreignMedicalInstitution Foreign medical institution where the treatment was received | Ārvalstu ārstniecības iestāde, kurā saņemta ārstēšana Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://onko.vvis.gov.lv/fhir/StructureDefinition/ForeignMedicalInstitutionExtension-v1 Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.informationSource.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idMedicationStatement.informationSource.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). 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.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationStatement.informationSource.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.informationSource.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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derivedFrom | I | 0..0 | Reference(Resource) | There are no (further) constraints on this element Element idMedicationStatement.derivedFrom Additional supporting information DefinitionAllows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. 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.
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reasonCode | 0..0 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonCode Reason for why the medication is being/was taken DefinitionA reason for why the medication is being/was taken. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. A coded concept identifying why the medication is being taken.
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reasonReference | I | 1..* | Reference(OncologyBasicDataOfDisease) | Element idMedicationStatement.reasonReference Treated disease | Ārstētā slimība DefinitionCondition or observation that supports why the medication is being/was taken. 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. Reference(OncologyBasicDataOfDisease) Constraints
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id | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.reasonReference.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.reasonReference.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.reasonReference.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 1..1 | uriBinding | There are no (further) constraints on this element Element idMedicationStatement.reasonReference.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). 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.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationStatement.reasonReference.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.reasonReference.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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note | 0..0 | Annotation | There are no (further) constraints on this element Element idMedicationStatement.note Further information about the statement DefinitionProvides extra information about the medication statement that is not conveyed by the other attributes. 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).
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dosage | 0..0 | Dosage | There are no (further) constraints on this element Element idMedicationStatement.dosage Details of how medication is/was taken or should be taken DefinitionIndicates how the medication is/was or should be taken by the patient. 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.
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Profila validācijas
Nr. | Nosacījums | Tips | Validācija FHIR |
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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 |
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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 |