Profiles
This IG uses the Medication
resource to represent the items within a formulary and the Composition
resource to depict the structure of formularies for a health insurer.
TODO: These profiles are using http://example.org/fhir as their baseurl, which is not real. Find an authoritative location to store these profiles.
FormularyList
The FormularyList
profile is based on Composition
and allows for the insurer and formulary metadata to be properly conveyed in a single resource. Since insurers are expected to maintain several formularies at any given time, each section
represents a single formulary and each section.entry
is a medication within that formulary.
Composition | I | Composition | There are no (further) constraints on this element Element idComposition A set of resources composed into a single coherent clinical statement with clinical attestation DefinitionA set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical. Composition Constraints
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idComposition.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. id Constraints
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idComposition.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Meta Constraints
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idComposition.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. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. uri Constraints
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idComposition.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). code BindingA human language. ?? (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idComposition.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 may 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 in formation is added later. Narrative Constraints
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contained | 0..* | Resource | There are no (further) constraints on this element Element idComposition.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. Resource Mappings
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.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. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.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. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idComposition.identifier Logical identifier of composition (version-independent) DefinitionLogical identifier for the composition, assigned when created. This identifier stays constant as the composition is changed over time. See discussion in resource definition for how these relate. Identifier Constraints
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element idComposition.status preliminary | final | amended | entered-in-error DefinitionThe workflow/clinical status of this composition. The status is a marker for the clinical standing of the document. Need to be able to mark interim, amended, or withdrawn compositions or documents. If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required. code BindingThe workflow/clinical status of the composition. ?? (required)Constraints
final
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type | Σ | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idComposition.type Kind of composition (LOINC if possible) DefinitionSpecifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition. Key metadata element describing the composition, used in searching/filtering. For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding. CodeableConcept BindingType of a composition. ?? (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.type.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.type.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idComposition.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. Coding Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.type.coding.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.type.coding.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 0..1 | uriFixed Value | Element idComposition.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. uri Constraints
http://loinc.org
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idComposition.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. string Constraints
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code | Σ | 0..1 | codeFixed Value | Element idComposition.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size code Constraints
TODO
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idComposition.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size string Constraints
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idComposition.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. boolean Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idComposition.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings. string Constraints
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class | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idComposition.class Categorization of Composition DefinitionA categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type. Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents. This is a metadata field from XDS/MHD. CodeableConcept BindingHigh-level kind of a clinical document at a macro level. ?? (example)Constraints
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subject | Σ I | 1..1 | Reference(http://hl7.org/fhir/StructureDefinition/Organization) | Element idComposition.subject Who and/or what the composition is about DefinitionWho or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about. For clinical documents, this is usually the patient. Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints
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encounter | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Encounter) | There are no (further) constraints on this element Element idComposition.encounter Context of the Composition DefinitionDescribes the clinical encounter or type of care this documentation is associated with. Provides context for the composition and supports searching. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Encounter) Constraints
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date | Σ | 1..1 | dateTime | Element idComposition.date Date Last Modified DefinitionThe date and time when the formulary list was last modified by the author. dateTime is used for tracking, organizing versions and searching. The Last Modified Date on the composition may be after the date of the document was attested without being changed. dateTime Constraints
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author | Σ I | 1..* | Reference(http://hl7.org/fhir/StructureDefinition/Organization) | Element idComposition.author Who and/or what authored the composition DefinitionIdentifies who is responsible for the information in the composition, not necessarily who typed it in. Identifies who is responsible for the content. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints
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title | Σ | 1..1 | string | There are no (further) constraints on this element Element idComposition.title Human Readable name/title DefinitionOfficial human-readable label for the composition. For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period. string Constraints
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confidentiality | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idComposition.confidentiality As defined by affinity domain DefinitionThe code specifying the level of confidentiality of the Composition. The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not. code BindingCodes specifying the level of confidentiality of the composition. ?? (required)Constraints
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attester | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idComposition.attester Attests to accuracy of composition DefinitionA participant who has attested to the accuracy of the composition/document. Identifies responsibility for the accuracy of the composition content. Only list each attester once. BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.attester.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.attester.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. In order 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. 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. Extension Sliced: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 idComposition.attester.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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mode | Σ | 1..* | codeBinding | There are no (further) constraints on this element Element idComposition.attester.mode personal | professional | legal | official DefinitionThe type of attestation the authenticator offers. Indicates the level of authority of the attestation. Use more than one code where a single attester has more than one mode (professional and legal are often paired). code BindingThe way in which a person authenticated a composition. ?? (required)Constraints
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time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idComposition.attester.time When the composition was attested DefinitionWhen the composition was attested by the party. Identifies when the information in the composition was deemed accurate. (Things may have changed since then.). dateTime Constraints
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party | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Practitioner | http://hl7.org/fhir/StructureDefinition/Organization) | There are no (further) constraints on this element Element idComposition.attester.party Who attested the composition DefinitionWho attested the composition in the specified way. Identifies who has taken on the responsibility for accuracy of the composition content. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Patient | http://hl7.org/fhir/StructureDefinition/Practitioner | http://hl7.org/fhir/StructureDefinition/Organization) Constraints
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custodian | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/Organization) | There are no (further) constraints on this element Element idComposition.custodian Organization which maintains the composition DefinitionIdentifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information. Identifies where to go to find the current version, where to report issues, etc. This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged. Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints
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relatesTo | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idComposition.relatesTo Relationships to other compositions/documents DefinitionRelationships that this composition has with other compositions or documents that already exist. A document is a version specific composition. BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.relatesTo.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.relatesTo.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. In order 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. 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. Extension Sliced: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 idComposition.relatesTo.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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code | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idComposition.relatesTo.code replaces | transforms | signs | appends DefinitionThe type of relationship that this composition has with anther composition or document. If this document appends another document, then the document cannot be fully understood without also accessing the referenced document. code BindingThe type of relationship between documents. ?? (required)Constraints
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target[x] | Σ | 1..1 | There are no (further) constraints on this element Element idComposition.relatesTo.target[x] Target of the relationship DefinitionThe target composition/document of this relationship.
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targetIdentifier | Identifier | There are no (further) constraints on this element Data type Identifier | ||
targetReference | Reference(http://hl7.org/fhir/StructureDefinition/Composition) | There are no (further) constraints on this element Data type Reference(http://hl7.org/fhir/StructureDefinition/Composition) | ||
event | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idComposition.event The clinical service(s) being documented DefinitionThe clinical service, such as a colonoscopy or an appendectomy, being documented. Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event. The event needs to be consistent with the type element, though can provide further information if desired. BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.event.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.event.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. In order 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. 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. Extension Sliced: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 idComposition.event.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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code | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idComposition.event.code Code(s) that apply to the event being documented DefinitionThis list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act. An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries. CodeableConcept BindingThis list of codes represents the main clinical acts being documented. ?? (example)Constraints
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idComposition.event.period The period covered by the documentation DefinitionThe period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration. Period Constraints
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detail | Σ I | 0..* | Reference(http://hl7.org/fhir/StructureDefinition/Resource) | There are no (further) constraints on this element Element idComposition.event.detail The event(s) being documented DefinitionThe description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.org/fhir/StructureDefinition/Resource) Constraints
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section | I | 1..* | BackboneElement | There are no (further) constraints on this element Element idComposition.section Composition is broken into sections DefinitionThe root of the sections that make up the composition. BackboneElement Constraints
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id | 1..1 | string | There are no (further) constraints on this element Element idComposition.section.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | Element idComposition.section.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. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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EffectiveFrom | I | 1..1 | Extension(dateTime) | Element idComposition.section.extension:EffectiveFrom Optional Extensions Element Alternate namesextensions, user content DefinitionThe date at which the formulary started to be relevant 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. Extension(dateTime) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-EffectiveFrom Constraints
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EffectiveTo | I | 0..1 | Extension(dateTime) | Element idComposition.section.extension:EffectiveTo Optional Extensions Element Alternate namesextensions, user content DefinitionThe date at which the formulary ceased to be relevant. Leave null if formulary is current 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. Extension(dateTime) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-EffectiveTo Constraints
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PlanYear | I | 1..1 | Extension(integer) | Element idComposition.section.extension:PlanYear Optional Extensions Element Alternate namesextensions, user content DefinitionThe year for which the formulary is relevant 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. Extension(integer) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-PlanYear Constraints
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HealthPlan | I | 1..1 | Extension(string) | Element idComposition.section.extension:HealthPlan Optional Extensions Element Alternate namesextensions, user content DefinitionThe health plan for which the formulary is relevant 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. Extension(string) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-HealthPlan Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.section.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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title | 0..1 | string | There are no (further) constraints on this element Element idComposition.section.title Label for section (e.g. for ToC) Alternate namesheader, label, caption DefinitionThe label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents. Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized. The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element. string Constraints
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code | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idComposition.section.code Classification of section (recommended) DefinitionA code identifying the kind of content contained within the section. This must be consistent with the section title. Provides computable standardized labels to topics within the document. The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code. CodeableConcept BindingClassification of a section of a composition/document. ?? (example)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.section.code.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.section.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. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 1..1 | Coding | Element idComposition.section.code.coding Code defined by a terminology system DefinitionLOINC 82215-5 | Medical equipment or product list Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. Coding Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idComposition.section.code.coding.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idComposition.section.code.coding.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idComposition.section.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. uri Constraints
http://loinc.org
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idComposition.section.code.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. string Constraints
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code | Σ | 1..1 | codeFixed Value | Element idComposition.section.code.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size code Constraints
82215-5
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idComposition.section.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size string Constraints
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idComposition.section.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. boolean Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idComposition.section.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. string Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idComposition.section.text Text summary of the section, for human interpretation DefinitionA human-readable narrative that contains the attested content of the section, 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. Document profiles may define what content should be represented in the narrative to ensure clinical safety. Narrative Constraints
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mode | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idComposition.section.mode working | snapshot | changes DefinitionHow the entry 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. Sections are used in various ways, and it must be known in what way it is safe to use the entries in them. This element is labeled as a modifier because a change list must not be mis-understood as a complete list. code BindingThe processing mode that applies to this section. ?? (required)Constraints
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orderedBy | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idComposition.section.orderedBy Order of section entries DefinitionSpecifies the order applied to the items in the section entries. Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries. 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. CodeableConcept BindingWhat order applies to the items in the entry. ?? (preferred)Constraints
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entry | I | 1..* | FormularyMedication(FormularyMedication) | Element idComposition.section.entry A reference to data that supports this section DefinitionA reference to the actual resource from which the narrative in the section is derived. If there are no entries in the list, an emptyReason SHOULD be provided. FormularyMedication(FormularyMedication) Constraints
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emptyReason | I | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idComposition.section.emptyReason Why the section is empty DefinitionIf the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason. Allows capturing things like "none exist" or "not asked" which can be important for most lists. The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content 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. CodeableConcept BindingIf a section is empty, why it is empty. ?? (preferred)Constraints
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section | I | 0..* | see (section) | There are no (further) constraints on this element Element idComposition.section.section Nested Section DefinitionA nested sub-section within this section. Nested sections are primarily used to help human readers navigate to particular portions of the document.
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FormularyMedication
The FormularyMedication
profile is based on the Medication
resource and does a few things:
- Adds formulary metadata elements as extensions
- Similar to US Core, it sets the code system as RxNorm
- TODO: actually base this resource on US Core instead
- It requires a text value to be associated with each medication
- TODO: is this appropriate?
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. It covers the ingredients and the packaging for a medication. Medication Constraints
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id | Σ | 0..1 | id | 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. id Constraints
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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 may not always be associated with version changes to the resource. Meta Constraints
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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. 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. uri Constraints
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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). code BindingA human language. ?? (extensible)Constraints
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text | I | 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 may 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 in formation is added later. Narrative Constraints
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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. Resource Mappings
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extension | I | 0..* | Extension | 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. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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CoPayRequired | I | 1..1 | Extension(boolean) | Element idMedication.extension:CoPayRequired Optional Extensions Element Alternate namesextensions, user content DefinitionIndicates whether a copay is required for a medication 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-CoPayRequired Constraints
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CoInsuranceRequired | I | 1..1 | Extension(boolean) | Element idMedication.extension:CoInsuranceRequired Optional Extensions Element Alternate namesextensions, user content DefinitionIndicates whether a coinsurance is required for a medication 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-CoInsuranceRequired Constraints
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PriorAuthRequired | I | 1..1 | Extension(boolean) | Element idMedication.extension:PriorAuthRequired Optional Extensions Element Alternate namesextensions, user content DefinitionAdditional actions are required (of the patient, the provider, or both) to receive authorization from the insurer before a medication is prescribed. 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-PriorAuthRequired Constraints
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PriorAuthDescription | I | 0..1 | Extension(string) | Element idMedication.extension:PriorAuthDescription Optional Extensions Element Alternate namesextensions, user content DefinitionPrior Authorization steps required before a medication can be prescribed 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. Extension(string) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-PriorAuthDescription Constraints
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StepTherapyRequired | I | 1..1 | Extension(boolean) | Element idMedication.extension:StepTherapyRequired Optional Extensions Element Alternate namesextensions, user content DefinitionIndicates whether a patient must try another medication before a medication may be prescribed 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-StepTherapyRequired Constraints
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StepTherapyDescription | I | 0..1 | Extension(string) | Element idMedication.extension:StepTherapyDescription Optional Extensions Element Alternate namesextensions, user content DefinitionA description of the medication (or medications) that need to be tried before a medication is prescribed 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. Extension(string) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-StepTherapyDescription Constraints
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QuantityLimitImposed | I | 1..1 | Extension(boolean) | Element idMedication.extension:QuantityLimitImposed Optional Extensions Element Alternate namesextensions, user content DefinitionIndicates whether there is a limit to the quantity or amount of a medication that will be covered under the health plan 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-QuantityLimitImposed Constraints
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QuantityLimitDescription | I | 0..1 | Extension(string) | Element idMedication.extension:QuantityLimitDescription Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(string) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-QuantityLimitDescription Constraints
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AgeLimitImposed | I | 1..1 | Extension(boolean) | Element idMedication.extension:AgeLimitImposed Optional Extensions Element Alternate namesextensions, user content DefinitionIndicates whether an age limit is imposed on a medication 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-AgeLimitImposed Constraints
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AgeLimitDescription | I | 0..1 | Extension(string) | Element idMedication.extension:AgeLimitDescription Optional Extensions Element Alternate namesextensions, user content DefinitionA description of the age limits imposed on a medication 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. Extension(string) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-AgeLimitDescription Constraints
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LimitedAccessImposed | I | 1..1 | Extension(boolean) | Element idMedication.extension:LimitedAccessImposed Optional Extensions Element Alternate namesextensions, user content DefinitionMedications are considered 'limited access' if the FDA says the drug can be given out only by certain facilities or doctors. These medications may require extra handling, provider coordination or patient education that can’t be done at a network pharmacy 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-LimitedAccessImposed Constraints
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LimitedAccessDescription | I | 0..1 | Extension(string) | Element idMedication.extension:LimitedAccessDescription Optional Extensions Element Alternate namesextensions, user content DefinitionA description of how and why a medication is classified as 'limited access' 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. Extension(string) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-LimitedAccessDescription Constraints
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Injectable | I | 1..1 | Extension(boolean) | Element idMedication.extension:Injectable Optional Extensions Element Alternate namesextensions, user content DefinitionThe medication is available in injectable form 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-Injectable Constraints
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MailOrder | I | 1..1 | Extension(boolean) | Element idMedication.extension:MailOrder Optional Extensions Element Alternate namesextensions, user content DefinitionThe medication is available through mail order 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-MailOrder Constraints
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PartBOrPartD | I | 1..1 | Extension(boolean) | Element idMedication.extension:PartBOrPartD Optional Extensions Element Alternate namesextensions, user content DefinitionThe medication may be covered under Medicare Part B or D depending upon the circumstances. Information may need to be submitted describing the use and setting of the medication to make the determination. 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. Extension(boolean) Extension URLhttp://example.org/fhir/StructureDefinition/Formulary-PartBOrPartD 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. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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code | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedication.code Codes that identify this medication DefinitionA code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems. Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. CodeableConcept BindingA coded concept that defines the type of a medication ?? (example)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedication.code.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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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. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedication.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. Coding Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedication.code.coding.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.code.coding.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. 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. Extension Sliced:Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedication.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. uri Constraints
http://www.nlm.nih.gov/research/umls/rxnorm
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedication.code.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. string Constraints
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedication.code.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size code Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedication.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size string Constraints
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedication.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. boolean Constraints
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text | Σ | 1..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. string Constraints
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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 not intended to specify if a medication is part of a formulary. code BindingA coded concept defining if the medication is in active use ?? (required)Constraints
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isBrand | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedication.isBrand True if a brand DefinitionSet to true if the item is attributable to a specific manufacturer. boolean Constraints
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isOverTheCounter | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedication.isOverTheCounter True if medication does not require a prescription DefinitionSet to true if the medication can be obtained without an order from a prescriber. boolean Constraints
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manufacturer | Σ I | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/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. Reference(http://hl7.org/fhir/StructureDefinition/Organization) Constraints
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form | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedication.form powder | tablets | capsule + DefinitionDescribes the form of the item. Powder; tablets; capsule. When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form. CodeableConcept BindingA coded concept defining the form of a medication ?? (example)Constraints
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ingredient | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedication.ingredient Active or inactive ingredient DefinitionIdentifies a particular constituent of interest in the product. The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients. BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedication.ingredient.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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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. In order 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. 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. Extension Sliced: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 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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item[x] | 1..1 | There are no (further) constraints on this element Element idMedication.ingredient.item[x] The product contained DefinitionThe actual ingredient - either a substance (simple ingredient) or another medication.
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itemCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type CodeableConcept | ||
itemReference | Reference(http://hl7.org/fhir/StructureDefinition/Substance | http://hl7.org/fhir/StructureDefinition/Medication) | There are no (further) constraints on this element Data type Reference(http://hl7.org/fhir/StructureDefinition/Substance | http://hl7.org/fhir/StructureDefinition/Medication) | ||
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). boolean Constraints
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amount | I | 0..1 | Ratio | There are no (further) constraints on this element Element idMedication.ingredient.amount Quantity of ingredient present DefinitionSpecifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet. Ratio Constraints
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package | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedication.package Details about packaged medications DefinitionInformation that only applies to packages (not products). BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedication.package.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.package.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. In order 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. 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. Extension Sliced: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.package.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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container | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedication.package.container E.g. box, vial, blister-pack DefinitionThe kind of container that this package comes as. 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. CodeableConcept BindingA coded concept defining the kind of container a medication package is packaged in ?? (example)Constraints
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content | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedication.package.content What is in the package DefinitionA set of components that go to make up the described item. BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedication.package.content.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.package.content.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. In order 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. 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. Extension Sliced: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.package.content.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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item[x] | 1..1 | There are no (further) constraints on this element Element idMedication.package.content.item[x] The item in the package DefinitionIdentifies one of the items in the package.
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itemCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type CodeableConcept | ||
itemReference | Reference(http://hl7.org/fhir/StructureDefinition/Medication) | There are no (further) constraints on this element Data type Reference(http://hl7.org/fhir/StructureDefinition/Medication) | ||
amount | I | 0..1 | http://hl7.org/fhir/StructureDefinition/SimpleQuantity | There are no (further) constraints on this element Element idMedication.package.content.amount Quantity present in the package DefinitionThe amount of the product that is in the package. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. http://hl7.org/fhir/StructureDefinition/SimpleQuantity Constraints
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batch | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedication.package.batch Identifies a single production run DefinitionInformation about a group of medication produced or packaged from one production run. BackboneElement Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedication.package.batch.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size string Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedication.package.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. In order 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. 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. Extension Sliced: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.package.batch.modifierExtension Extensions that cannot be ignored 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 that contains it. Usually modifier elements provide negation or qualification. In order 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. 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. Extension Constraints
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lotNumber | 0..1 | string | There are no (further) constraints on this element Element idMedication.package.batch.lotNumber Identifier assigned to batch DefinitionThe assigned lot number of a batch of the specified product. Note that FHIR strings may not exceed 1MB in size string Constraints
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expirationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idMedication.package.batch.expirationDate When batch will expire DefinitionWhen this specific batch of product will expire. dateTime Constraints
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image | I | 0..* | Attachment | There are no (further) constraints on this element Element idMedication.image Picture of the medication DefinitionPhoto(s) or graphic representation(s) of the medication. Note that "image" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg). When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". Attachment Constraints
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