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    1. Index
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    3. Profiles
    4. MedicationStatement (CA-Core)

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

MedicationStatement (CA-Core)

Links

Profile

medicationstatement-ca-core

Derived from

http://hl7.org/fhir/StructureDefinition/MedicationStatement

Examples

example-medicationstatement-ca-core

Description

This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context.

References to this resource

CFMM: 2

Resource Content

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MedicationStatementCACore (MedicationStatement)CMedicationStatement
There are no (further) constraints on this element
Element id
MedicationStatement
Short description

Record of medication being taken by a patient

Definition

A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

Comments

When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

Data type

MedicationStatement

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: 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
    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()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: SubstanceAdministration
idΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.id
Short description

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.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
MedicationStatement.meta
Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
MedicationStatement.implicitRules
Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
language0..1codeBinding
There are no (further) constraints on this element
Element id
MedicationStatement.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
text0..1Narrative
There are no (further) constraints on this element
Element id
MedicationStatement.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

Comments

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
MedicationStatement.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
extensionC0..*ExtensionElement id
MedicationStatement.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RenderedDosageInstructionC0..1Extension(string)Element id
MedicationStatement.extension:RenderedDosageInstruction
Short description

Extension for representing rendered dosage instruction.

Alternate names

extensions, user content

Definition

A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.

Comments

Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.

Data type

Extension(string)

Extension URL

http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
MedicationStatement.identifier
Short description

External identifier

Definition

Identifiers associated with this Medication Statement 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.

Comments

This is a business identifier, not a resource identifier.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: 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]
  • servd: Identifier
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: .id
basedOnΣ C0..*Reference(CarePlan | MedicationRequest | ServiceRequest)
There are no (further) constraints on this element
Element id
MedicationStatement.basedOn
Short description

Fulfils plan, proposal or order

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event.

Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Comments

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.

Data type

Reference(CarePlan | MedicationRequest | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.basedOn
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
partOfΣ C0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Observation | Procedure)
There are no (further) constraints on this element
Element id
MedicationStatement.partOf
Short description

Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Requirements

This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

Comments

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.

Data type

Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.partOf
  • rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]
statusSO Σ ?!1..1codeBindingElement id
MedicationStatement.status
Short description

active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken

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.

Comments

MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Data type

code

Binding

A coded concept indicating the current status of a MedicationStatement.

Medication Status Codes (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: .statusCode
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
statusReason0..*CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.statusReason
Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationStatement.

Comments

This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

Data type

CodeableConcept

Binding

A coded concept indicating the reason for the status of the statement.

SNOMEDCTDrugTherapyStatusCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.statusReason
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
categoryΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
MedicationStatement.category
Short description

Type of medication usage

Definition

Indicates where the medication is expected to be consumed or administered.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConcept

Binding

A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

Medication usage category codes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medication[x]SO Σ1..1Element id
MedicationStatement.medication[x]
Short description

What medication was taken

Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Comments

The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.

Slicing

Unordered, Open, by $this(Type)

Binding

A coded concept identifying the substance or product being taken.

SNOMEDCTMedicationCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
medicationReferenceΣ0..1Reference(MedicationCACore)Element id
MedicationStatement.medication[x]:medicationReference
Short description

What medication was taken

Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Comments

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.

Data type

Reference(MedicationCACore)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
medicationCodeableConceptΣ0..1CodeableConceptCACoreBindingElement id
MedicationStatement.medication[x]:medicationCodeableConcept
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Comments

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.

Data type

CodeableConceptCACore

Binding

A coded concept identifying the substance or product being taken.

PrescriptionMedicinalProduct (preferred)

Additional bindings
  • LicensedNaturalHealthProducts (candidate)

    ValueSet for licensed natural health products

  • WhoAtcUvIps (candidate)

    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

  • PharmaceuticalBiologicProductAndSubstanceCode (candidate)

    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

  • DINvs (candidate)

    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. It uniquely identifies all drug products sold in a dosage form in Canada

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • CACDI: Medication
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
codingΣ0..*CodingCACore
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding
Short description

A reference to a code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Data type

CodingCACore

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
systemΣ0..1uriElement id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.system
Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  • CACDI: Drug Code System URI
versionΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ0..1code
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.code
Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1stringElement id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display
Short description

Representation defined by the system

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • CACDI: Drug English Description
  • CACDI: Drug French Description
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
translationC0..*Extension(Complex)
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension:translation
Short description

Language Translation (Localization)

Alternate names

extensions, user content

Definition

Language translation from base language of resource to another language.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension(Complex)

Extension URL

http://hl7.org/fhir/StructureDefinition/translation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • rim: ST.translation
value0..1System.String
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.value
Short description

Primitive value for string

Definition

Primitive value for string

Data type

System.String

Maximum string length

1048576

userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.userSelected
Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: 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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.text
Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subjectSO Σ C1..1Reference(PatientCACore | Group)Element id
MedicationStatement.subject
Short description

Who is/was taking the medication

Definition

The person, animal or group who is/was taking the medication.

Comments

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.

Data type

Reference(PatientCACore | Group)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3-Patient ID List
  • rim: .participation[typeCode=SBJ].role[classCode=PAT]
  • w5: FiveWs.subject
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
contextΣ C0..1Reference(Encounter | EpisodeOfCare)
There are no (further) constraints on this element
Element id
MedicationStatement.context
Short description

Encounter / Episode associated with MedicationStatement

Definition

The encounter or episode of care that establishes the context for this MedicationStatement.

Comments

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.

Data type

Reference(Encounter | EpisodeOfCare)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.context
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
effective[x]SO Σ0..1Element id
MedicationStatement.effective[x]
Short description

The date/time or interval when the medication is/was/will be taken

Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
effectiveDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

effectivePeriodΣ0..1PeriodElement id
MedicationStatement.effective[x]:effectivePeriod
Short description

The date/time or interval when the medication is/was/will be taken

Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
startΣ C0..1dateTime
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.start
Short description

Starting time with inclusive boundary

Definition

The start of the period. The boundary is inclusive.

Comments

If the low element is missing, the meaning is that the low boundary is not known.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
endΣ C0..1dateTimeElement id
MedicationStatement.effective[x]:effectivePeriod.end
Short description

End time with inclusive boundary, if not ongoing

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
  • CACDI: Medication End Date and Time
dateAssertedΣ0..1dateTime
There are no (further) constraints on this element
Element id
MedicationStatement.dateAsserted
Short description

When the statement was asserted?

Definition

The date when the medication statement was asserted by the information source.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.recorded
  • rim: .participation[typeCode=AUT].time
informationSourceC0..1Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
MedicationStatement.informationSource
Short description

Person or organization that provided the information about the taking of this medication

Definition

The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

Comments

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.

Data type

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.source
  • rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)
derivedFromC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
MedicationStatement.derivedFrom
Short description

Additional supporting information

Definition

Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

Comments

Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]
reasonCodeO0..*CodeableConceptCACoreBindingElement id
MedicationStatement.reasonCode
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConceptCACore

Binding

A coded concept identifying why the medication is being taken.

MedicationReasonCode (preferred)

Additional bindings
  • PrescriptionIndicationForUse (candidate)

    Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)

  • HealthConditionCode (candidate)

    A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.reasonCode
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • CACDI: Medication Reason
Obligations
CodeActor
MAY:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
reasonReferenceO C0..*Reference(Condition | DiagnosticReport | Observation)Element id
MedicationStatement.reasonReference
Short description

Condition or observation that supports why the medication is being/was taken

Definition

Condition or observation that supports why the medication is being/was taken.

Comments

This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

Data type

Reference(Condition | DiagnosticReport | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.reasonReference
  • w5: FiveWs.why[x]
  • rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value
  • CACDI: Medication Reason
Obligations
CodeActor
MAY:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
note0..*Annotation
There are no (further) constraints on this element
Element id
MedicationStatement.note
Short description

Further information about the statement

Definition

Provides extra information about the medication statement that is not conveyed by the other attributes.

Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Event.note
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosageO0..*DosageElement id
MedicationStatement.dosage
Short description

Details of how medication is/was taken or should be taken

Definition

Indicates how the medication is/was or should be taken by the patient.

Comments

The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

Data type

Dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • rim: refer dosageInstruction mapping
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
sequenceΣ0..1integer
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.sequence
Short description

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.

Comments

32 bit number; for values larger than this, use decimal

Data type

integer

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-1
  • rim: .text
textO Σ0..1stringElement id
MedicationStatement.dosage.text
Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-6; RXE-21
  • rim: .text
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
additionalInstructionΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.additionalInstruction
Short description

Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Data type

CodeableConcept

Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-7
  • rim: .text
patientInstructionΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.patientInstruction
Short description

Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-7
  • rim: .text
timingΣ0..1TimingElement id
MedicationStatement.dosage.timing
Short description

When medication should be administered

Definition

When medication should be administered.

Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

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.

Data type

Timing

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: QSET<TS> (GTS)
  • rim: .effectiveTime
  • CACDI: Medication Timing
asNeeded[x]Σ0..1
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.asNeeded[x]
Short description

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).

Comments

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".

Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

SNOMEDCTMedicationAsNeededReasonCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-9
  • rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBooleanboolean
There are no (further) constraints on this element
Data type

boolean

asNeededCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

siteΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.site
Short description

Body site to administer to

Definition

Body site to administer to.

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Data type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-2
  • rim: .approachSiteCode
routeΣ0..1CodeableConceptCACoreBindingElement id
MedicationStatement.dosage.route
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConceptCACore

Binding

SCTCA Route of Administration

RouteOfAdministration (preferred)

Additional bindings
  • PrescriptionRouteOfAdministration (candidate)

    Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-1
  • rim: .routeCode
  • CACDI: Medication Route of Administration
methodΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.method
Short description

Technique for administering medication

Definition

Technique for administering medication.

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Data type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-4
  • rim: .doseQuantity
doseAndRateΣ0..*Element
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate
Short description

Amount of medication administered

Definition

The amount of medication administered.

Data type

Element

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-2
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
typeΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.type
Short description

The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Requirements

If the type is not populated, assume to be "ordered".

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConcept

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-21; RXE-23
dose[x]Σ0..1BindingElement id
MedicationStatement.dosage.doseAndRate.dose[x]
Short description

Amount of medication per dose

Definition

Amount of medication per dose.

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range

Slicing

Unordered, Open, by $this(Type)

Binding

Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set

PrescriptionDoseQuantityUnit (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
doseRangeRange
There are no (further) constraints on this element
Data type

Range

doseQuantityΣ C0..1SimpleQuantityElement id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity
Short description

A fixed quantity (no comparator)

Definition

The comparator is not used on a SimpleQuantity

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
valueΣ0..1decimalElement id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value
Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

decimal

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • CACDI: Medication Dose Value
comparatorΣ ?!0..0codeBinding
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator
Short description

< | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

code

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
unitΣ0..1stringElement id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit
Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
  • CACDI: Medication Dose Unit of Measure
systemΣ C0..1uri
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system
Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, qty-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
codeΣ0..1code
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code
Short description

Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
rate[x]Σ0..1
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.rate[x]
Short description

Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

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 MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXE22, RXE23, RXE-24
  • rim: .rateQuantity
rateQuantitySimpleQuantity
There are no (further) constraints on this element
Data type

SimpleQuantity

rateRangeRange
There are no (further) constraints on this element
Data type

Range

rateRatioRatio
There are no (further) constraints on this element
Data type

Ratio

maxDosePerPeriodΣ C0..1Ratio
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.maxDosePerPeriod
Short description

Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

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".

Data type

Ratio

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
    (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: RTO
  • v2: RXO-23, RXE-19
  • rim: .maxDoseQuantity
maxDosePerAdministrationΣ C0..1SimpleQuantity
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.maxDosePerAdministration
Short description

Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

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.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
maxDosePerLifetimeΣ C0..1SimpleQuantity
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.maxDosePerLifetime
Short description

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.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
MedicationStatementCACore (MedicationStatement)CMedicationStatement
There are no (further) constraints on this element
Element id
MedicationStatement
Short description

Record of medication being taken by a patient

Definition

A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

Comments

When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

Data type

MedicationStatement

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: 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
    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()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: SubstanceAdministration
idΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.id
Short description

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.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
MedicationStatement.meta
Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
MedicationStatement.implicitRules
Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
language0..1codeBinding
There are no (further) constraints on this element
Element id
MedicationStatement.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
text0..1Narrative
There are no (further) constraints on this element
Element id
MedicationStatement.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

Comments

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
MedicationStatement.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
RenderedDosageInstructionC0..1Extension(string)
There are no (further) constraints on this element
Element id
MedicationStatement.extension:RenderedDosageInstruction
Short description

Extension for representing rendered dosage instruction.

Alternate names

extensions, user content

Definition

A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.

Comments

Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.

Data type

Extension(string)

Extension URL

http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
MedicationStatement.identifier
Short description

External identifier

Definition

Identifiers associated with this Medication Statement 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.

Comments

This is a business identifier, not a resource identifier.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: 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]
  • servd: Identifier
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: .id
basedOnΣ C0..*Reference(CarePlan | MedicationRequest | ServiceRequest)
There are no (further) constraints on this element
Element id
MedicationStatement.basedOn
Short description

Fulfils plan, proposal or order

Definition

A plan, proposal or order that is fulfilled in whole or in part by this event.

Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Comments

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.

Data type

Reference(CarePlan | MedicationRequest | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.basedOn
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
partOfΣ C0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Observation | Procedure)
There are no (further) constraints on this element
Element id
MedicationStatement.partOf
Short description

Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Requirements

This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

Comments

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.

Data type

Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.partOf
  • rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]
statusSO Σ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
MedicationStatement.status
Short description

active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken

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.

Comments

MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Data type

code

Binding

A coded concept indicating the current status of a MedicationStatement.

Medication Status Codes (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: .statusCode
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
statusReason0..*CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.statusReason
Short description

Reason for current status

Definition

Captures the reason for the current state of the MedicationStatement.

Comments

This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

Data type

CodeableConcept

Binding

A coded concept indicating the reason for the status of the statement.

SNOMEDCTDrugTherapyStatusCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.statusReason
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
categoryΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
MedicationStatement.category
Short description

Type of medication usage

Definition

Indicates where the medication is expected to be consumed or administered.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConcept

Binding

A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

Medication usage category codes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medication[x]SO Σ1..1
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]
Short description

What medication was taken

Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Comments

The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.

Slicing

Unordered, Open, by $this(Type)

Binding

A coded concept identifying the substance or product being taken.

SNOMEDCTMedicationCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
medicationReferenceΣ0..1Reference(MedicationCACore)
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationReference
Short description

What medication was taken

Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Comments

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.

Data type

Reference(MedicationCACore)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
medicationCodeableConceptΣ0..1CodeableConceptCACoreBinding
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Comments

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.

Data type

CodeableConceptCACore

Binding

A coded concept identifying the substance or product being taken.

PrescriptionMedicinalProduct (preferred)

Additional bindings
  • LicensedNaturalHealthProducts (candidate)

    ValueSet for licensed natural health products

  • WhoAtcUvIps (candidate)

    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

  • PharmaceuticalBiologicProductAndSubstanceCode (candidate)

    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

  • DINvs (candidate)

    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. It uniquely identifies all drug products sold in a dosage form in Canada

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • CACDI: Medication
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
codingΣ0..*CodingCACore
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding
Short description

A reference to a code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Data type

CodingCACore

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
systemΣ0..1uri
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.system
Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  • CACDI: Drug Code System URI
versionΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.version
Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeΣ0..1code
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.code
Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display
Short description

Representation defined by the system

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.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • CACDI: Drug English Description
  • CACDI: Drug French Description
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
translationC0..*Extension(Complex)
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension:translation
Short description

Language Translation (Localization)

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension(Complex)

Extension URL

http://hl7.org/fhir/StructureDefinition/translation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • rim: ST.translation
value0..1System.String
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.value
Short description

Primitive value for string

Definition

Primitive value for string

Data type

System.String

Maximum string length

1048576

userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.coding.userSelected
Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: 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 ]
textΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.medication[x]:medicationCodeableConcept.text
Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subjectSO Σ C1..1Reference(PatientCACore | Group)
There are no (further) constraints on this element
Element id
MedicationStatement.subject
Short description

Who is/was taking the medication

Definition

The person, animal or group who is/was taking the medication.

Comments

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.

Data type

Reference(PatientCACore | Group)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3-Patient ID List
  • rim: .participation[typeCode=SBJ].role[classCode=PAT]
  • w5: FiveWs.subject
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
contextΣ C0..1Reference(Encounter | EpisodeOfCare)
There are no (further) constraints on this element
Element id
MedicationStatement.context
Short description

Encounter / Episode associated with MedicationStatement

Definition

The encounter or episode of care that establishes the context for this MedicationStatement.

Comments

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.

Data type

Reference(Encounter | EpisodeOfCare)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.context
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
effective[x]SO Σ0..1
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]
Short description

The date/time or interval when the medication is/was/will be taken

Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
effectiveDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

effectivePeriodΣ0..1Period
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod
Short description

The date/time or interval when the medication is/was/will be taken

Definition

The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

Comments

This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • rim: .effectiveTime
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
startΣ C0..1dateTime
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.start
Short description

Starting time with inclusive boundary

Definition

The start of the period. The boundary is inclusive.

Comments

If the low element is missing, the meaning is that the low boundary is not known.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
endΣ C0..1dateTime
There are no (further) constraints on this element
Element id
MedicationStatement.effective[x]:effectivePeriod.end
Short description

End time with inclusive boundary, if not ongoing

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
  • CACDI: Medication End Date and Time
dateAssertedΣ0..1dateTime
There are no (further) constraints on this element
Element id
MedicationStatement.dateAsserted
Short description

When the statement was asserted?

Definition

The date when the medication statement was asserted by the information source.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.recorded
  • rim: .participation[typeCode=AUT].time
informationSourceC0..1Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
MedicationStatement.informationSource
Short description

Person or organization that provided the information about the taking of this medication

Definition

The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

Comments

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.

Data type

Reference(Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.source
  • rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)
derivedFromC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
MedicationStatement.derivedFrom
Short description

Additional supporting information

Definition

Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

Comments

Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]
reasonCodeO0..*CodeableConceptCACoreBinding
There are no (further) constraints on this element
Element id
MedicationStatement.reasonCode
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConceptCACore

Binding

A coded concept identifying why the medication is being taken.

MedicationReasonCode (preferred)

Additional bindings
  • PrescriptionIndicationForUse (candidate)

    Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)

  • HealthConditionCode (candidate)

    A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Event.reasonCode
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • CACDI: Medication Reason
Obligations
CodeActor
MAY:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
reasonReferenceO C0..*Reference(Condition | DiagnosticReport | Observation)
There are no (further) constraints on this element
Element id
MedicationStatement.reasonReference
Short description

Condition or observation that supports why the medication is being/was taken

Definition

Condition or observation that supports why the medication is being/was taken.

Comments

This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

Data type

Reference(Condition | DiagnosticReport | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Event.reasonReference
  • w5: FiveWs.why[x]
  • rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value
  • CACDI: Medication Reason
Obligations
CodeActor
MAY:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
note0..*Annotation
There are no (further) constraints on this element
Element id
MedicationStatement.note
Short description

Further information about the statement

Definition

Provides extra information about the medication statement that is not conveyed by the other attributes.

Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Event.note
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosageO0..*Dosage
There are no (further) constraints on this element
Element id
MedicationStatement.dosage
Short description

Details of how medication is/was taken or should be taken

Definition

Indicates how the medication is/was or should be taken by the patient.

Comments

The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

Data type

Dosage

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • rim: refer dosageInstruction mapping
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
sequenceΣ0..1integer
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.sequence
Short description

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.

Comments

32 bit number; for values larger than this, use decimal

Data type

integer

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-1
  • rim: .text
textO Σ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.text
Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-6; RXE-21
  • rim: .text
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
additionalInstructionΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.additionalInstruction
Short description

Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Data type

CodeableConcept

Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-7
  • rim: .text
patientInstructionΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.patientInstruction
Short description

Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-7
  • rim: .text
timingΣ0..1Timing
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.timing
Short description

When medication should be administered

Definition

When medication should be administered.

Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

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.

Data type

Timing

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: QSET<TS> (GTS)
  • rim: .effectiveTime
  • CACDI: Medication Timing
asNeeded[x]Σ0..1
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.asNeeded[x]
Short description

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).

Comments

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".

Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

SNOMEDCTMedicationAsNeededReasonCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-9
  • rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBooleanboolean
There are no (further) constraints on this element
Data type

boolean

asNeededCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

siteΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.site
Short description

Body site to administer to

Definition

Body site to administer to.

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Data type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-2
  • rim: .approachSiteCode
routeΣ0..1CodeableConceptCACoreBinding
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.route
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConceptCACore

Binding

SCTCA Route of Administration

RouteOfAdministration (preferred)

Additional bindings
  • PrescriptionRouteOfAdministration (candidate)

    Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-1
  • rim: .routeCode
  • CACDI: Medication Route of Administration
methodΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.method
Short description

Technique for administering medication

Definition

Technique for administering medication.

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Data type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXR-4
  • rim: .doseQuantity
doseAndRateΣ0..*Element
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate
Short description

Amount of medication administered

Definition

The amount of medication administered.

Data type

Element

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: TQ1-2
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
typeΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.type
Short description

The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Requirements

If the type is not populated, assume to be "ordered".

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConcept

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: RXO-21; RXE-23
dose[x]Σ0..1Binding
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]
Short description

Amount of medication per dose

Definition

Amount of medication per dose.

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range

Slicing

Unordered, Open, by $this(Type)

Binding

Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set

PrescriptionDoseQuantityUnit (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
doseRangeRange
There are no (further) constraints on this element
Data type

Range

doseQuantityΣ C0..1SimpleQuantity
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity
Short description

A fixed quantity (no comparator)

Definition

The comparator is not used on a SimpleQuantity

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
id0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
valueΣ0..1decimal
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value
Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

decimal

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • CACDI: Medication Dose Value
comparatorΣ ?!0..0codeBinding
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator
Short description

< | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

code

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: SN.1 / CQ.1
  • rim: IVL properties
unitΣ0..1string
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit
Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
  • CACDI: Medication Dose Unit of Measure
systemΣ C0..1uri
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system
Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, qty-3

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
codeΣ0..1code
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code
Short description

Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
rate[x]Σ0..1
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.doseAndRate.rate[x]
Short description

Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

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 MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: RXE22, RXE23, RXE-24
  • rim: .rateQuantity
rateQuantitySimpleQuantity
There are no (further) constraints on this element
Data type

SimpleQuantity

rateRangeRange
There are no (further) constraints on this element
Data type

Range

rateRatioRatio
There are no (further) constraints on this element
Data type

Ratio

maxDosePerPeriodΣ C0..1Ratio
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.maxDosePerPeriod
Short description

Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

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".

Data type

Ratio

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
    (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: RTO
  • v2: RXO-23, RXE-19
  • rim: .maxDoseQuantity
maxDosePerAdministrationΣ C0..1SimpleQuantity
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.maxDosePerAdministration
Short description

Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

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.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
maxDosePerLifetimeΣ C0..1SimpleQuantity
There are no (further) constraints on this element
Element id
MedicationStatement.dosage.maxDosePerLifetime
Short description

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.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: not supported
{{ren
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="medicationstatement-ca-core" />
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="2" />
</extension>
<url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medicationstatement-ca-core" />
<version value="1.1.0" />
<name value="MedicationStatementCACore" />
<title value="Medication Statement (CA-Core)" />
<status value="active" />
<experimental value="false" />
<date value="2025-08-27" />
<publisher value="Canada Health Infoway" />
<contact>
<name value="National Standards Release Centre" />
<telecom>
<system value="url" />
<value value="http://www.infoway-inforoute.ca" />
</telecom>
<telecom>
<system value="email" />
<value value="standards@infoway-inforoute.ca" />
</telecom>
</contact>
<description value="This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context." />
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166" />
<code value="CA" />
</coding>
</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)." />
<fhirVersion value="4.0.1" />
<mapping>
<identity value="CACDI" />
<name value="Canadian Core Data for Interoperability (CACDI)" />
<comment value="Mapping for MedicationStatementCACore to Canadian Core Data for Interoperability (CACDI)." />
</mapping>
<kind value="resource" />
<abstract value="false" />
<type value="MedicationStatement" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
<derivation value="constraint" />
<snapshot>
<element id="MedicationStatement">
<path value="MedicationStatement" />
<short value="Record of medication being taken by a patient" />
<definition value="A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. \n\nThe primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information." />
<comment value="When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\nMedicationStatement.status + MedicationStatement.wasNotTaken\nStatus=Active + NotTaken=T = Not currently taking\nStatus=Completed + NotTaken=T = Not taken in the past\nStatus=Intended + NotTaken=T = No intention of taking\nStatus=Active + NotTaken=F = Taking, but not as prescribed\nStatus=Active + NotTaken=F = Taking\nStatus=Intended +NotTaken= F = Will be taking (not started)\nStatus=Completed + NotTaken=F = Taken in past\nStatus=In Error + NotTaken=N/A = In Error." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement" />
<min value="0" />
<max value="*" />
</base>
<constraint>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-3" />
<severity value="error" />
<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='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</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>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event" />
</mapping>
<mapping>
<identity value="rim" />
<map value="SubstanceAdministration" />
</mapping>
</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 only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isSummary value="true" />
</element>
<element id="MedicationStatement.meta">
<path value="MedicationStatement.meta" />
<short value="Metadata about the resource" />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Meta" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.implicitRules">
<path value="MedicationStatement.implicitRules" />
<short value="A set of rules under which this content was created" />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<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" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.language">
<path value="MedicationStatement.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<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)." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.text">
<path value="MedicationStatement.text" />
<short value="Text summary of the resource, for human interpretation" />
<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." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="MedicationStatement.contained">
<path value="MedicationStatement.contained" />
<short value="Contained, inline Resources" />
<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." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Resource" />
</type>
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.extension">
<path value="MedicationStatement.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.extension:RenderedDosageInstruction">
<path value="MedicationStatement.extension" />
<sliceName value="RenderedDosageInstruction" />
<short value="Extension for representing rendered dosage instruction." />
<definition value="A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider." />
<comment value="Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.modifierExtension">
<path value="MedicationStatement.modifierExtension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Extensions that cannot be ignored" />
<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)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.identifier">
<path value="MedicationStatement.identifier" />
<short value="External identifier" />
<definition value="Identifiers associated with this Medication Statement 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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<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>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
</element>
<element id="MedicationStatement.basedOn">
<path value="MedicationStatement.basedOn" />
<short value="Fulfils plan, proposal or order" />
<definition value="A plan, proposal or order that is fulfilled in whole or in part by this event." />
<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." />
<requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.basedOn" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.basedOn" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]" />
</mapping>
</element>
<element id="MedicationStatement.partOf">
<path value="MedicationStatement.partOf" />
<short value="Part of referenced event" />
<definition value="A larger event of which this particular event is a component or step." />
<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." />
<requirements value="This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.partOf" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.partOf" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]" />
</mapping>
</element>
<element id="MedicationStatement.status">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.status" />
<short value="active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken" />
<definition value="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." />
<comment value="MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
<min value="1" />
<max value="1" />
<base>
<path value="MedicationStatement.status" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
<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 indicating the current status of a MedicationStatement." />
<valueSet value="http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.status" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".statusCode" />
</mapping>
</element>
<element id="MedicationStatement.statusReason">
<path value="MedicationStatement.statusReason" />
<short value="Reason for current status" />
<definition value="Captures the reason for the current state of the MedicationStatement." />
<comment value="This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.statusReason" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationStatementStatusReason" />
</extension>
<strength value="example" />
<description value="A coded concept indicating the reason for the status of the statement." />
<valueSet value="http://hl7.org/fhir/ValueSet/reason-medication-status-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.statusReason" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" />
</mapping>
</element>
<element id="MedicationStatement.category">
<path value="MedicationStatement.category" />
<short value="Type of medication usage" />
<definition value="Indicates where the medication is expected to be consumed or administered." />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="MedicationStatement.category" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationStatementCategory" />
</extension>
<strength value="preferred" />
<description value="A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered." />
<valueSet value="http://hl7.org/fhir/ValueSet/medication-statement-category" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.medication[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="What medication was taken" />
<definition value="Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications." />
<comment value="The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides." />
<min value="1" />
<max value="1" />
<base>
<path value="MedicationStatement.medication[x]" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationCode" />
</extension>
<strength value="example" />
<description value="A coded concept identifying the substance or product being taken." />
<valueSet value="http://hl7.org/fhir/ValueSet/medication-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationReference">
<path value="MedicationStatement.medication[x]" />
<sliceName value="medicationReference" />
<short value="What medication was taken" />
<definition value="Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications." />
<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="0" />
<max value="1" />
<base>
<path value="MedicationStatement.medication[x]" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept">
<path value="MedicationStatement.medication[x]" />
<sliceName value="medicationCodeableConcept" />
<short value="Concept - reference to a terminology or just text" />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="MedicationStatement.medication[x]" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationCode" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts" />
</extension>
<extension url="documentation">
<valueMarkdown value="ValueSet for licensed natural health products" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" />
</extension>
<extension url="documentation">
<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 url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" />
</extension>
<extension url="documentation">
<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 url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/DIN" />
</extension>
<extension url="documentation">
<valueMarkdown value="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. It uniquely identifies all drug products sold in a dosage form in Canada" />
</extension>
</extension>
<strength value="preferred" />
<description value="A coded concept identifying the substance or product being taken." />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.id">
<path value="MedicationStatement.medication[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.extension">
<path value="MedicationStatement.medication[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding">
<path value="MedicationStatement.medication[x].coding" />
<short value="A reference to a code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<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." />
<min value="0" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.id">
<path value="MedicationStatement.medication[x].coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.extension">
<path value="MedicationStatement.medication[x].coding.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.system">
<path value="MedicationStatement.medication[x].coding.system" />
<short value="Identity of the terminology system" />
<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." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Drug Code System URI" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.version">
<path value="MedicationStatement.medication[x].coding.version" />
<short value="Version of the system - if relevant" />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.code">
<path value="MedicationStatement.medication[x].coding.code" />
<short value="Symbol in syntax defined by the system" />
<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)." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to refer to a particular code in the system." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="MedicationStatement.medication[x].coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Drug English Description" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Drug French Description" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.id">
<path value="MedicationStatement.medication[x].coding.display.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension">
<path value="MedicationStatement.medication[x].coding.display.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension:translation">
<path value="MedicationStatement.medication[x].coding.display.extension" />
<sliceName value="translation" />
<short value="Language Translation (Localization)" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/translation" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="ST.translation" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.value">
<path value="MedicationStatement.medication[x].coding.display.value" />
<representation value="xmlAttr" />
<short value="Primitive value for string" />
<definition value="Primitive value for string" />
<min value="0" />
<max value="1" />
<base>
<path value="string.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/regex">
<valueString value="[ \r\n\t\S]+" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<maxLength value="1048576" />
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.userSelected">
<path value="MedicationStatement.medication[x].coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<mapping>
<identity value="orim" />
<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>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="MedicationStatement.medication[x].text" />
<short value="Plain text representation of the concept" />
<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." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="MedicationStatement.subject">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.subject" />
<short value="Who is/was taking the medication" />
<definition value="The person, animal or group who is/was taking the medication." />
<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." />
<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://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.subject" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PID-3-Patient ID List" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].role[classCode=PAT]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="MedicationStatement.context">
<path value="MedicationStatement.context" />
<short value="Encounter / Episode associated with MedicationStatement" />
<definition value="The encounter or episode of care that establishes the context for this MedicationStatement." />
<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." />
<min value="0" />
<max value="1" />
<base>
<path value="MedicationStatement.context" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.context" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]" />
</mapping>
</element>
<element id="MedicationStatement.effective[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.effective[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="The date/time or interval when the medication is/was/will be taken" />
<definition value="The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No)." />
<comment value="This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text." />
<min value="0" />
<max value="1" />
<base>
<path value="MedicationStatement.effective[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<type>
<code value="Period" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod">
<path value="MedicationStatement.effective[x]" />
<sliceName value="effectivePeriod" />
<short value="The date/time or interval when the medication is/was/will be taken" />
<definition value="The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No)." />
<comment value="This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text." />
<min value="0" />
<max value="1" />
<base>
<path value="MedicationStatement.effective[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod.id">
<path value="MedicationStatement.effective[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod.extension">
<path value="MedicationStatement.effective[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod.start">
<path value="MedicationStatement.effective[x].start" />
<short value="Starting time with inclusive boundary" />
<definition value="The start of the period. The boundary is inclusive." />
<comment value="If the low element is missing, the meaning is that the low boundary is not known." />
<min value="0" />
<max value="1" />
<base>
<path value="Period.start" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<condition value="per-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./low" />
</mapping>
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod.end">
<path value="MedicationStatement.effective[x].end" />
<short value="End time with inclusive boundary, if not ongoing" />
<definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
<comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
<min value="0" />
<max value="1" />
<base>
<path value="Period.end" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
<condition value="ele-1" />
<condition value="per-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./high" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication End Date and Time" />
</mapping>
</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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.recorded" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=AUT].time" />
</mapping>
</element>
<element id="MedicationStatement.informationSource">
<path value="MedicationStatement.informationSource" />
<short value="Person or organization that provided the information about the taking of this medication" />
<definition value="The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest." />
<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." />
<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="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.source" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)" />
</mapping>
</element>
<element id="MedicationStatement.derivedFrom">
<path value="MedicationStatement.derivedFrom" />
<short value="Additional supporting information" />
<definition value="Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement." />
<comment value="Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.derivedFrom" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" />
</mapping>
</element>
<element id="MedicationStatement.reasonCode">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="MAY:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.reasonCode" />
<short value="Concept - reference to a terminology or just text" />
<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." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.reasonCode" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationReason" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse" />
</extension>
<extension url="documentation">
<valueMarkdown value="Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode" />
</extension>
<extension url="documentation">
<valueMarkdown value="A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment" />
</extension>
</extension>
<strength value="preferred" />
<description value="A coded concept identifying why the medication is being taken." />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.reasonCode" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".reasonCode" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication Reason" />
</mapping>
</element>
<element id="MedicationStatement.reasonReference">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="MAY:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.reasonReference" />
<short value="Condition or observation that supports why the medication is being/was taken" />
<definition value="Condition or observation that supports why the medication is being/was taken." />
<comment value="This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode." />
<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="http://hl7.org/fhir/StructureDefinition/Observation" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<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, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.reasonReference" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication Reason" />
</mapping>
</element>
<element id="MedicationStatement.note">
<path value="MedicationStatement.note" />
<short value="Further information about the statement" />
<definition value="Provides extra information about the medication statement that is not conveyed by the other attributes." />
<comment value="For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.note" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Annotation" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.note" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value" />
</mapping>
</element>
<element id="MedicationStatement.dosage">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.dosage" />
<short value="Details of how medication is/was taken or should be taken" />
<definition value="Indicates how the medication is/was or should be taken by the patient." />
<comment value="The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest." />
<min value="0" />
<max value="*" />
<base>
<path value="MedicationStatement.dosage" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Dosage" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" />
</mapping>
<mapping>
<identity value="rim" />
<map value="refer dosageInstruction mapping" />
</mapping>
</element>
<element id="MedicationStatement.dosage.id">
<path value="MedicationStatement.dosage.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.dosage.extension">
<path value="MedicationStatement.dosage.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.dosage.modifierExtension">
<path value="MedicationStatement.dosage.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<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)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</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." />
<comment value="32 bit number; for values larger than this, use decimal" />
<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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="TQ1-1" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
</element>
<element id="MedicationStatement.dosage.text">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<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="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-6; RXE-21" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
</element>
<element id="MedicationStatement.dosage.additionalInstruction">
<path value="MedicationStatement.dosage.additionalInstruction" />
<short value="Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"" />
<definition value="Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps")." />
<comment value="Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text." />
<requirements value="Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded." />
<min value="0" />
<max value="*" />
<base>
<path value="Dosage.additionalInstruction" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="AdditionalInstruction" />
</extension>
<strength value="example" />
<description value="A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery"." />
<valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
</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." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.patientInstruction" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
</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." />
<requirements value="The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.timing" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Timing" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="QSET<TS> (GTS)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication Timing" />
</mapping>
</element>
<element id="MedicationStatement.dosage.asNeeded[x]">
<path value="MedicationStatement.dosage.asNeeded[x]" />
<short value="Take "as needed" (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 "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 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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<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. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc." />
<valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="TQ1-9" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept" />
</mapping>
</element>
<element id="MedicationStatement.dosage.site">
<path value="MedicationStatement.dosage.site" />
<short value="Body site to administer to" />
<definition value="Body site to administer to." />
<comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both." />
<requirements value="A coded specification of the anatomic site where the medication first enters the body." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.site" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<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>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXR-2" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".approachSiteCode" />
</mapping>
</element>
<element id="MedicationStatement.dosage.route">
<path value="MedicationStatement.dosage.route" />
<short value="Concept - reference to a terminology or just text" />
<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="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's 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://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="RouteOfAdministration" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration" />
</extension>
<extension url="documentation">
<valueMarkdown value="Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." />
</extension>
</extension>
<strength value="preferred" />
<description value="SCTCA Route of Administration" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXR-1" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".routeCode" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication Route of Administration" />
</mapping>
</element>
<element id="MedicationStatement.dosage.method">
<path value="MedicationStatement.dosage.method" />
<short value="Technique for administering medication" />
<definition value="Technique for administering medication." />
<comment value="Terminologies used often pre-coordinate this term with the route and or form of administration." />
<requirements value="A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.method" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<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>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXR-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".doseQuantity" />
</mapping>
</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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="TQ1-2" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.id">
<path value="MedicationStatement.dosage.doseAndRate.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.extension">
<path value="MedicationStatement.dosage.doseAndRate.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.type">
<path value="MedicationStatement.dosage.doseAndRate.type" />
<short value="The kind of dose or rate specified" />
<definition value="The kind of dose or rate specified, for example, ordered or calculated." />
<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="If the type is not populated, assume to be "ordered"." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.doseAndRate.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DoseAndRateType" />
</extension>
<strength value="example" />
<description value="The kind of dose or rate specified." />
<valueSet value="http://hl7.org/fhir/ValueSet/dose-rate-type" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-21; RXE-23" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]">
<path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Amount of medication per dose" />
<definition value="Amount of medication per dose." />
<comment value="Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range" />
<requirements value="The amount of therapeutic or other substance given at one administration event." />
<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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<strength value="preferred" />
<description value="Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-2, RXE-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".doseQuantity" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="normative" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
<valueCode value="4.0.0" />
</extension>
<path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
<sliceName value="doseQuantity" />
<short value="A fixed quantity (no comparator)" />
<definition value="The comparator is not used on a SimpleQuantity" />
<comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
<requirements value="The amount of therapeutic or other substance given at one administration event." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.doseAndRate.dose[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<xpath value="not(exists(f:comparator))" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-2, RXE-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".doseQuantity" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.id">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.extension">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].value" />
<short value="Numerical value (with implicit precision)" />
<definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
<comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
<requirements value="Precision is handled implicitly in almost all cases of measurement." />
<min value="0" />
<max value="1" />
<base>
<path value="Quantity.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="decimal" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SN.2 / CQ - N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication Dose Value" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].comparator" />
<short value="< | <= | >= | > - how to understand the value" />
<definition value="Not allowed to be used in this context" />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology." />
<min value="0" />
<max value="0" />
<base>
<path value="Quantity.comparator" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="QuantityComparator" />
</extension>
<strength value="required" />
<description value="How the Quantity should be understood and represented." />
<valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SN.1 / CQ.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="IVL properties" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="MedicationStatement.dosage.doseAndRate.dose[x].unit" />
<short value="Unit representation" />
<definition value="A human-readable form of the unit." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
<min value="0" />
<max value="1" />
<base>
<path value="Quantity.unit" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.unit" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Medication Dose Unit of Measure" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].system" />
<short value="System that defines coded unit form" />
<definition value="The identification of the system that provides the coded form of the unit." />
<comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
<requirements value="Need to know the system that defines the coded form of the unit." />
<min value="0" />
<max value="1" />
<base>
<path value="Quantity.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<condition value="qty-3" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CO.codeSystem, PQ.translation.codeSystem" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].code" />
<short value="Coded form of the unit" />
<definition value="A computer processable form of the unit in some unit representation system." />
<comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system." />
<requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
<min value="0" />
<max value="1" />
<base>
<path value="Quantity.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="(see OBX.6 etc.) / CQ.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ.code, MO.currency, PQ.translation.code" />
</mapping>
</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 MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\n\nIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour." />
<requirements value="Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." />
<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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXE22, RXE23, RXE-24" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".rateQuantity" />
</mapping>
</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 "2 tablets every 4 hours to a maximum of 8/day"." />
<requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours." />
<min value="0" />
<max value="1" />
<base>
<path value="Dosage.maxDosePerPeriod" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Ratio" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="rat-1" />
<severity value="error" />
<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))" />
<source value="http://hl7.org/fhir/StructureDefinition/Ratio" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="RTO" />
</mapping>
<mapping>
<identity value="v2" />
<map value="RXO-23, RXE-19" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".maxDoseQuantity" />
</mapping>
</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." />
<requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration." />
<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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<xpath value="not(exists(f:comparator))" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
<mapping>
<identity value="rim" />
<map value="not supported" />
</mapping>
</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." />
<comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
<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>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<xpath value="not(exists(f:comparator))" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
<mapping>
<identity value="rim" />
<map value="not supported" />
</mapping>
</element>
</snapshot>
<differential>
<element id="MedicationStatement.extension">
<path value="MedicationStatement.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="MedicationStatement.extension:RenderedDosageInstruction">
<path value="MedicationStatement.extension" />
<sliceName value="RenderedDosageInstruction" />
<short value="Extension for representing rendered dosage instruction." />
<definition value="A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider." />
<comment value="Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use." />
<min value="0" />
<max value="1" />
<type>
<code value="Extension" />
<profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage" />
</type>
</element>
<element id="MedicationStatement.status">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.status" />
<mustSupport value="true" />
</element>
<element id="MedicationStatement.medication[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.medication[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<comment value="The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides." />
<mustSupport value="true" />
</element>
<element id="MedicationStatement.medication[x]:medicationReference">
<path value="MedicationStatement.medication[x]" />
<sliceName value="medicationReference" />
<min value="0" />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core" />
</type>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept">
<path value="MedicationStatement.medication[x]" />
<sliceName value="medicationCodeableConcept" />
<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." />
<min value="0" />
<max value="1" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<binding>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts" />
</extension>
<extension url="documentation">
<valueMarkdown value="ValueSet for licensed natural health products" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" />
</extension>
<extension url="documentation">
<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 url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" />
</extension>
<extension url="documentation">
<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 url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/DIN" />
</extension>
<extension url="documentation">
<valueMarkdown value="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. It uniquely identifies all drug products sold in a dosage form in Canada" />
</extension>
</extension>
<strength value="preferred" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" />
</binding>
<mapping>
<identity value="CACDI" />
<map value="Medication" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.system">
<path value="MedicationStatement.medication[x].coding.system" />
<mapping>
<identity value="CACDI" />
<map value="Drug Code System URI" />
</mapping>
</element>
<element id="MedicationStatement.medication[x]:medicationCodeableConcept.coding.display">
<path value="MedicationStatement.medication[x].coding.display" />
<mapping>
<identity value="CACDI" />
<map value="Drug English Description" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Drug French Description" />
</mapping>
</element>
<element id="MedicationStatement.subject">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.subject" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationStatement.effective[x]">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.effective[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<mustSupport value="true" />
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod">
<path value="MedicationStatement.effective[x]" />
<sliceName value="effectivePeriod" />
<min value="0" />
<max value="1" />
<type>
<code value="Period" />
</type>
</element>
<element id="MedicationStatement.effective[x]:effectivePeriod.end">
<path value="MedicationStatement.effective[x].end" />
<mapping>
<identity value="CACDI" />
<map value="Medication End Date and Time" />
</mapping>
</element>
<element id="MedicationStatement.reasonCode">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="MAY:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.reasonCode" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<binding>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse" />
</extension>
<extension url="documentation">
<valueMarkdown value="Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode" />
</extension>
<extension url="documentation">
<valueMarkdown value="A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment" />
</extension>
</extension>
<strength value="preferred" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode" />
</binding>
<mapping>
<identity value="CACDI" />
<map value="Medication Reason" />
</mapping>
</element>
<element id="MedicationStatement.reasonReference">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="MAY:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.reasonReference" />
<mapping>
<identity value="CACDI" />
<map value="Medication Reason" />
</mapping>
</element>
<element id="MedicationStatement.dosage">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.dosage" />
</element>
<element id="MedicationStatement.dosage.text">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="MedicationStatement.dosage.text" />
</element>
<element id="MedicationStatement.dosage.timing">
<path value="MedicationStatement.dosage.timing" />
<mapping>
<identity value="CACDI" />
<map value="Medication Timing" />
</mapping>
</element>
<element id="MedicationStatement.dosage.route">
<path value="MedicationStatement.dosage.route" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<binding>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration" />
</extension>
<extension url="documentation">
<valueMarkdown value="Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." />
</extension>
</extension>
<strength value="preferred" />
<description value="SCTCA Route of Administration" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration" />
</binding>
<mapping>
<identity value="CACDI" />
<map value="Medication Route of Administration" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]">
<path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<comment value="Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range" />
<binding>
<strength value="preferred" />
<description value="Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit" />
</binding>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity">
<path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
<sliceName value="doseQuantity" />
<min value="0" />
<max value="1" />
<type>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</type>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].value" />
<mapping>
<identity value="CACDI" />
<map value="Medication Dose Value" />
</mapping>
</element>
<element id="MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit">
<path value="MedicationStatement.dosage.doseAndRate.dose[x].unit" />
<mapping>
<identity value="CACDI" />
<map value="Medication Dose Unit of Measure" />
</mapping>
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"id": "medicationstatement-ca-core",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
}
],
"url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medicationstatement-ca-core",
"version": "1.1.0",
"name": "MedicationStatementCACore",
"title": "Medication Statement (CA-Core)",
"status": "active",
"experimental": false,
"date": "2025-08-27",
"publisher": "Canada Health Infoway",
"contact": [
{
"name": "National Standards Release Centre",
"telecom": [
{
"system": "url",
"value": "http://www.infoway-inforoute.ca"
},
{
"system": "email",
"value": "standards@infoway-inforoute.ca"
}
]
}
],
"description": "This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "CA"
}
]
}
],
"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).",
"fhirVersion": "4.0.1",
"mapping": [
{
"identity": "CACDI",
"name": "Canadian Core Data for Interoperability (CACDI)",
"comment": "Mapping for MedicationStatementCACore to Canadian Core Data for Interoperability (CACDI)."
}
],
"kind": "resource",
"abstract": false,
"type": "MedicationStatement",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "MedicationStatement",
"path": "MedicationStatement",
"short": "Record of medication being taken by a patient",
"definition": "A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. \n\nThe primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.",
"comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\nMedicationStatement.status + MedicationStatement.wasNotTaken\nStatus=Active + NotTaken=T = Not currently taking\nStatus=Completed + NotTaken=T = Not taken in the past\nStatus=Intended + NotTaken=T = No intention of taking\nStatus=Active + NotTaken=F = Taking, but not as prescribed\nStatus=Active + NotTaken=F = Taking\nStatus=Intended +NotTaken= F = Will be taking (not started)\nStatus=Completed + NotTaken=F = Taken in past\nStatus=In Error + NotTaken=N/A = In Error.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"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='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"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."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "rim",
"map": "SubstanceAdministration"
}
]
},
{
"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 only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isSummary": true
},
{
"id": "MedicationStatement.meta",
"path": "MedicationStatement.meta",
"short": "Metadata about the resource",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.implicitRules",
"path": "MedicationStatement.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"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",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.language",
"path": "MedicationStatement.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"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).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.text",
"path": "MedicationStatement.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"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.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "MedicationStatement.contained",
"path": "MedicationStatement.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, 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.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.extension",
"path": "MedicationStatement.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.extension:RenderedDosageInstruction",
"path": "MedicationStatement.extension",
"sliceName": "RenderedDosageInstruction",
"short": "Extension for representing rendered dosage instruction.",
"definition": "A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.",
"comment": "Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.modifierExtension",
"path": "MedicationStatement.modifierExtension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.identifier",
"path": "MedicationStatement.identifier",
"short": "External identifier",
"definition": "Identifiers associated with this Medication Statement 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"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"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]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
}
]
},
{
"id": "MedicationStatement.basedOn",
"path": "MedicationStatement.basedOn",
"short": "Fulfils plan, proposal or order",
"definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
"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.",
"requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.basedOn",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.basedOn"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
}
]
},
{
"id": "MedicationStatement.partOf",
"path": "MedicationStatement.partOf",
"short": "Part of referenced event",
"definition": "A larger event of which this particular event is a component or step.",
"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.",
"requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.partOf",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
"http://hl7.org/fhir/StructureDefinition/MedicationDispense",
"http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"http://hl7.org/fhir/StructureDefinition/Procedure",
"http://hl7.org/fhir/StructureDefinition/Observation"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.partOf"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]"
}
]
},
{
"id": "MedicationStatement.status",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.status",
"short": "active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken",
"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.",
"comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"min": 1,
"max": "1",
"base": {
"path": "MedicationStatement.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementStatus"
}
],
"strength": "required",
"description": "A coded concept indicating the current status of a MedicationStatement.",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": ".statusCode"
}
]
},
{
"id": "MedicationStatement.statusReason",
"path": "MedicationStatement.statusReason",
"short": "Reason for current status",
"definition": "Captures the reason for the current state of the MedicationStatement.",
"comment": "This is generally only used for \"exception\" statuses such as \"not-taken\", \"on-hold\", \"cancelled\" or \"entered-in-error\". The reason for performing the event at all is captured in reasonCode, not here.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.statusReason",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementStatusReason"
}
],
"strength": "example",
"description": "A coded concept indicating the reason for the status of the statement.",
"valueSet": "http://hl7.org/fhir/ValueSet/reason-medication-status-codes"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.statusReason"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"
}
]
},
{
"id": "MedicationStatement.category",
"path": "MedicationStatement.category",
"short": "Type of medication usage",
"definition": "Indicates where the medication is expected to be consumed or administered.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "MedicationStatement.category",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementCategory"
}
],
"strength": "preferred",
"description": "A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-category"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
}
]
},
{
"id": "MedicationStatement.medication[x]",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.medication[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"short": "What medication was taken",
"definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
"comment": "The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.",
"min": 1,
"max": "1",
"base": {
"path": "MedicationStatement.medication[x]",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
},
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Medication"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationCode"
}
],
"strength": "example",
"description": "A coded concept identifying the substance or product being taken.",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-codes"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationReference",
"path": "MedicationStatement.medication[x]",
"sliceName": "medicationReference",
"short": "What medication was taken",
"definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
"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": 0,
"max": "1",
"base": {
"path": "MedicationStatement.medication[x]",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept",
"path": "MedicationStatement.medication[x]",
"sliceName": "medicationCodeableConcept",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "MedicationStatement.medication[x]",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationCode"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts"
},
{
"url": "documentation",
"valueMarkdown": "ValueSet for licensed natural health products"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
},
{
"url": "documentation",
"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"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
},
{
"url": "documentation",
"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"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/DIN"
},
{
"url": "documentation",
"valueMarkdown": "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. It uniquely identifies all drug products sold in a dosage form in Canada"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"description": "A coded concept identifying the substance or product being taken.",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "CACDI",
"map": "Medication"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.id",
"path": "MedicationStatement.medication[x].id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.extension",
"path": "MedicationStatement.medication[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding",
"path": "MedicationStatement.medication[x].coding",
"short": "A reference to a code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.id",
"path": "MedicationStatement.medication[x].coding.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.extension",
"path": "MedicationStatement.medication[x].coding.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system",
"path": "MedicationStatement.medication[x].coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"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.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
},
{
"identity": "CACDI",
"map": "Drug Code System URI"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.version",
"path": "MedicationStatement.medication[x].coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.code",
"path": "MedicationStatement.medication[x].coding.code",
"short": "Symbol in syntax defined by the system",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "MedicationStatement.medication[x].coding.display",
"short": "Representation defined by the system",
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
},
{
"identity": "CACDI",
"map": "Drug English Description"
},
{
"identity": "CACDI",
"map": "Drug French Description"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.id",
"path": "MedicationStatement.medication[x].coding.display.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension",
"path": "MedicationStatement.medication[x].coding.display.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension:translation",
"path": "MedicationStatement.medication[x].coding.display.extension",
"sliceName": "translation",
"short": "Language Translation (Localization)",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/translation"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "ST.translation"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.value",
"path": "MedicationStatement.medication[x].coding.display.value",
"representation": [
"xmlAttr"
],
"short": "Primitive value for string",
"definition": "Primitive value for string",
"min": 0,
"max": "1",
"base": {
"path": "string.value",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/regex",
"valueString": "[ \\r\\n\\t\\S]+"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"maxLength": 1048576
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.userSelected",
"path": "MedicationStatement.medication[x].coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"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 ]"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "MedicationStatement.medication[x].text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "MedicationStatement.subject",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.subject",
"short": "Who is/was taking the medication",
"definition": "The person, animal or group who is/was taking the medication.",
"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.",
"min": 1,
"max": "1",
"base": {
"path": "MedicationStatement.subject",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3-Patient ID List"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].role[classCode=PAT]"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "MedicationStatement.context",
"path": "MedicationStatement.context",
"short": "Encounter / Episode associated with MedicationStatement",
"definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "MedicationStatement.context",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter",
"http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.context"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
}
]
},
{
"id": "MedicationStatement.effective[x]",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.effective[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"short": "The date/time or interval when the medication is/was/will be taken",
"definition": "The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).",
"comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.",
"min": 0,
"max": "1",
"base": {
"path": "MedicationStatement.effective[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod",
"path": "MedicationStatement.effective[x]",
"sliceName": "effectivePeriod",
"short": "The date/time or interval when the medication is/was/will be taken",
"definition": "The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).",
"comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.",
"min": 0,
"max": "1",
"base": {
"path": "MedicationStatement.effective[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod.id",
"path": "MedicationStatement.effective[x].id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod.extension",
"path": "MedicationStatement.effective[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod.start",
"path": "MedicationStatement.effective[x].start",
"short": "Starting time with inclusive boundary",
"definition": "The start of the period. The boundary is inclusive.",
"comment": "If the low element is missing, the meaning is that the low boundary is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Period.start",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"condition": [
"ele-1",
"per-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR.1"
},
{
"identity": "rim",
"map": "./low"
}
]
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod.end",
"path": "MedicationStatement.effective[x].end",
"short": "End time with inclusive boundary, if not ongoing",
"definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
"min": 0,
"max": "1",
"base": {
"path": "Period.end",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
"condition": [
"ele-1",
"per-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR.2"
},
{
"identity": "rim",
"map": "./high"
},
{
"identity": "CACDI",
"map": "Medication End Date and Time"
}
]
},
{
"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"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.recorded"
},
{
"identity": "rim",
"map": ".participation[typeCode=AUT].time"
}
]
},
{
"id": "MedicationStatement.informationSource",
"path": "MedicationStatement.informationSource",
"short": "Person or organization that provided the information about the taking of this medication",
"definition": "The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "MedicationStatement.informationSource",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.source"
},
{
"identity": "rim",
"map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
}
]
},
{
"id": "MedicationStatement.derivedFrom",
"path": "MedicationStatement.derivedFrom",
"short": "Additional supporting information",
"definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
"comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.derivedFrom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
}
]
},
{
"id": "MedicationStatement.reasonCode",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "MAY:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.reasonCode",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.reasonCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationReason"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
},
{
"url": "documentation",
"valueMarkdown": "Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode"
},
{
"url": "documentation",
"valueMarkdown": "A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"description": "A coded concept identifying why the medication is being taken.",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.reasonCode"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "rim",
"map": ".reasonCode"
},
{
"identity": "CACDI",
"map": "Medication Reason"
}
]
},
{
"id": "MedicationStatement.reasonReference",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "MAY:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.reasonReference",
"short": "Condition or observation that supports why the medication is being/was taken",
"definition": "Condition or observation that supports why the medication is being/was taken.",
"comment": "This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.reasonReference",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"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, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.reasonReference"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value"
},
{
"identity": "CACDI",
"map": "Medication Reason"
}
]
},
{
"id": "MedicationStatement.note",
"path": "MedicationStatement.note",
"short": "Further information about the statement",
"definition": "Provides extra information about the medication statement that is not conveyed by the other attributes.",
"comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.note",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Annotation"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act"
},
{
"identity": "workflow",
"map": "Event.note"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
}
]
},
{
"id": "MedicationStatement.dosage",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.dosage",
"short": "Details of how medication is/was taken or should be taken",
"definition": "Indicates how the medication is/was or should be taken by the patient.",
"comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\" It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
"min": 0,
"max": "*",
"base": {
"path": "MedicationStatement.dosage",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Dosage"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"
},
{
"identity": "rim",
"map": "refer dosageInstruction mapping"
}
]
},
{
"id": "MedicationStatement.dosage.id",
"path": "MedicationStatement.dosage.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.dosage.extension",
"path": "MedicationStatement.dosage.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.dosage.modifierExtension",
"path": "MedicationStatement.dosage.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"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.",
"comment": "32 bit number; for values larger than this, use decimal",
"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"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "TQ1-1"
},
{
"identity": "rim",
"map": ".text"
}
]
},
{
"id": "MedicationStatement.dosage.text",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.dosage.text",
"short": "Free text dosage instructions e.g. SIG",
"definition": "Free text dosage instructions e.g. SIG.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "RXO-6; RXE-21"
},
{
"identity": "rim",
"map": ".text"
}
]
},
{
"id": "MedicationStatement.dosage.additionalInstruction",
"path": "MedicationStatement.dosage.additionalInstruction",
"short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"",
"definition": "Supplemental instructions to the patient on how to take the medication (e.g. \"with meals\" or\"take half to one hour before food\") or warnings for the patient about the medication (e.g. \"may cause drowsiness\" or \"avoid exposure of skin to direct sunlight or sunlamps\").",
"comment": "Information about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.",
"requirements": "Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, \"Swallow with plenty of water\" which might or might not be coded.",
"min": 0,
"max": "*",
"base": {
"path": "Dosage.additionalInstruction",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdditionalInstruction"
}
],
"strength": "example",
"description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\".",
"valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "RXO-7"
},
{
"identity": "rim",
"map": ".text"
}
]
},
{
"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.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.patientInstruction",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "RXO-7"
},
{
"identity": "rim",
"map": ".text"
}
]
},
{
"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.",
"requirements": "The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.timing",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Timing"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "QSET<TS> (GTS)"
},
{
"identity": "rim",
"map": ".effectiveTime"
},
{
"identity": "CACDI",
"map": "Medication Timing"
}
]
},
{
"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"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"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. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "TQ1-9"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept"
}
]
},
{
"id": "MedicationStatement.dosage.site",
"path": "MedicationStatement.dosage.site",
"short": "Body site to administer to",
"definition": "Body site to administer to.",
"comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both.",
"requirements": "A coded specification of the anatomic site where the medication first enters the body.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.site",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"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"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "RXR-2"
},
{
"identity": "rim",
"map": ".approachSiteCode"
}
]
},
{
"id": "MedicationStatement.dosage.route",
"path": "MedicationStatement.dosage.route",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"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": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.route",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RouteOfAdministration"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration"
},
{
"url": "documentation",
"valueMarkdown": "Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"description": "SCTCA Route of Administration",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "RXR-1"
},
{
"identity": "rim",
"map": ".routeCode"
},
{
"identity": "CACDI",
"map": "Medication Route of Administration"
}
]
},
{
"id": "MedicationStatement.dosage.method",
"path": "MedicationStatement.dosage.method",
"short": "Technique for administering medication",
"definition": "Technique for administering medication.",
"comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
"requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.method",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"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"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "RXR-4"
},
{
"identity": "rim",
"map": ".doseQuantity"
}
]
},
{
"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"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "TQ1-2"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.id",
"path": "MedicationStatement.dosage.doseAndRate.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.extension",
"path": "MedicationStatement.dosage.doseAndRate.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.type",
"path": "MedicationStatement.dosage.doseAndRate.type",
"short": "The kind of dose or rate specified",
"definition": "The kind of dose or rate specified, for example, ordered or calculated.",
"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": "If the type is not populated, assume to be \"ordered\".",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.doseAndRate.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DoseAndRateType"
}
],
"strength": "example",
"description": "The kind of dose or rate specified.",
"valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "RXO-21; RXE-23"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]",
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"short": "Amount of medication per dose",
"definition": "Amount of medication per dose.",
"comment": "Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"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"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"strength": "preferred",
"description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "RXO-2, RXE-3"
},
{
"identity": "rim",
"map": ".doseQuantity"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
}
],
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"sliceName": "doseQuantity",
"short": "A fixed quantity (no comparator)",
"definition": "The comparator is not used on a SimpleQuantity",
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.doseAndRate.dose[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "RXO-2, RXE-3"
},
{
"identity": "rim",
"map": ".doseQuantity"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.id",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.extension",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].value",
"short": "Numerical value (with implicit precision)",
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"max": "1",
"base": {
"path": "Quantity.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "decimal"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN.2 / CQ - N/A"
},
{
"identity": "rim",
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"
},
{
"identity": "CACDI",
"map": "Medication Dose Value"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].comparator",
"short": "< | <= | >= | > - how to understand the value",
"definition": "Not allowed to be used in this context",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"max": "0",
"base": {
"path": "Quantity.comparator",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
}
],
"strength": "required",
"description": "How the Quantity should be understood and represented.",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN.1 / CQ.1"
},
{
"identity": "rim",
"map": "IVL properties"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
"short": "Unit representation",
"definition": "A human-readable form of the unit.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"max": "1",
"base": {
"path": "Quantity.unit",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "PQ.unit"
},
{
"identity": "CACDI",
"map": "Medication Dose Unit of Measure"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].system",
"short": "System that defines coded unit form",
"definition": "The identification of the system that provides the coded form of the unit.",
"comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"max": "1",
"base": {
"path": "Quantity.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1",
"qty-3"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "CO.codeSystem, PQ.translation.codeSystem"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].code",
"short": "Coded form of the unit",
"definition": "A computer processable form of the unit in some unit representation system.",
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"max": "1",
"base": {
"path": "Quantity.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "(see OBX.6 etc.) / CQ.2"
},
{
"identity": "rim",
"map": "PQ.code, MO.currency, PQ.translation.code"
}
]
},
{
"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 MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\n\nIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.",
"requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"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"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "RXE22, RXE23, RXE-24"
},
{
"identity": "rim",
"map": ".rateQuantity"
}
]
},
{
"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\".",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.maxDosePerPeriod",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Ratio"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "rat-1",
"severity": "error",
"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))",
"source": "http://hl7.org/fhir/StructureDefinition/Ratio"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "RTO"
},
{
"identity": "v2",
"map": "RXO-23, RXE-19"
},
{
"identity": "rim",
"map": ".maxDoseQuantity"
}
]
},
{
"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.",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
"min": 0,
"max": "1",
"base": {
"path": "Dosage.maxDosePerAdministration",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity": "rim",
"map": "not supported"
}
]
},
{
"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.",
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"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"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity": "rim",
"map": "not supported"
}
]
}
]
},
"differential": {
"element": [
{
"id": "MedicationStatement.extension",
"path": "MedicationStatement.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "MedicationStatement.extension:RenderedDosageInstruction",
"path": "MedicationStatement.extension",
"sliceName": "RenderedDosageInstruction",
"short": "Extension for representing rendered dosage instruction.",
"definition": "A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.",
"comment": "Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.",
"min": 0,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
]
}
]
},
{
"id": "MedicationStatement.status",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.status",
"mustSupport": true
},
{
"id": "MedicationStatement.medication[x]",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.medication[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"comment": "The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.",
"mustSupport": true
},
{
"id": "MedicationStatement.medication[x]:medicationReference",
"path": "MedicationStatement.medication[x]",
"sliceName": "medicationReference",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core"
]
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept",
"path": "MedicationStatement.medication[x]",
"sliceName": "medicationCodeableConcept",
"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.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"binding": {
"extension": [
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts"
},
{
"url": "documentation",
"valueMarkdown": "ValueSet for licensed natural health products"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
},
{
"url": "documentation",
"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"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
},
{
"url": "documentation",
"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"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/DIN"
},
{
"url": "documentation",
"valueMarkdown": "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. It uniquely identifies all drug products sold in a dosage form in Canada"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"
},
"mapping": [
{
"identity": "CACDI",
"map": "Medication"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system",
"path": "MedicationStatement.medication[x].coding.system",
"mapping": [
{
"identity": "CACDI",
"map": "Drug Code System URI"
}
]
},
{
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display",
"path": "MedicationStatement.medication[x].coding.display",
"mapping": [
{
"identity": "CACDI",
"map": "Drug English Description"
},
{
"identity": "CACDI",
"map": "Drug French Description"
}
]
},
{
"id": "MedicationStatement.subject",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.subject",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
"mustSupport": true
},
{
"id": "MedicationStatement.effective[x]",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.effective[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"mustSupport": true
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod",
"path": "MedicationStatement.effective[x]",
"sliceName": "effectivePeriod",
"min": 0,
"max": "1",
"type": [
{
"code": "Period"
}
]
},
{
"id": "MedicationStatement.effective[x]:effectivePeriod.end",
"path": "MedicationStatement.effective[x].end",
"mapping": [
{
"identity": "CACDI",
"map": "Medication End Date and Time"
}
]
},
{
"id": "MedicationStatement.reasonCode",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "MAY:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.reasonCode",
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"binding": {
"extension": [
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
},
{
"url": "documentation",
"valueMarkdown": "Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode"
},
{
"url": "documentation",
"valueMarkdown": "A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode"
},
"mapping": [
{
"identity": "CACDI",
"map": "Medication Reason"
}
]
},
{
"id": "MedicationStatement.reasonReference",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "MAY:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.reasonReference",
"mapping": [
{
"identity": "CACDI",
"map": "Medication Reason"
}
]
},
{
"id": "MedicationStatement.dosage",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.dosage"
},
{
"id": "MedicationStatement.dosage.text",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "MedicationStatement.dosage.text"
},
{
"id": "MedicationStatement.dosage.timing",
"path": "MedicationStatement.dosage.timing",
"mapping": [
{
"identity": "CACDI",
"map": "Medication Timing"
}
]
},
{
"id": "MedicationStatement.dosage.route",
"path": "MedicationStatement.dosage.route",
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"binding": {
"extension": [
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration"
},
{
"url": "documentation",
"valueMarkdown": "Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"description": "SCTCA Route of Administration",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
},
"mapping": [
{
"identity": "CACDI",
"map": "Medication Route of Administration"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]",
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"comment": "Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range",
"binding": {
"strength": "preferred",
"description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit"
}
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity",
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"sliceName": "doseQuantity",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].value",
"mapping": [
{
"identity": "CACDI",
"map": "Medication Dose Value"
}
]
},
{
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
"mapping": [
{
"identity": "CACDI",
"map": "Medication Dose Unit of Measure"
}
]
}
]
}
}

Terminology bindings

PathConformanceValueSet
MedicationStatement.medication[x]:medicationCodeableConceptpreferredhttps://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct
MedicationStatement.reasonCodepreferredhttps://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode
MedicationStatement.dosage.routepreferredhttps://fhir.infoway-inforoute.ca/ValueSet/routeofadministration
MedicationStatement.dosage.doseAndRate.dose[x]preferredhttps://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit

Additional Terminology Bindings

These bindings may be used in lieu of the primary bindings in the table above.

PathConformanceAdditionalValueSet
MedicationStatement.medication[x]:medicationCodeableConceptcandidatehttps://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts
MedicationStatement.reasonCodecandidatehttps://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse
MedicationStatement.dosage.routecandidatehttps://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration

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 ElementCACDI Element(s)
MedicationStatement.medication[x]:medicationCodeableConceptMedication
MedicationStatement.medication[x]:medicationCodeableConcept.coding.systemDrug Code System URI
MedicationStatement.medication[x]:medicationCodeableConcept.coding.displayDrug English Description, Drug French Description
MedicationStatement.effective[x]:effectivePeriod.endMedication End Date and Time
MedicationStatement.reasonCodeMedication Reason
MedicationStatement.reasonReferenceMedication Reason
MedicationStatement.dosage.timingMedication Timing
MedicationStatement.dosage.routeMedication Route of Administration
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.valueMedication Dose Value
MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unitMedication Dose Unit of Measure

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