CA Core+
1.2.0-dft-ballot 
DFT-Ballot - The specification is a DFT-Ballot version of CA Core+ for collecting ballot feedback. For a full list of available versions, see the Directory of published versions
Medication (CA-Core)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/Medication
Examples
example-medication-ca-core, example-Medication-ca-core2
Description
This profile applies constraints to the Medication resource for CA Core+ to support representation of medication products in the pan-Canadian context.
References to this resource
MedicationRequestCACore, MedicationStatementCACore
CFMM: 2
Resource Content
| MedicationCACore (Medication) | C | Medication | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| strength | O C | 0..1 | Extension(string) |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| code | O Σ | 1..1 | CodeableConceptCACoreBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 0..* | CodingCACore |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | Σ | 0..1 | uri |
| version | Σ | 0..1 | string |
| code | Σ | 0..1 | code |
| display | Σ | 0..1 | string |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| translation | C | 0..* | Extension(Complex) |
| value | 0..1 | System.String | |
| userSelected | Σ | 0..1 | boolean |
| text | Σ | 0..1 | string |
| status | Σ ?! | 0..1 | codeBinding |
| manufacturer | Σ C | 0..1 | Reference(Organization) |
| form | 0..1 | CodeableConceptCACoreBinding | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 0..* | CodingCACore |
| text | SO Σ | 0..1 | string |
| amount | Σ C | 0..1 | Ratio |
| ingredient | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| item[x] | 1..1 | ||
| itemReference | Reference(Medication | Substance) | ||
| itemCodeableConcept | 0..1 | CodeableConceptCACoreBinding | |
| isActive | 0..1 | boolean | |
| strength | C | 0..1 | Ratio |
| batch | 0..1 | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| lotNumber | 0..1 | string | |
| expirationDate | 0..1 | dateTime |
| MedicationCACore (Medication) | C | Medication | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| strength | O C | 0..1 | Extension(string) |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| code | O Σ | 1..1 | CodeableConceptCACoreBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 0..* | CodingCACore |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | Σ | 0..1 | uri |
| version | Σ | 0..1 | string |
| code | Σ | 0..1 | code |
| display | Σ | 0..1 | string |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| translation | C | 0..* | Extension(Complex) |
| value | 0..1 | System.String | |
| userSelected | Σ | 0..1 | boolean |
| text | Σ | 0..1 | string |
| status | Σ ?! | 0..1 | codeBinding |
| manufacturer | Σ C | 0..1 | Reference(Organization) |
| form | 0..1 | CodeableConceptCACoreBinding | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | Σ | 0..* | CodingCACore |
| text | SO Σ | 0..1 | string |
| amount | Σ C | 0..1 | Ratio |
| ingredient | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| item[x] | 1..1 | ||
| itemReference | Reference(Medication | Substance) | ||
| itemCodeableConcept | 0..1 | CodeableConceptCACoreBinding | |
| isActive | 0..1 | boolean | |
| strength | C | 0..1 | Ratio |
| batch | 0..1 | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| lotNumber | 0..1 | string | |
| expirationDate | 0..1 | dateTime |
</extension>
</telecom>
</telecom>
</contact>
<description value="This profile applies constraints to the Medication resource for CA Core+ to support representation of medication products in the pan-Canadian context." />
</jurisdiction>
<copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<comment value="Mapping for MedicationCACore to Canadian Core Data for Interoperability (CACDI)." />
</mapping>
<definition value="This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</mapping>
<map value="NewRx/MedicationPrescribed\n-or-\nRxFill/MedicationDispensed\n-or-\nRxHistoryResponse/MedicationDispensed\n-or-\nRxHistoryResponse/MedicationPrescribed" />
</mapping>
</mapping>
</element>
<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 only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
</mapping>
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</binding>
</mapping>
</element>
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="These 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." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
</base>
</type>
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<comment value="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." />
</base>
<profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description" />
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis" />
</extension>
</extension>
</extension>
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" />
</extension>
<valueMarkdown value="per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets" />
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="ValueSet for DIN. A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada." />
</extension>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
<map value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\n\ncoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\n\ncoding.display = //element(*,MedicationType)/DrugDescription" />
</mapping>
</mapping>
<map value="RXO-1.1-Requested Give Code.code / RXE-2.1-Give Code.code / RXD-2.1-Dispense/Give Code.code / RXG-4.1-Give Code.code /RXA-5.1-Administered Code.code / RXC-2.1 Component Code" />
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Language translation from base language of resource to another language, used to provide translations for strings, including markdown. Generally, the type of the translation extension SHOULD match that of the element being extended." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</base>
</extension>
</extension>
</type>
</element>
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="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." />
<requirements value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
<map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" />
</mapping>
</element>
</extension>
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<requirements value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
<definition value="Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product." />
<comment value="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." />
</base>
</type>
</constraint>
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
<map value="RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name" />
</mapping>
</mapping>
</element>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="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." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</extension>
</extension>
</extension>
</extension>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
<map value="coding.code = //element(*,DrugCodedType)/FormCode\n\ncoding.system = //element(*,DrugCodedType)/FormSourceCode" />
</mapping>
<map value="RXO-5-Requested Dosage Form / RXE-6-Give Dosage Form / RXD-6-Actual Dosage Form / RXG-8-Give Dosage Form / RXA-8-Administered Dosage Form" />
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<requirements value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)." />
<comment value="The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio." />
</base>
</type>
</constraint>
<human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" />
<expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" />
<xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="The actual ingredient - either a substance (simple ingredient) or another medication of a medication." />
<requirements value="The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base)." />
</base>
</type>
</type>
</constraint>
</mapping>
<map value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\n\ncoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\n\ncoding.display = //element(*,MedicationType)/DrugDescription" />
</mapping>
<map value="RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code" />
</mapping>
</mapping>
</element>
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="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." />
<requirements value="The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base)." />
</base>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</constraint>
</binding>
</mapping>
<map value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\n\ncoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\n\ncoding.display = //element(*,MedicationType)/DrugDescription" />
</mapping>
<map value="RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code" />
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Indication of whether this ingredient affects the therapeutic action of the drug." />
<requirements value="True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). \nFalse indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Specifies 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." />
<comment value="The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio." />
</base>
</type>
</constraint>
<human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" />
<expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" />
<xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
<map value="RXC-3-Component Amount & RXC-4-Component Units if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units" />
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
<map value="participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime" />
</mapping>
</element>
</snapshot>
</discriminator>
</slicing>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description" />
</type>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<comment value="The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet." />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis" />
</extension>
</extension>
</extension>
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" />
</extension>
<valueMarkdown value="per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets" />
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="ValueSet for DIN. A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada." />
</extension>
</extension>
</binding>
</mapping>
</element>
</mapping>
</element>
</mapping>
</mapping>
</element>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</extension>
</extension>
</extension>
</extension>
</binding>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</discriminator>
</slicing>
</element>
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</binding>
</element>
</differential>
</StructureDefinition>
{
],
{
{
},
{
}
]
}
],
"description": "This profile applies constraints to the Medication resource for CA Core+ to support representation of medication products in the pan-Canadian context.",
],
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
}
],
{
"definition": "This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.",
},
{
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
},
{
}
],
{
},
{
"map": "NewRx/MedicationPrescribed\n-or-\nRxFill/MedicationDispensed\n-or-\nRxHistoryResponse/MedicationDispensed\n-or-\nRxHistoryResponse/MedicationPrescribed"
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
},
],
"ele-1"
],
{
}
],
]
},
{
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
},
],
"ele-1"
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
]
},
{
"comment": "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).",
},
],
"ele-1"
],
{
}
],
{
},
{
}
],
},
]
},
{
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "These 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.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"comment": "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.",
"extensions",
"user content"
],
},
{
"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description"
]
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
},
{
},
{
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
},
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
"valueMarkdown": "per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis"
}
],
},
{
{
},
{
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
},
{
"valueMarkdown": "per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
}
],
},
{
{
},
{
},
{
"valueMarkdown": "ValueSet for DIN. A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada."
}
],
}
],
},
{
},
{
},
{
},
{
},
{
"map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\n\ncoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\n\ncoding.display = //element(*,MedicationType)/DrugDescription"
},
{
},
{
"map": "RXO-1.1-Requested Give Code.code / RXE-2.1-Give Code.code / RXD-2.1-Dispense/Give Code.code / RXG-4.1-Give Code.code /RXA-5.1-Administered Code.code / RXC-2.1 Component Code"
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"comment": "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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "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.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
{
}
],
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "Language translation from base language of resource to another language, used to provide translations for strings, including markdown. Generally, the type of the translation extension SHOULD match that of the element being extended.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
},
{
{
},
{
}
],
}
],
},
{
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "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.",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
{
}
],
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"comment": "This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product \"ABC Hospital Special Cream\" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to \"entered in error\". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.",
},
],
"ele-1"
],
{
}
],
{
}
],
},
]
},
{
"definition": "Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.",
"comment": "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.",
},
{
}
],
"ele-1"
],
{
},
{
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
}
],
{
},
{
},
{
},
{
},
{
"map": "RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name"
},
{
}
]
},
{
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "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.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
},
{
{
},
{
},
{
}
],
}
],
},
{
},
{
},
{
},
{
},
{
"map": "coding.code = //element(*,DrugCodedType)/FormCode\n\ncoding.system = //element(*,DrugCodedType)/FormSourceCode"
},
{
"map": "RXO-5-Requested Dosage Form / RXE-6-Give Dosage Form / RXD-6-Actual Dosage Form / RXG-8-Give Dosage Form / RXA-8-Administered Dosage Form"
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"comment": "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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core"
]
}
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).",
"comment": "The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to \"1\", Quantity should be used instead of Ratio.",
},
],
"ele-1"
],
{
},
{
"human": "Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present",
"expression": "(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())",
"xpath": "(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))",
}
],
{
},
{
},
{
},
{
}
]
},
{
"comment": "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.",
},
],
"ele-1"
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
"ele-1"
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
"definition": "The actual ingredient - either a substance (simple ingredient) or another medication of a medication.",
"requirements": "The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).",
},
{
},
{
"http://hl7.org/fhir/StructureDefinition/Substance",
"http://hl7.org/fhir/StructureDefinition/Medication"
]
}
],
"ele-1"
],
{
}
],
{
},
{
"map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\n\ncoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\n\ncoding.display = //element(*,MedicationType)/DrugDescription"
},
{
"map": "RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code"
},
{
}
]
},
{
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "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.",
"requirements": "The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"ele-1"
],
{
}
],
},
{
},
{
"map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\n\ncoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\n\ncoding.display = //element(*,MedicationType)/DrugDescription"
},
{
"map": "RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code"
},
{
},
{
},
{
},
{
}
]
},
{
"requirements": "True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). \nFalse indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).",
},
],
"ele-1"
],
{
}
],
]
},
{
"definition": "Specifies 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.",
"comment": "The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to \"1\", Quantity should be used instead of Ratio.",
},
],
"ele-1"
],
{
},
{
"human": "Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present",
"expression": "(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())",
"xpath": "(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))",
}
],
{
},
{
},
{
},
{
},
{
"map": "RXC-3-Component Amount & RXC-4-Component Units if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units"
},
{
}
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
"ele-1"
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
},
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
"map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
}
]
}
]
},
{
}
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
{
"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description"
]
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet.",
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
}
],
},
{
{
},
{
},
{
"valueMarkdown": "per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis"
}
],
},
{
{
},
{
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
},
{
"valueMarkdown": "per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
}
],
},
{
{
},
{
},
{
"valueMarkdown": "ValueSet for DIN. A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada."
}
],
}
],
},
]
},
{
]
},
{
{
},
{
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
{
{
},
{
},
{
}
],
}
],
}
},
{
{
},
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
}
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
}
}
]
}
}
Terminology bindings
| Path | Conformance | ValueSet |
|---|---|---|
| Medication.code | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct |
| Medication.form | preferred | https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode |
| Medication.ingredient.item[x]:itemCodeableConcept | preferred | https://fhir.infoway-inforoute.ca/ValueSet/drugormedicamentsubstancecode |
Additional Terminology Bindings
These bindings may be used in lieu of the primary bindings in the table above.
| Path | Conformance | AdditionalValueSet |
|---|---|---|
| Medication.code | candidate | https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts |
| Medication.form | candidate | https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondrugform |
Mappings to CACDI
The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.
| FHIR Profile Element | CACDI Element(s) |
|---|---|
| Medication.code | Medication |
| Medication.code.coding.system | Drug Code System URI |
| Medication.code.coding.display | Drug English Description, Drug French Description |