<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="MedicationStatement-verto" />
    <url value="http://verto.ca/fhir/StructureDefinition/MedicationStatement" />
    <version value="1.0.0" />
    <name value="MedicationStatement" />
    <title value="Verto&#39;s MedicationStatement Profile" />
    <status value="active" />
    <experimental value="true" />
    <date value="2025-01-13" />
    <publisher value="Verto Health" />
    <description value="Medication Statement constrained by Verto&#39;s Digital Twin, based on the International and Canadian Patient Summaries" />
    <fhirVersion value="5.0.0" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationStatement" />
    <baseDefinition value="http://hl7.org/fhir/R4/StructureDefinition/MedicationStatement" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationStatement">
            <path value="MedicationStatement" />
            <short value="Verto&#39;s MedicationStatement Profile" />
            <definition value="Record of medication being taken by a patient" />
            <type>
                <code value="MedicationStatement" />
            </type>
        </element>
        <element id="MedicationStatement.id">
            <path value="MedicationStatement.id" />
            <short value="Logical id of this artifact" />
            <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
            <comment value="The id is auto-generated as a UUID by Verto when the resource is created, and is used as an internal identifier within the Digital Twin. It has no business meaning outside of the Digital Twin&#39;s context." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Resource.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.identifier">
            <path value="MedicationStatement.identifier" />
            <short value="External ids from the source system of record" />
            <definition value="Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server." />
            <comment value="This is a business identifier, not a resource identifier." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.status">
            <path value="MedicationStatement.status" />
            <short value="The current state of the medication&#39;s use" />
            <definition value="A code representing the patient or other source&#39;s judgment about the state of the medication used that this statement is about.  Generally, this will be active or completed." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.status" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <isModifier value="true" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationStatementStatus" />
                </extension>
                <strength value="required" />
                <description value="A coded concept specifying the state of the MedicationStatement" />
                <valueSet value="http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1" />
            </binding>
        </element>
        <element id="MedicationStatement.medication">
            <path value="MedicationStatement.medication" />
            <short value="What medication was taken" />
            <definition value="Identifies the medication being administered or the reason for absent or unknown Medication. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code. To improve global interoperability is strongly encouraged that the reference to a medication resource is used, limiting the usage of the medicationCodeableConcept only to the cases in which no other information than a simple code is available." />
            <comment value="If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number, then you must reference the Medication resource." />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="CodeableReference" />
                <targetProfile value="http://verto.ca/fhir/StructureDefinition/medication-custom" />
            </type>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.subject">
            <path value="MedicationStatement.subject" />
            <short value="Who the medication statement relates to" />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.subject" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.encounter">
            <path value="MedicationStatement.encounter" />
            <short value="The encounter the medication request occurred under" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.encounter" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/encounter" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dateAsserted">
            <path value="MedicationStatement.dateAsserted" />
            <short value="When the statement was asserted" />
            <definition value="The date when the medication statement was asserted by the information source." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.dateAsserted" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.informationSource">
            <path value="MedicationStatement.informationSource" />
            <short value="The person or organization who provided information about the taking of this medication" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.informationSource" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/patient" />
                <targetProfile value="https://hl7.org/fhir/StructureDefinition/practitioner" />
                <targetProfile value="https://hl7.org/fhir/StructureDefinition/organization" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.reasonReference">
            <path value="MedicationStatement.reasonReference" />
            <short value="Condition or observation that supports why the medication is being/was taken" />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.reasonReference" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/condition" />
                <targetProfile value="https://hl7.org/fhir/StructureDefinition/observation" />
                <targetProfile value="https://hl7.org/fhir/StructureDefinition/diagnosticReport" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.note">
            <path value="MedicationStatement.note" />
            <short value="Information about the prescription" />
            <definition value="Extra information about the prescription that could not be conveyed by the other attributes." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.note" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Annotation" />
            </type>
        </element>
        <element id="MedicationStatement.renderedDosageInstructions">
            <path value="MedicationStatement.renderedDosageInstructions" />
            <short value="Full representation of the dosage instructions in human-readable form" />
            <definition value="The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="markdown" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dosage">
            <path value="MedicationStatement.dosage" />
            <short value="How the medication should be taken" />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Dosage" />
            </type>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dosage.id">
            <path value="MedicationStatement.dosage.id" />
            <short value="Unique, Verto-specific id for inter-element referencing" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="string" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dosage.sequence">
            <path value="MedicationStatement.dosage.sequence" />
            <short value="The order of the dosage instructions" />
            <definition value="Indicates the order in which the dosage instructions should be applied or interpreted." />
            <requirements value="If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.sequence" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="integer" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dosage.text">
            <path value="MedicationStatement.dosage.text" />
            <short value="Free text dosage instructions e.g. SIG" />
            <definition value="Free text dosage instructions e.g. SIG" />
            <comment value="Free text dosage instructions can be used for cases where the instructions are too complex to code." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dosage.additionalInstruction">
            <path value="MedicationStatement.dosage.additionalInstruction" />
            <short value="Supplemental instruction or warnings to the patient - e.g. &quot;take with meals&quot;" />
            <definition value="Supplemental instructions to the patient on how to take the medication or warnings for the patient about the medication." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Dosage.additionalInstruction" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AdditionalInstruction" />
                </extension>
                <strength value="example" />
                <valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes" />
            </binding>
        </element>
        <element id="MedicationStatement.dosage.patientInstruction">
            <path value="MedicationStatement.dosage.patientInstruction" />
            <short value="Patient or consumer oriented instructions" />
            <definition value="Instructions in terms that are understood by the patient or consumer." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.patientInstruction" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.timing">
            <path value="MedicationStatement.dosage.timing" />
            <short value="When medication should be administered" />
            <definition value="When medication should be administered." />
            <comment value="This attribute might not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.timing" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Timing" />
            </type>
            <mustSupport value="true" />
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.asNeeded[x]">
            <path value="MedicationStatement.dosage.asNeeded[x]" />
            <short value="Take &quot;as needed&quot; (for x)" />
            <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept)." />
            <comment value="Can express &quot;as needed&quot; without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express &quot;as needed&quot; with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not &quot;prn&quot; or &quot;as needed&quot;." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.asNeeded[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="CodeableConcept" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationAsNeededReason" />
                </extension>
                <strength value="example" />
                <description value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose." />
                <valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason" />
            </binding>
        </element>
        <element id="MedicationStatement.dosage.site">
            <path value="MedicationStatement.dosage.site" />
            <short value="Body site to administer to" />
            <definition value="Anatomic site where the medication should be administered." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.site" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationAdministrationSite" />
                </extension>
                <strength value="example" />
                <description value="A coded concept describing the site location the medicine enters into or onto the body." />
                <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-codes" />
            </binding>
        </element>
        <element id="MedicationStatement.dosage.route">
            <path value="MedicationStatement.dosage.route" />
            <short value="How drug should enter body" />
            <definition value="How drug should enter body." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.route" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
                <profile value="http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <strength value="preferred" />
                <description value="EDQM Standards Terms" />
                <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration" />
            </binding>
        </element>
        <element id="MedicationStatement.dosage.method">
            <path value="MedicationStatement.dosage.method" />
            <short value="Technique for administering medication" />
            <definition value="Technique for administering medication." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.method" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationAdministrationMethod" />
                </extension>
                <strength value="example" />
                <description value="A coded concept describing the technique by which the medicine is administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/administration-method-codes" />
            </binding>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate">
            <path value="MedicationStatement.dosage.doseAndRate" />
            <short value="Amount of medication administered" />
            <definition value="The amount of medication administered." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Dosage.doseAndRate" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Element" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.id">
            <path value="MedicationStatement.dosage.doseAndRate.id" />
            <short value="Unique, Verto-specific id for inter-element referencing" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Element.id" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <isModifier value="false" />
            <isSummary value="false" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x]">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
            <short value="Amount of medication per dose" />
            <definition value="Amount of medication per dose." />
            <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.doseAndRate.dose[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Range" />
            </type>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.rate[x]">
            <path value="MedicationStatement.dosage.doseAndRate.rate[x]" />
            <short value="Amount of medication per unit of time" />
            <definition value="Amount of medication per unit of time." />
            <comment value="It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationStatement with an updated rate, or captured with a new MedicationStatement with the new rate." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.doseAndRate.rate[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Ratio" />
            </type>
            <type>
                <code value="Range" />
            </type>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.maxDosePerPeriod">
            <path value="MedicationStatement.dosage.maxDosePerPeriod" />
            <short value="Upper limit on medication per unit of time" />
            <definition value="Upper limit on medication per unit of time." />
            <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example &quot;2 tablets every 4 hours to a maximum of 8/day&quot;." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.maxDosePerPeriod" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Ratio" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration">
            <path value="MedicationStatement.dosage.maxDosePerAdministration" />
            <short value="Upper limit on medication per administration" />
            <definition value="Upper limit on medication per administration." />
            <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.maxDosePerAdministration" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime">
            <path value="MedicationStatement.dosage.maxDosePerLifetime" />
            <short value="Upper limit on medication per lifetime of the patient" />
            <definition value="Upper limit on medication per lifetime of the patient." />
            <requirements value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.maxDosePerLifetime" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.adherence">
            <path value="MedicationStatement.adherence" />
            <short value="Indicates whether the medication is or is not being consumed or administered" />
            <comment value="This element can be used to indicate whether a patient is following a course of treatment as instructed/prescribed or whether they are taking medications of their own volition. It can also be used to indicate that a patient is not taking a medication, either because they were told not to or because they decided on their own." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="BackboneElement" />
            </type>
            <mustSupport value="false" />
            <isModifier value="false" />
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.adherence.code">
            <path value="MedicationStatement.adherence.code" />
            <short value="Type of adherence" />
            <definition value="Type of the adherence for the medication." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="adherence.code" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <isModifier value="false" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationStatement Adherence Codes" />
                </extension>
                <strength value="example" />
                <valueSet value="http://hl7.org/fhir/ValueSet/medication-statement-adherence" />
            </binding>
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "MedicationStatement-verto",
    "url": "http://verto.ca/fhir/StructureDefinition/MedicationStatement",
    "version": "1.0.0",
    "name": "MedicationStatement",
    "title": "Verto's MedicationStatement Profile",
    "status": "active",
    "experimental": true,
    "date": "2025-01-13",
    "publisher": "Verto Health",
    "description": "Medication Statement constrained by Verto's Digital Twin, based on the International and Canadian Patient Summaries",
    "fhirVersion": "5.0.0",
    "kind": "resource",
    "abstract": false,
    "type": "MedicationStatement",
    "baseDefinition": "http://hl7.org/fhir/R4/StructureDefinition/MedicationStatement",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationStatement",
                "path": "MedicationStatement",
                "short": "Verto's MedicationStatement Profile",
                "definition": "Record of medication being taken by a patient",
                "type":  [
                    {
                        "code": "MedicationStatement"
                    }
                ]
            },
            {
                "id": "MedicationStatement.id",
                "path": "MedicationStatement.id",
                "short": "Logical id of this artifact",
                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
                "comment": "The id is auto-generated as a UUID by Verto when the resource is created, and is used as an internal identifier within the Digital Twin. It has no business meaning outside of the Digital Twin's context.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.identifier",
                "path": "MedicationStatement.identifier",
                "short": "External ids from the source system of record",
                "definition": "Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.",
                "comment": "This is a business identifier, not a resource identifier.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.status",
                "path": "MedicationStatement.status",
                "short": "The current state of the medication's use",
                "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about.  Generally, this will be active or completed.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.status",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "isModifier": true,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationStatementStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "A coded concept specifying the state of the MedicationStatement",
                    "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1"
                }
            },
            {
                "id": "MedicationStatement.medication",
                "path": "MedicationStatement.medication",
                "short": "What medication was taken",
                "definition": "Identifies the medication being administered or the reason for absent or unknown Medication. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code. To improve global interoperability is strongly encouraged that the reference to a medication resource is used, limiting the usage of the medicationCodeableConcept only to the cases in which no other information than a simple code is available.",
                "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number, then you must reference the Medication resource.",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "CodeableReference",
                        "targetProfile":  [
                            "http://verto.ca/fhir/StructureDefinition/medication-custom"
                        ]
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.subject",
                "path": "MedicationStatement.subject",
                "short": "Who the medication statement relates to",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.subject",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.encounter",
                "path": "MedicationStatement.encounter",
                "short": "The encounter the medication request occurred under",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.encounter",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/encounter"
                        ]
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dateAsserted",
                "path": "MedicationStatement.dateAsserted",
                "short": "When the statement was asserted",
                "definition": "The date when the medication statement was asserted by the information source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.dateAsserted",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.informationSource",
                "path": "MedicationStatement.informationSource",
                "short": "The person or organization who provided information about the taking of this medication",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.informationSource",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/patient",
                            "https://hl7.org/fhir/StructureDefinition/practitioner",
                            "https://hl7.org/fhir/StructureDefinition/organization"
                        ]
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.reasonReference",
                "path": "MedicationStatement.reasonReference",
                "short": "Condition or observation that supports why the medication is being/was taken",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.reasonReference",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/condition",
                            "https://hl7.org/fhir/StructureDefinition/observation",
                            "https://hl7.org/fhir/StructureDefinition/diagnosticReport"
                        ]
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.note",
                "path": "MedicationStatement.note",
                "short": "Information about the prescription",
                "definition": "Extra information about the prescription that could not be conveyed by the other attributes.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.note",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Annotation"
                    }
                ]
            },
            {
                "id": "MedicationStatement.renderedDosageInstructions",
                "path": "MedicationStatement.renderedDosageInstructions",
                "short": "Full representation of the dosage instructions in human-readable form",
                "definition": "The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "markdown"
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dosage",
                "path": "MedicationStatement.dosage",
                "short": "How the medication should be taken",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Dosage"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dosage.id",
                "path": "MedicationStatement.dosage.id",
                "short": "Unique, Verto-specific id for inter-element referencing",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dosage.sequence",
                "path": "MedicationStatement.dosage.sequence",
                "short": "The order of the dosage instructions",
                "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
                "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.sequence",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "integer"
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dosage.text",
                "path": "MedicationStatement.dosage.text",
                "short": "Free text dosage instructions e.g. SIG",
                "definition": "Free text dosage instructions e.g. SIG",
                "comment": "Free text dosage instructions can be used for cases where the instructions are too complex to code.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dosage.additionalInstruction",
                "path": "MedicationStatement.dosage.additionalInstruction",
                "short": "Supplemental instruction or warnings to the patient - e.g. \"take with meals\"",
                "definition": "Supplemental instructions to the patient on how to take the medication or warnings for the patient about the medication.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Dosage.additionalInstruction",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AdditionalInstruction"
                        }
                    ],
                    "strength": "example",
                    "valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes"
                }
            },
            {
                "id": "MedicationStatement.dosage.patientInstruction",
                "path": "MedicationStatement.dosage.patientInstruction",
                "short": "Patient or consumer oriented instructions",
                "definition": "Instructions in terms that are understood by the patient or consumer.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.patientInstruction",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.timing",
                "path": "MedicationStatement.dosage.timing",
                "short": "When medication should be administered",
                "definition": "When medication should be administered.",
                "comment": "This attribute might not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.timing",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Timing"
                    }
                ],
                "mustSupport": true,
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.asNeeded[x]",
                "path": "MedicationStatement.dosage.asNeeded[x]",
                "short": "Take \"as needed\" (for x)",
                "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
                "comment": "Can express \"as needed\" without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express \"as needed\" with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.asNeeded[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationAsNeededReason"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
                }
            },
            {
                "id": "MedicationStatement.dosage.site",
                "path": "MedicationStatement.dosage.site",
                "short": "Body site to administer to",
                "definition": "Anatomic site where the medication should be administered.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.site",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationAdministrationSite"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept describing the site location the medicine enters into or onto the body.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/approach-site-codes"
                }
            },
            {
                "id": "MedicationStatement.dosage.route",
                "path": "MedicationStatement.dosage.route",
                "short": "How drug should enter body",
                "definition": "How drug should enter body.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.route",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept",
                        "profile":  [
                            "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips"
                        ]
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "strength": "preferred",
                    "description": "EDQM Standards Terms",
                    "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration"
                }
            },
            {
                "id": "MedicationStatement.dosage.method",
                "path": "MedicationStatement.dosage.method",
                "short": "Technique for administering medication",
                "definition": "Technique for administering medication.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.method",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationAdministrationMethod"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept describing the technique by which the medicine is administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/administration-method-codes"
                }
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate",
                "path": "MedicationStatement.dosage.doseAndRate",
                "short": "Amount of medication administered",
                "definition": "The amount of medication administered.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Dosage.doseAndRate",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Element"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.id",
                "path": "MedicationStatement.dosage.doseAndRate.id",
                "short": "Unique, Verto-specific id for inter-element referencing",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "isModifier": false,
                "isSummary": false
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x]",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x]",
                "short": "Amount of medication per dose",
                "definition": "Amount of medication per dose.",
                "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.doseAndRate.dose[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Range"
                    },
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.rate[x]",
                "path": "MedicationStatement.dosage.doseAndRate.rate[x]",
                "short": "Amount of medication per unit of time",
                "definition": "Amount of medication per unit of time.",
                "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationStatement with an updated rate, or captured with a new MedicationStatement with the new rate.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.doseAndRate.rate[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Ratio"
                    },
                    {
                        "code": "Range"
                    },
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerPeriod",
                "path": "MedicationStatement.dosage.maxDosePerPeriod",
                "short": "Upper limit on medication per unit of time",
                "definition": "Upper limit on medication per unit of time.",
                "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example \"2 tablets every 4 hours to a maximum of 8/day\".",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.maxDosePerPeriod",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Ratio"
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration",
                "path": "MedicationStatement.dosage.maxDosePerAdministration",
                "short": "Upper limit on medication per administration",
                "definition": "Upper limit on medication per administration.",
                "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.maxDosePerAdministration",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime",
                "path": "MedicationStatement.dosage.maxDosePerLifetime",
                "short": "Upper limit on medication per lifetime of the patient",
                "definition": "Upper limit on medication per lifetime of the patient.",
                "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.maxDosePerLifetime",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.adherence",
                "path": "MedicationStatement.adherence",
                "short": "Indicates whether the medication is or is not being consumed or administered",
                "comment": "This element can be used to indicate whether a patient is following a course of treatment as instructed/prescribed or whether they are taking medications of their own volition. It can also be used to indicate that a patient is not taking a medication, either because they were told not to or because they decided on their own.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "BackboneElement"
                    }
                ],
                "mustSupport": false,
                "isModifier": false,
                "isSummary": true
            },
            {
                "id": "MedicationStatement.adherence.code",
                "path": "MedicationStatement.adherence.code",
                "short": "Type of adherence",
                "definition": "Type of the adherence for the medication.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "adherence.code",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationStatement Adherence Codes"
                        }
                    ],
                    "strength": "example",
                    "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-adherence"
                }
            }
        ]
    }
}