PatientMedicationList
| Canonical URL | https://fhir.synapxe.sg/StructureDefinition/profile-list-medicationstatement |
|---|---|
| Version | 1.2.0 |
| Status | Active |
| Description | A List of MedicationStatement resources is used to store a list of medications that are consumed by a patient. |
| PatientMedicationList (List) | C | List | |
| id | Σ | 0..1 | id |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | C | 0..1 | Narrative |
| contained | C | 0..* | Resource |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| identifier | C | 1..1 | Identifier |
| id | 0..0 | string | |
| extension | C | 0..0 | Extension |
| use | Σ ?! | 0..0 | codeBinding |
| type | Σ | 0..0 | CodeableConceptBinding |
| system | Σ | 1..1 | uriFixed Value |
| value | Σ C | 1..1 | string |
| period | Σ C | 0..0 | Period |
| assigner | Σ C | 0..0 | Reference(Organization) |
| status | Σ ?! | 1..1 | codeBinding |
| mode | Σ ?! | 1..1 | codeBindingPattern |
| title | Σ | 0..0 | string |
| code | Σ | 1..1 | CodeableConceptBinding |
| id | 0..0 | string | |
| extension | C | 0..* | Extension |
| coding | Σ C | 1..* | Coding |
| id | 0..0 | string | |
| extension | C | 0..0 | Extension |
| system | Σ | 1..1 | uriFixed Value |
| version | Σ | 0..1 | string |
| code | Σ C | 1..1 | codePattern |
| display | Σ C | 1..1 | string |
| userSelected | Σ | 0..0 | boolean |
| text | Σ | 0..0 | string |
| subject | Σ C | 1..1 | Reference(Patient) |
| encounter | C | 0..1 | Reference(Encounter) |
| date | Σ | 1..1 | dateTime |
| source | Σ C | 1..1 | Reference(PractitionerRole) |
| orderedBy | 0..0 | CodeableConceptBinding | |
| note | 0..1 | Annotation | |
| id | 0..0 | string | |
| extension | C | 1..* | Extension |
| annotationType | C | 1..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | C | 0..1 | CodeableConceptBinding |
| id | 0..0 | string | |
| extension | C | 0..* | Extension |
| coding | Σ C | 1..* | Coding |
| id | 0..0 | string | |
| extension | C | 0..0 | Extension |
| system | Σ | 1..1 | uriFixed Value |
| version | Σ | 0..1 | string |
| code | Σ C | 1..1 | code |
| display | Σ C | 1..1 | string |
| userSelected | Σ | 0..0 | boolean |
| text | Σ | 0..0 | string |
| author[x] | Σ | 0..0 | |
| time | Σ | 0..0 | dateTime |
| text | Σ | 1..1 | markdown |
| entry | C | 1..* | BackboneElement |
| id | 0..0 | string | |
| extension | C | 0..0 | Extension |
| modifierExtension | Σ ?! C | 0..0 | Extension |
| flag | 0..0 | CodeableConcept | |
| deleted | ?! | 0..0 | boolean |
| date | 1..1 | dateTime | |
| item | C | 1..1 | Reference(MedicationStatement) |
| emptyReason | C | 0..0 | CodeableConceptBinding |
| List | |
| Short | A list is a curated collection of resources |
| Definition | A List is a curated collection of resources, for things such as problem lists, allergy lists, facility list, organization list, etc. |
| Cardinality | 0..* |
| Alias | Collection, WorkingList, Organizer |
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| List.id | |
| Short | Logical id of this artifact |
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
| Cardinality | 0..1 |
| Type | id |
| Summary | True |
| Comments | Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. |
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| List.meta | |
| Short | Metadata about a resource |
| Definition | The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
| Cardinality | 0..1 |
| Type | Meta |
| Summary | True |
| Constraints |
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| List.implicitRules | |
| Short | A set of rules under which this content was created |
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
| Cardinality | 0..1 |
| Type | uri |
| Modifier | True |
| Summary | True |
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. |
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| List.language | |
| Short | Language of the resource content |
| Definition | The base language in which the resource is written. |
| Cardinality | 0..1 |
| Type | code |
| Binding | IETF language tag for a human language |
| Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
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| List.text | |
| Short | Text summary of the resource, for human interpretation |
| Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
| Cardinality | 0..1 |
| Type | Narrative |
| Alias | narrative, html, xhtml, display |
| Comments | Contained resources do not have a 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. |
| Conditions | The cardinality or value of this element may be affected by these constraints: dom-6 |
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| List.contained | |
| Short | Contained, inline Resources |
| Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. |
| Cardinality | 0..* |
| Type | Resource |
| Alias | inline resources, anonymous resources, contained resources |
| Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. |
| Conditions | The cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5 |
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| List.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
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| List.modifierExtension | |
| Short | Extensions that cannot be ignored |
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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). |
| Cardinality | 0..* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
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| List.identifier | |
| Short | An identifier intended for computation |
| Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. |
| Cardinality | 1..1 |
| Type | Identifier |
| Comments | The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension. |
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| List.identifier.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
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| List.identifier.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..0 |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
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| List.identifier.use | |
| Short | usual | official | temp | secondary | old (If known) |
| Definition | The purpose of this identifier. |
| Cardinality | 0..0 |
| Type | code |
| Binding | Identifies the purpose for this identifier, if known . |
| Modifier | True |
| Summary | True |
| Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
| Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
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| List.identifier.type | |
| Short | Description of identifier |
| Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
| Cardinality | 0..0 |
| Type | CodeableConcept |
| Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| Summary | True |
| Requirements | Allows users to make use of identifiers when the identifier system is not known. |
| Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
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| List.identifier.system | |
| Short | The namespace for the identifier value |
| Definition | Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique. |
| Cardinality | 1..1 |
| Type | uri |
| Summary | True |
| Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
| Comments | Identifier.system is always case sensitive. |
| Constraints |
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| Fixed Value | https://fhir.synapxe.sg/NamingSystem/pml-id |
| Examples | Generalhttp://www.acme.com/identifiers/patient |
| Mappings |
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| List.identifier.value | |
| Short | The value that is unique |
| Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
| Cardinality | 1..1 |
| Type | string |
| Summary | True |
| Comments | 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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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. |
| Conditions | The cardinality or value of this element may be affected by these constraints: ident-1 |
| Constraints |
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| Examples | General123456 |
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| List.identifier.period | |
| Short | Time period when id is/was valid for use |
| Definition | Time period during which identifier is/was valid for use. |
| Cardinality | 0..0 |
| Type | Period |
| Summary | True |
| Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. |
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| List.identifier.assigner | |
| Short | Organization that issued id (may be just text) |
| Definition | Organization that issued/manages the identifier. |
| Cardinality | 0..0 |
| Type | Reference(Organization) |
| Summary | True |
| Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
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| List.status | |
| Short | current | retired | entered-in-error |
| Definition | Indicates the current state of this list. |
| Cardinality | 1..1 |
| Type | code |
| Binding | The current state of the list. |
| Modifier | True |
| Summary | True |
| Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
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| List.mode | |
| Short | working | snapshot | changes |
| Definition | How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted. |
| Cardinality | 1..1 |
| Type | code |
| Binding | The processing mode that applies to this list. |
| Modifier | True |
| Summary | True |
| Requirements | Lists are used in various ways, and it must be known in what way it is safe to use them. |
| Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list. |
| Constraints |
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| Pattern | working |
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| List.title | |
| Short | Descriptive name for the list |
| Definition | A label for the list assigned by the author. |
| Cardinality | 0..0 |
| Type | string |
| Summary | True |
| Requirements | Allows customization beyond just the code identifying the kind of list. |
| Comments | Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size |
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| Examples | GeneralDr. Jane's Patients |
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| List.code | |
| Short | Concept - reference to a terminology or just text |
| Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. |
| Cardinality | 1..1 |
| Type | CodeableConcept |
| Binding | What the purpose of a list is. |
| Summary | True |
| Requirements | Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included. |
| Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
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| List.code.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
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| List.code.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
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| List.code.coding | |
| Short | Code defined by a terminology system |
| Definition | A reference to a code defined by a terminology system. |
| Cardinality | 1..* |
| Type | Coding |
| Summary | True |
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
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| List.code.coding.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
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| List.code.coding.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..0 |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
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| List.code.coding.system | |
| Short | Identity of the terminology system |
| Definition | The identification of the code system that defines the meaning of the symbol in the code. |
| Cardinality | 1..1 |
| Type | uri |
| Summary | True |
| Requirements | Need to be unambiguous about the source of the definition of the symbol. |
| Comments | 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. |
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| Fixed Value | http://loinc.org |
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| List.code.coding.version | |
| Short | Version of the system - if relevant |
| Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. |
| Cardinality | 0..1 |
| Type | string |
| Summary | True |
| Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. |
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| List.code.coding.code | |
| Short | Symbol in syntax defined by the system |
| Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| Cardinality | 1..1 |
| Type | code |
| Summary | True |
| Requirements | Need to refer to a particular code in the system. |
| Comments | Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size |
| Conditions | The cardinality or value of this element may be affected by these constraints: cod-1 |
| Constraints |
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| Pattern | 10160-0 |
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| List.code.coding.display | |
| Short | Representation defined by the system |
| Definition | A representation of the meaning of the code in the system, following the rules of the system. |
| Cardinality | 1..1 |
| Type | string |
| Summary | True |
| Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
| Comments | Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size |
| Conditions | The cardinality or value of this element may be affected by these constraints: cod-1 |
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| List.code.coding.userSelected | |
| Short | If this coding was chosen directly by the user |
| Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). |
| Cardinality | 0..0 |
| Type | boolean |
| Summary | True |
| Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
| Comments | 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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| List.code.text | |
| Short | Plain text representation of the concept |
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
| Cardinality | 0..0 |
| Type | string |
| Summary | True |
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
| Comments | Very often the text is the same as a displayName of one of the codings. |
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| List.subject | |
| Short | A reference from one resource to another |
| Definition | A reference from one resource to another. |
| Cardinality | 1..1 |
| Type | Reference(Patient) |
| Summary | True |
| Requirements | The primary purpose of listing the subject explicitly is to help with finding the right list. |
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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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| List.encounter | |
| Short | A reference from one resource to another |
| Definition | A reference from one resource to another. |
| Cardinality | 0..1 |
| Type | Reference(Encounter) |
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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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| List.date | |
| Short | When the list was prepared |
| Definition | Date list was last reviewed/revised and determined to be 'current'. |
| Cardinality | 1..1 |
| Type | dateTime |
| Summary | True |
| Requirements | Identifies how current the list is which affects relevance. |
| Comments | The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs. |
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| List.source | |
| Short | Who and/or what defined the list contents (aka Author) |
| Definition | The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list. |
| Cardinality | 1..1 |
| Type | Reference(PractitionerRole) |
| Summary | True |
| Alias | Author |
| Requirements | Allows follow-up as well as context. |
| Comments | The primary source is the entity that made the decisions what items are in the list. This may be software or user. |
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| List.orderedBy | |
| Short | What order the list has |
| Definition | What order applies to the items in the list. |
| Cardinality | 0..0 |
| Type | CodeableConcept |
| Binding | What order applies to the items in a list. |
| Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries. |
| Comments | Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order. |
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| List.note | |
| Short | Text node with attribution |
| Definition | A text note which also contains information about who made the statement and when. |
| Cardinality | 0..1 |
| Type | Annotation |
| Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). |
| Constraints |
|
| Mappings |
|
| List.note.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
| Mappings |
|
| List.note.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 1..* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 1..1 |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..1 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
| Mappings |
|
| List.note.extension:annotationType.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.url | |
| Short | identifies the meaning of the extension |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Cardinality | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://hl7.org/fhir/StructureDefinition/annotationType |
| Mappings |
|
| List.note.extension:annotationType.value[x] | |
| Short | Concept - reference to a terminology or just text |
| Definition | A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. |
| Cardinality | 0..1 |
| Type | CodeableConcept |
| Binding | |
| Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
| Conditions | The cardinality or value of this element may be affected by these constraints: ext-1 |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
| Mappings |
|
| List.note.extension:annotationType.value[x].extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].coding | |
| Short | Code defined by a terminology system |
| Definition | A reference to a code defined by a terminology system. |
| Cardinality | 1..* |
| Type | Coding |
| Summary | True |
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..0 |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.system | |
| Short | Identity of the terminology system |
| Definition | The identification of the code system that defines the meaning of the symbol in the code. |
| Cardinality | 1..1 |
| Type | uri |
| Summary | True |
| Requirements | Need to be unambiguous about the source of the definition of the symbol. |
| Comments | 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 be an absolute reference to some definition that establishes the system clearly and unambiguously. |
| Constraints |
|
| Fixed Value | https://fhir.synapxe.sg/CodeSystem/annotation-type |
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.version | |
| Short | Version of the system - if relevant |
| Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. |
| Cardinality | 0..1 |
| Type | string |
| Summary | True |
| Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.code | |
| Short | Symbol in syntax defined by the system |
| Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| Cardinality | 1..1 |
| Type | code |
| Summary | True |
| Requirements | Need to refer to a particular code in the system. |
| Comments | Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size |
| Conditions | The cardinality or value of this element may be affected by these constraints: cod-1 |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.display | |
| Short | Representation defined by the system |
| Definition | A representation of the meaning of the code in the system, following the rules of the system. |
| Cardinality | 1..1 |
| Type | string |
| Summary | True |
| Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
| Comments | Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size |
| Conditions | The cardinality or value of this element may be affected by these constraints: cod-1 |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].coding.userSelected | |
| Short | If this coding was chosen directly by the user |
| Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). |
| Cardinality | 0..0 |
| Type | boolean |
| Summary | True |
| Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
| Comments | 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. |
| Constraints |
|
| Mappings |
|
| List.note.extension:annotationType.value[x].text | |
| Short | Plain text representation of the concept |
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
| Cardinality | 0..0 |
| Type | string |
| Summary | True |
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
| Comments | Very often the text is the same as a displayName of one of the codings. |
| Constraints |
|
| Mappings |
|
| List.note.author[x] | |
| Short | Individual responsible for the annotation |
| Definition | The individual responsible for making the annotation. |
| Cardinality | 0..0 |
| Type | Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) | string |
| Summary | True |
| Comments | Organization is used when there's no need for specific attribution as to who made the comment. |
| Constraints |
|
| Mappings |
|
| List.note.time | |
| Short | When the annotation was made |
| Definition | Indicates when this particular annotation was made. |
| Cardinality | 0..0 |
| Type | dateTime |
| Summary | True |
| Comments | UTC offset is allowed for dates and partial dates |
| Constraints |
|
| Mappings |
|
| List.note.text | |
| Short | The annotation - text content (as markdown) |
| Definition | The text of the annotation in markdown format. |
| Cardinality | 1..1 |
| Type | markdown |
| Summary | True |
| Comments | Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ |
| Constraints |
|
| Mappings |
|
| List.entry | |
| Short | Entries in the list |
| Definition | Entries in this list. |
| Cardinality | 1..* |
| Type | BackboneElement |
| Comments | If there are no entries in the list, an emptyReason SHOULD be provided. |
| Conditions | The cardinality or value of this element may be affected by these constraints: lst-1 |
| Constraints |
|
| Mappings |
|
| List.entry.id | |
| Short | Unique id for inter-element referencing |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..0 |
| Type | string |
| Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 |
| Mappings |
|
| List.entry.extension | |
| Short | Additional content defined by implementations |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0..0 |
| Type | Extension |
| Alias | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url |
| Constraints |
|
| Mappings |
|
| List.entry.modifierExtension | |
| Short | Extensions that cannot be ignored even if unrecognized |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0..0 |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Constraints |
|
| Mappings |
|
| List.entry.flag | |
| Short | Status/Workflow information about this item |
| Definition | The flag allows the system constructing the list to indicate the role and significance of the item in the list. |
| Cardinality | 0..0 |
| Type | CodeableConcept |
| Binding | Codes that provide further information about the reason and meaning of the item in the list. |
| Requirements | This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list. |
| Comments | The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true |
| Constraints |
|
| Mappings |
|
| List.entry.deleted | |
| Short | If this item is actually marked as deleted |
| Definition | True if this item is marked as deleted in the list. |
| Cardinality | 0..0 |
| Type | boolean |
| Modifier | True |
| Requirements | The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted". |
| Comments | If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list. |
| Meaning when missing | List items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes' |
| Constraints |
|
| Mappings |
|
| List.entry.date | |
| Short | When item added to list |
| Definition | When this item was added to the list. |
| Cardinality | 1..1 |
| Type | dateTime |
| Requirements | The date may be significant for understanding the meaning of items in a working list. |
| Comments | UTC offset is allowed for dates and partial dates |
| Constraints |
|
| Mappings |
|
| List.entry.item | |
| Short | Actual entry |
| Definition | A reference to the actual resource from which data was derived. |
| Cardinality | 1..1 |
| Type | Reference(MedicationStatement) |
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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. |
| Constraints |
|
| Mappings |
|
| List.emptyReason | |
| Short | Why list is empty |
| Definition | If the list is empty, why the list is empty. |
| Cardinality | 0..0 |
| Type | CodeableConcept |
| Binding | If a list is empty, why it is empty. |
| Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists. |
| Comments | The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases. |
| Conditions | The cardinality or value of this element may be affected by these constraints: lst-1 |
| Constraints |
|
| Mappings |
|
Business Information Model
Key Design Considerations
As both PatientMedicationList and ProblemList are using List resource, code will be used to indicate the list type. In this case, code.coding.code should be set as medications.
API Specification
See List.$submit and List.$retrieve for the API specification to submit and retrieve patient medication lists.
Terminology Bindings
| Path | Binding Strength | Value Set (Code System) | Description |
|---|---|---|---|
| List.language | required | http://hl7.org/fhir/ValueSet/all-languages|5.0.0 | IETF language tag for a human language |
| List.status | required | http://hl7.org/fhir/ValueSet/list-status|5.0.0 | The current state of the list. |
| List.mode | required | http://hl7.org/fhir/ValueSet/list-mode|5.0.0 | The processing mode that applies to this list. |
| List.code | required | https://fhir.synapxe.sg/ValueSet/list-codes | What the purpose of a list is. |
| List.note.extension.value[x] | required | https://fhir.synapxe.sg/ValueSet/annotation-type |