This is the current version of the PS-CA Implementation Guide. Other releases of the PS-CA Implementation Guide may be found at Guides.
Medication (PS-CA)
Additional information on this profile (including the JSON & XML structure and detailed element descriptions) can be found at Medication (PS-CA)
Profile
| Medication | I | Medication | There are no (further) constraints on this element Element idMedication Definition of a Medication DefinitionThis resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.
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| id | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedication.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 | 0..1 | Meta | There are no (further) constraints on this element Element idMedication.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedication.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..1 | codeBinding | There are no (further) constraints on this element Element idMedication.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). A human language.
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idMedication.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 | 0..* | Resource | There are no (further) constraints on this element Element idMedication.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 | 0..* | Extension | There are no (further) constraints on this element Element idMedication.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, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| strength | I | 0..1 | Extension(string) | Element idMedication.extension:strength Extension for representing overall medication strength. Alternate namesextensions, user content DefinitionThe overall medication strength, rather than the strength of a specific ingredient. 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. http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description Constraints
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| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.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 | 0..* | Identifier | There are no (further) constraints on this element Element idMedication.identifier Business identifier for this medication DefinitionBusiness identifier for this medication. The serial number could be included as an identifier.
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| code | S Σ | 1..1 | Data Type: Codeable Concept (PS-CA)Binding | Element idMedication.code Medication that was administered or was to be administered (medication code from any code system) DefinitionMedication that was administered or was to be administered. A variety of terminology is used across the Canadian Landscape to codify medications. Various code systems in use in Canada are put forward as examples and optional slices have been created to encourage the use of SNOMED CT CA terminology. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. IPS-UV Note: Several kinds of medication coding could be provided as:
The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available. Data Type: Codeable Concept (PS-CA) BindingCanadian Clinical Drug Data Set codes
DIN {
"coding": [
{
"system": "http://hl7.org/fhir/NamingSystem/ca-hc-din",
"code": "02247611",
"display": "Acetaminophen 325mg (Jamieson Laboratories Ltd.)"
}
],
"text": "ACETAMINOPHEN 325MG"
}NPN {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-hc-npn",
"code": "80016551",
"display": "Echinacea with Garlic and Ginger (Jamieson Laboratories Ltd.)"
}
],
"text": "Echinacea with Garlic and Ginger"
}CCDD {
"coding": [
{
"system": "https://fhir.infoway-inforoute.ca/CodeSystem/canadianclinicaldrugdataset",
"code": "02240105",
"display": "AVEENO ANTI-ITCH LOTION (calamine 3 % and pramoxine hydrochloride 1 % lotion) JOHNSON & JOHNSON INC"
}
],
"text": "Aveeno Anti-Itch Lotion"
}Mappings
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedication.code.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 idMedication.code.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 | 0..* | Data Type: Coding (PS-CA) | Element idMedication.code.coding A reference to a 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. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content Unordered, Open, by $this(Pattern) Discriminated by value set Constraints
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| atcClass | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.code.coding:atcClass Optional slice for representing WHO ATC classification DefinitionWHO ATC classification Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content
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| codeSctIpsFreeSet | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.code.coding:codeSctIpsFreeSet Optional slice from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set) DefinitionThis slice is derived from IPS and draws on values from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set). Thus, the concepts are potentially dated, do not reflect Canadian content, and may be too generic for domestic Canadian use. SNOMED CT is not a generally used terminology in Canada for medications. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content MedicationsSnomedCtIpsFreeSet (required) Constraints
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| codeCCDD | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.code.coding:codeCCDD Optional slice for representing Canadian Clinical Drug Data Set codes DefinitionValue set consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content PrescriptionMedicinalProduct (required) Constraints
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| codeLNHP | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.code.coding:codeLNHP Optional slice for representing NPN and DIN-HM codes in the Licensed Natural Health Products Database DefinitionValue set consisting of all Natural Product Number (NPN) and Homepathic Medicine Number (DIN-HM) codes that are licensed by Health Canada and present in the Licensed Natural Health Products Database. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content LicensedNaturalHealthProducts (required) Constraints
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedication.code.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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| status | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedication.status active | inactive | entered-in-error DefinitionA code to indicate if the medication is in active use. This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status. A coded concept defining if the medication is in active use.
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| manufacturer | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idMedication.manufacturer Manufacturer of the item DefinitionDescribes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product. 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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| form | S | 0..1 | Data Type: Codeable Concept (PS-CA)Binding | Element idMedication.form Concept - reference to a terminology or just text DefinitionAdministrable Pharmaceutical Dose Form. This code represents the form of the medication (e.g. tablet, capsule, liquid) Since the EDQM Standards Terms, together with UCUM, is one of the IDMP terminologies actually available for usage, this code system has been selected as referenceterminology for representing Pharmaceutical Dose forms; Packages and Route of Administration It is known that also alternative jurisdictional and international terminologies are known to be used for this concept domain, as NCI or SNOMED CT. For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text. Data Type: Codeable Concept (PS-CA) BindingSCTCA Pharmaceutical Dose Form
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedication.form.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 idMedication.form.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 | 0..* | Data Type: Coding (PS-CA) | Element idMedication.form.coding A reference to a 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. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content Unordered, Open, by $this(Pattern) Discriminated by the bound value set Constraints
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| formEDQM | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.form.coding:formEDQM Optional slice for representing EDQM dose forms DefinitionEDQM Medicine dose forms Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content MedicineDoseFormUvIps (required) Constraints
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| formSCTCA | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.form.coding:formSCTCA Optional slice for representing SNOMED CT Canadian edition dose forms DefinitionSNOMED CT Canadian edition dose forms Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content PharmaceuticalDoseFormCode (required) Constraints
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| OrdereableDrugFormV3PrescribeIT | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element idMedication.form.coding:OrdereableDrugFormV3PrescribeIT Optional slice for representing HL7 V3 codes for orderable drug forms from the PrescribeIT value set DefinitionHL7 V3 Codes from the PrescribeIT value set indicating the form in which the drug product is capable of being administered, dispensed, or ordered Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content PrescriptionDrugForm (required) Constraints
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idMedication.form.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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| amount | Σ I | 0..1 | Ratio | There are no (further) constraints on this element Element idMedication.amount Amount of drug in package DefinitionSpecific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.). The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.
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| ingredient | 0..* | BackboneElement | Element idMedication.ingredient Active or inactive ingredient DefinitionIdentifies a particular constituent of interest in the product. IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedication.ingredient.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 idMedication.ingredient.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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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.ingredient.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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.
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| item[x] | 1..1 | There are no (further) constraints on this element Element idMedication.ingredient.item[x] The actual ingredient or content DefinitionThe actual ingredient - either a substance (simple ingredient) or another medication of a medication. The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base). Unordered, Open, by $this(Type) Constraints
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| itemReference | Reference(Substance | Medication) | There are no (further) constraints on this element Data type | ||
| itemCodeableConcept | 0..1 | CodeableConceptBinding | Element idMedication.ingredient.item[x]:itemCodeableConcept The actual ingredient or content DefinitionThe actual ingredient - either a substance (simple ingredient) or another medication of a medication. The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base). IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain this element within the context of their own jurisdictional content. IPS UV Note: The IDMP ISO 11238 standard addresses the identification and exchange of regulated information on substances. The Global Ingredient Archival System (GInAS) will provide a common global identifier for all of the substances used in medicinal products, providing a definition of substances globally consistent with this standard. Those identifiers however are yet available for concrete usage, therefore in this version of the template, SNOMED CT has been chosen as reference terminology also for the active substances. This choice will be revised based on the availability and the maturity of GInAS. SNOMED CT CA drug substances.
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedication.ingredient.item[x]:itemCodeableConcept.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 idMedication.ingredient.item[x]:itemCodeableConcept.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 | 0..* | Coding | Element idMedication.ingredient.item[x]:itemCodeableConcept.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 $this(Pattern) Discriminated by value set Constraints
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| ingredientSCTCA | Σ | 0..* | CodingBinding | Element idMedication.ingredient.item[x]:itemCodeableConcept.coding:ingredientSCTCA Optional slice for representing SNOMED CT Canadian edition drug active substances DefinitionSNOMED CT Canadian edition drug active substances Allows for alternative encodings within a code system, and translations to other code systems. This value set is inclusive of the SNOMED CT values put for in the Medicine Active Substances - IPS value set DrugOrMedicamentSubstanceCode (required) Constraints
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedication.ingredient.item[x]:itemCodeableConcept.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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| isActive | 0..1 | boolean | There are no (further) constraints on this element Element idMedication.ingredient.isActive Active ingredient indicator DefinitionIndication of whether this ingredient affects the therapeutic action of the drug. True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).
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| strength | I | 0..1 | Data Type: Ratio (PS-CA) | Element idMedication.ingredient.strength A ratio of two Quantity values - a numerator and a denominator DefinitionA relationship of two Quantity values - expressed as a numerator and a denominator. IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.
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| batch | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedication.batch Details about packaged medications DefinitionInformation that only applies to packages (not products).
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| id | 0..1 | string | There are no (further) constraints on this element Element idMedication.batch.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 idMedication.batch.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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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.batch.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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.
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| lotNumber | 0..1 | string | There are no (further) constraints on this element Element idMedication.batch.lotNumber Identifier assigned to batch DefinitionThe assigned lot number of a batch of the specified product. Note that FHIR strings SHALL NOT exceed 1MB in size
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| expirationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idMedication.batch.expirationDate When batch will expire DefinitionWhen this specific batch of product will expire.
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Extensions
This profile uses the following extensions:
Medication: Medication Strength Description
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
The following elements are considered Must Support in the Medication (IPS) profile that are relaxed in this version of the PS-CA profile:
Medication.ingredientand sub-elementsNote: Systems that support these elements are encouraged to send them in patient summaries
Cardinality Differences:
There are no cardinality differences between this profile and IPS-UV
Vocabulary Differences:
Medication.code- optional slices added for PrescriptionMedicinalProduct (CCDD) codes, Licensed Natural Health Products Database (LicensedNaturalHealthProducts) codes, and IPS FreeSet.
- PrescriptionMedicinalProduct indicated as preferred
Medication.form- optional slices added for SNOMED CT Canadian edition PharmaceuticalDoseFormCode, Prescribe IT PrescriptionDrugForm (derived from HL7 v3)
- PharmaceuticalDoseFormCode indicated as preferred
Medication.ingredient.itemCodeableConcept.coding- optional slice added for SNOMED CT Canadian edition DrugOrMedicamentSubstanceCode
- SNOMED CT Canadian edition DrugOrMedicamentSubstanceCode indicated as preferred
Other differences between the IPS and PS-CA Include:
Medication.code:- IPS datatype profile replaced with PS-CA datatype profile
- Canadian vocabulary examples added
Medication.form:- IPS datatype profile replaced with PS-CA datatype profile
Medication.ingredient.strength:- IPS datatype profile replaced with PS-CA datatype profile