Profile: CareConnect-GPC-MedicationStatement-1
CareConnect-GPC-MedicationStatement-1 (MedicationStatement) | C | MedicationStatement | |
id | Σ | 0..1 | id |
meta | Σ | 0..1 | Meta |
id | 0..1 | string | |
extension | 0..* | Extension | |
versionId | Σ | 0..1 | id |
lastUpdated | Σ | 0..1 | instant |
profile | Σ | 1..* | uri |
security | Σ | 0..* | CodingBinding |
tag | Σ | 0..* | Coding |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | C | 0..1 | Narrative |
contained | 0..* | Resource | |
extension | 1..* | Extension | |
lastIssueDate | S C | 0..1 | Extension(dateTime) |
changeSummary | C | 0..1 | Extension(Complex) |
prescribingAgency | C | 1..1 | Extension(CodeableConcept) |
dosageLastChanged | C | 0..1 | Extension(dateTime) |
id | 0..1 | string | |
extension | C | 0..* | Extension |
url | 1..1 | uriAuto Value | |
valueDateTime | 0..1 | dateTime | |
modifierExtension | ?! | 0..* | Extension |
identifier | Σ | 1..* | Identifier |
id | 0..1 | string | |
extension | 0..* | Extension | |
use | Σ ?! | 0..1 | codeBinding |
type | Σ | 0..1 | CodeableConceptBinding |
system | Σ | 1..1 | uri |
value | Σ | 1..1 | string |
period | Σ | 0..1 | Period |
assigner | Σ | 0..1 | Reference(Organization) |
basedOn | Σ | 0..1 | Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-GPC-MedicationRequest-1) |
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-GPC-MedicationStatement-1) |
context | S Σ | 0..1 | Reference(EpisodeOfCare | CareConnect-Encounter-1) |
status | Σ ?! | 1..1 | codeBinding |
category | Σ | 0..1 | CodeableConceptBinding |
medication[x] | Σ | 1..1 | |
medicationCodeableConcept | CodeableConcept | ||
medicationReference | Reference(CareConnect-GPC-Medication-1) | ||
effective[x] | S Σ | 0..1 | |
effectiveDateTime | dateTime | ||
effectivePeriod | Period | ||
dateAsserted | Σ | 1..1 | dateTime |
informationSource | 0..1 | Reference(RelatedPerson | CareConnect-GPC-Organization-1 | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1) | |
subject | Σ | 1..1 | Reference(Group | CareConnect-GPC-Patient-1) |
derivedFrom | 0..* | Reference(Resource) | |
taken | Σ ?! | 1..1 | codeBinding |
reasonNotTaken | C | 0..* | CodeableConcept |
reasonCode | 0..* | CodeableConcept | |
reasonReference | 0..* | Reference(CareConnect-Observation-1 | CareConnect-Condition-1) | |
note | S | 0..* | Annotation |
id | 0..1 | string | |
extension | 0..* | Extension | |
author[x] | Σ | 0..1 | |
authorString | string | ||
authorReference | Reference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1) | ||
time | Σ | 0..1 | dateTime |
text | 1..1 | string | |
dosage | 1..* | Dosage | |
id | 0..1 | string | |
extension | 0..* | Extension | |
sequence | Σ | 0..1 | integer |
text | Σ | 1..1 | string |
additionalInstruction | Σ | 0..* | CodeableConcept |
patientInstruction | S Σ | 0..1 | string |
timing | Σ | 0..1 | Timing |
asNeeded[x] | Σ | 0..1 | |
asNeededBoolean | boolean | ||
asNeededCodeableConcept | CodeableConcept | ||
site | Σ | 0..1 | CodeableConcept |
route | Σ | 0..1 | CodeableConcept |
id | 0..1 | string | |
extension | 0..* | Extension | |
coding | Σ | 0..* | Coding |
snomedCT | Σ | 0..1 | Coding |
id | 0..1 | string | |
extension | 0..* | Extension | |
snomedCTDescriptionID | C | 0..1 | Extension(Complex) |
system | Σ | 1..1 | uriAuto Value |
version | Σ | 0..0 | string |
code | Σ | 1..1 | code |
display | Σ | 1..1 | string |
userSelected | Σ | 0..1 | boolean |
text | Σ | 0..1 | string |
method | Σ | 0..1 | CodeableConcept |
dose[x] | Σ | 0..1 | |
doseRange | Range | ||
doseQuantity | SimpleQuantity | ||
maxDosePerPeriod | Σ | 0..1 | Ratio |
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity |
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity |
rate[x] | Σ | 0..1 | |
rateRatio | Ratio | ||
rateRange | Range | ||
rateQuantity | SimpleQuantity |
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 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. | ||
Cardinality | 0..* | ||
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. | ||
Constraints |
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Mappings |
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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. | ||
Cardinality | 0..1 | ||
Type | id | ||
Summary | True | ||
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. | ||
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 may not always be associated with version changes to the resource. | ||
Cardinality | 0..1 | ||
Type | Meta | ||
Summary | True | ||
MedicationStatement.meta.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
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MedicationStatement.meta.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
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MedicationStatement.meta.versionId | |||
Short | Version specific identifier | ||
Definition | The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted. | ||
Cardinality | 0..1 | ||
Type | id | ||
Summary | True | ||
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. | ||
MedicationStatement.meta.lastUpdated | |||
Short | When the resource version last changed | ||
Definition | When the resource last changed - e.g. when the version changed. | ||
Cardinality | 0..1 | ||
Type | instant | ||
Summary | True | ||
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. | ||
MedicationStatement.meta.profile | |||
Short | Profiles this resource claims to conform to | ||
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. | ||
Cardinality | 1..* | ||
Type | uri | ||
Summary | True | ||
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. | ||
MedicationStatement.meta.security | |||
Short | Security Labels applied to this resource | ||
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. | ||
Cardinality | 0..* | ||
Type | Coding | ||
Binding | Security Labels from the Healthcare Privacy and Security Classification System. | ||
Summary | True | ||
Comments | The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. | ||
MedicationStatement.meta.tag | |||
Short | Tags applied to this resource | ||
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. | ||
Cardinality | 0..* | ||
Type | Coding | ||
Binding | Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones" | ||
Summary | True | ||
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. | ||
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. | ||
Cardinality | 0..1 | ||
Type | uri | ||
Modifier | True | ||
Summary | True | ||
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. | ||
MedicationStatement.language | |||
Short | Language of the resource content | ||
Definition | The base language in which the resource is written. | ||
Cardinality | 0..1 | ||
Type | code | ||
Binding | A human language. Binding extensions
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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). | ||
MedicationStatement.text | |||
Short | Text summary of the resource, for human interpretation | ||
Definition | A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||
Cardinality | 0..1 | ||
Type | Narrative | ||
Alias | narrative, html, xhtml, display | ||
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 in formation is added later. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: dom-1 | ||
Mappings |
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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. | ||
Cardinality | 0..* | ||
Type | Resource | ||
Alias | inline resources, anonymous resources, contained resources | ||
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. | ||
Mappings |
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MedicationStatement.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 1..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) | ||
Mappings |
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MedicationStatement.extension:lastIssueDate | |||
Short | The date a prescription was last issued | ||
Definition | The date a prescription was last issued. | ||
Cardinality | 0..1 | ||
Type | Extension(dateTime) | ||
Must Support | True | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.extension:changeSummary | |||
Short | Optional Extensions Element | ||
Definition | Optional Extension Element - found in all resources. | ||
Cardinality | 0..1 | ||
Type | Extension(Complex) | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.extension:prescribingAgency | |||
Short | The type of organisation/setting responsible for authorising and issuing the medication | ||
Definition | The type of organisation/setting responsible for authorising and issuing the medication. | ||
Cardinality | 1..1 | ||
Type | Extension(CodeableConcept) | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.extension:dosageLastChanged | |||
Short | The date when the dosage instructions were last changed | ||
Definition | Only populate where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan. Set to the date when the dosage instructions were last changed. | ||
Cardinality | 0..1 | ||
Type | Extension(dateTime) | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.extension:dosageLastChanged.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Comments | Note that FHIR strings may not exceed 1MB in size | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.extension:dosageLastChanged.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.extension:dosageLastChanged.url | |||
Short | identifies the meaning of the extension | ||
Definition | Source of the definition for the extension code - a logical name or a URL. | ||
Cardinality | 1..1 | ||
Type | uri | ||
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Auto Value | https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1 | ||
Mappings |
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MedicationStatement.extension:dosageLastChanged.value[x]:valueDateTime | |||
Short | The date when the dosage instructions were last changed | ||
Definition | The date when the dosage instructions were last changed. | ||
Cardinality | 0..1 | ||
Type | dateTime | ||
Comments | A stream of bytes, base64 encoded | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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MedicationStatement.modifierExtension | |||
Short | Extensions that cannot be ignored | ||
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Modifier | True | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Mappings |
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MedicationStatement.identifier | |||
Short | External identifier | ||
Definition | External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated. | ||
Cardinality | 1..* | ||
Type | Identifier | ||
Summary | True | ||
Mappings |
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MedicationStatement.identifier.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
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MedicationStatement.identifier.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
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MedicationStatement.identifier.use | |||
Short | usual | official | temp | secondary (If known) | ||
Definition | The purpose of this identifier. | ||
Cardinality | 0..1 | ||
Type | code | ||
Binding | Identifies the purpose for this identifier, if known . | ||
Modifier | True | ||
Summary | True | ||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||
Comments | This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||
Mappings |
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MedicationStatement.identifier.type | |||
Short | Description of identifier | ||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||
Summary | True | ||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||
Mappings |
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MedicationStatement.identifier.system | |||
Short | The namespace for the identifier value | ||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||
Cardinality | 1..1 | ||
Type | uri | ||
Summary | True | ||
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||
Examples | Generalhttp://www.acme.com/identifiers/patient | ||
Mappings |
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MedicationStatement.identifier.value | |||
Short | The value that is unique | ||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||
Cardinality | 1..1 | ||
Type | string | ||
Summary | True | ||
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. | ||
Examples | General123456 | ||
Mappings |
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MedicationStatement.identifier.period | |||
Short | Time period when id is/was valid for use | ||
Definition | Time period during which identifier is/was valid for use. | ||
Cardinality | 0..1 | ||
Type | Period | ||
Summary | True | ||
Mappings |
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MedicationStatement.identifier.assigner | |||
Short | Organization that issued id (may be just text) | ||
Definition | Organization that issued/manages the identifier. | ||
Cardinality | 0..1 | ||
Type | Reference(Organization) | ||
Summary | True | ||
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. | ||
Mappings |
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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. | ||
Cardinality | 0..1 | ||
Type | Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-GPC-MedicationRequest-1) | ||
Summary | True | ||
Requirements | Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. | ||
Mappings |
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MedicationStatement.partOf | |||
Short | Part of referenced event | ||
Definition | A larger event of which this particular event is a component or step. | ||
Cardinality | 0..* | ||
Type | Reference(MedicationAdministration | MedicationDispense | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-GPC-MedicationStatement-1) | ||
Summary | True | ||
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. | ||
Mappings |
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MedicationStatement.context | |||
Short | Encounter / Episode associated with MedicationStatement | ||
Definition | The encounter or episode of care that establishes the context for this MedicationStatement. | ||
Cardinality | 0..1 | ||
Type | Reference(EpisodeOfCare | CareConnect-Encounter-1) | ||
Must Support | True | ||
Summary | True | ||
Mappings |
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MedicationStatement.status | |||
Short | active | completed | entered-in-error | intended | stopped | on-hold | ||
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. | ||
Cardinality | 1..1 | ||
Type | code | ||
Binding | A coded concept indicating the current status of a MedicationStatement. | ||
Modifier | True | ||
Summary | True | ||
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. | ||
Mappings |
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MedicationStatement.category | |||
Short | Type of medication usage | ||
Definition | Indicates where type of medication statement and where the medication is expected to be consumed or administered. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered | ||
Summary | True | ||
Mappings |
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MedicationStatement.medication[x] | |||
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. | ||
Cardinality | 1..1 | ||
Type | Reference(CareConnect-GPC-Medication-1), CodeableConcept | ||
Binding | A coded concept identifying the substance or product being taken. | ||
Summary | True | ||
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. . | ||
Mappings |
| ||
MedicationStatement.effective[x] | |||
Short | The date/time or interval when the medication was taken | ||
Definition | The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true). | ||
Cardinality | 0..1 | ||
Type | dateTime, Period | ||
Must Support | True | ||
Summary | True | ||
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. | ||
Mappings |
| ||
MedicationStatement.dateAsserted | |||
Short | When the statement was asserted? | ||
Definition | The date when the medication statement was asserted by the information source. | ||
Cardinality | 1..1 | ||
Type | dateTime | ||
Summary | True | ||
Mappings |
| ||
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. | ||
Cardinality | 0..1 | ||
Type | Reference(RelatedPerson | CareConnect-GPC-Organization-1 | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1) | ||
Mappings |
| ||
MedicationStatement.subject | |||
Short | Who is/was taking the medication | ||
Definition | The person, animal or group who is/was taking the medication. | ||
Cardinality | 1..1 | ||
Type | Reference(Group | CareConnect-GPC-Patient-1) | ||
Summary | True | ||
Mappings |
| ||
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. | ||
Cardinality | 0..* | ||
Type | Reference(Resource) | ||
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. | ||
Mappings |
| ||
MedicationStatement.taken | |||
Short | y | n | unk | na | ||
Definition | Indicator of the certainty of whether the medication was taken by the patient. | ||
Cardinality | 1..1 | ||
Type | code | ||
Binding | A coded concept identifying level of certainty if patient has taken or has not taken the medication | ||
Modifier | True | ||
Summary | True | ||
Comments | This element is labeled as a modifier because it indicates that the medication was not taken. | ||
Mappings |
| ||
MedicationStatement.reasonNotTaken | |||
Short | True if asserting medication was not given | ||
Definition | A code indicating why the medication was not taken. | ||
Cardinality | 0..* | ||
Type | CodeableConcept | ||
Binding | A coded concept indicating the reason why the medication was not taken | ||
Conditions | The cardinality or value of this element may be affected by these constraints: mst-1 | ||
Mappings |
| ||
MedicationStatement.reasonCode | |||
Short | Reason for why the medication is being/was taken | ||
Definition | A reason for why the medication is being/was taken. | ||
Cardinality | 0..* | ||
Type | CodeableConcept | ||
Binding | A coded concept identifying why the medication is being taken. | ||
Comments | This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. | ||
Mappings |
| ||
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. | ||
Cardinality | 0..* | ||
Type | Reference(CareConnect-Observation-1 | CareConnect-Condition-1) | ||
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. | ||
Mappings |
| ||
MedicationStatement.note | |||
Short | Further information about the statement | ||
Definition | Provides extra information about the medication statement that is not conveyed by the other attributes. | ||
Cardinality | 0..* | ||
Type | Annotation | ||
Must Support | True | ||
Mappings |
| ||
MedicationStatement.note.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
| ||
MedicationStatement.note.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
| ||
MedicationStatement.note.author[x] | |||
Short | Individual responsible for the annotation | ||
Definition | The individual responsible for making the annotation. | ||
Cardinality | 0..1 | ||
Type | Reference(RelatedPerson | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1), string | ||
Summary | True | ||
Mappings |
| ||
MedicationStatement.note.time | |||
Short | When the annotation was made | ||
Definition | Indicates when this particular annotation was made. | ||
Cardinality | 0..1 | ||
Type | dateTime | ||
Summary | True | ||
Mappings |
| ||
MedicationStatement.note.text | |||
Short | The annotation - text content | ||
Definition | The text of the annotation. | ||
Cardinality | 1..1 | ||
Type | string | ||
Mappings |
| ||
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. | ||
Cardinality | 1..* | ||
Type | Dosage | ||
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. | ||
Mappings |
| ||
MedicationStatement.dosage.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
| ||
MedicationStatement.dosage.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
| ||
MedicationStatement.dosage.sequence | |||
Short | The order of the dosage instructions | ||
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. | ||
Cardinality | 0..1 | ||
Type | integer | ||
Summary | True | ||
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. | ||
Mappings |
| ||
MedicationStatement.dosage.text | |||
Short | Free text dosage instructions e.g. SIG | ||
Definition | Free text dosage instructions e.g. SIG. | ||
Cardinality | 1..1 | ||
Type | string | ||
Summary | True | ||
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. | ||
Mappings |
| ||
MedicationStatement.dosage.additionalInstruction | |||
Short | Supplemental instruction - e.g. "with meals" | ||
Definition | Supplemental instruction - e.g. "with meals". | ||
Cardinality | 0..* | ||
Type | CodeableConcept | ||
Binding | A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||
Summary | True | ||
Requirements | Additional instruction such as "Swallow with plenty of water" which may or may not be coded. | ||
Mappings |
| ||
MedicationStatement.dosage.patientInstruction | |||
Short | Patient or consumer oriented instructions | ||
Definition | Instructions in terms that are understood by the patient or consumer. | ||
Cardinality | 0..1 | ||
Type | string | ||
Must Support | True | ||
Summary | True | ||
Mappings |
| ||
MedicationStatement.dosage.timing | |||
Short | When medication should be administered | ||
Definition | When medication should be administered. | ||
Cardinality | 0..1 | ||
Type | Timing | ||
Summary | True | ||
Requirements | The timing schedule for giving the medication to the patient. The Schedule 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 may 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. | ||
Mappings |
| ||
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). | ||
Cardinality | 0..1 | ||
Type | boolean, CodeableConcept | ||
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. | ||
Summary | True | ||
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". | ||
Mappings |
| ||
MedicationStatement.dosage.site | |||
Short | Body site to administer to | ||
Definition | Body site to administer to. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example) | ||
Summary | True | ||
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 body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. | ||
Mappings |
| ||
MedicationStatement.dosage.route | |||
Short | How drug should enter body | ||
Definition | How drug should enter body. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | ||
Summary | True | ||
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. | ||
Mappings |
| ||
MedicationStatement.dosage.route.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
| ||
MedicationStatement.dosage.route.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding | |||
Short | Code defined by a terminology system | ||
Definition | A reference to a code defined by a terminology system. | ||
Cardinality | 0..* | ||
Type | Coding | ||
Summary | True | ||
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. | ||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||
Slicing | Unordered, Open, by system(Value) | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT | |||
Short | Code defined by a terminology system | ||
Definition | A reference to a code defined by a terminology system. | ||
Cardinality | 0..1 | ||
Type | Coding | ||
Binding | A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. | ||
Summary | True | ||
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. | ||
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID | |||
Short | The SNOMED CT Description ID for the display | ||
Definition | The SNOMED CT Description ID for the display. | ||
Cardinality | 0..1 | ||
Type | Extension(Complex) | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
| ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.system | |||
Short | Identity of the terminology system | ||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||
Cardinality | 1..1 | ||
Type | uri | ||
Summary | True | ||
Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. | ||
Auto Value | http://snomed.info/sct | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.version | |||
Short | Version of the system - if relevant | ||
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||
Cardinality | 0..0 | ||
Type | string | ||
Summary | True | ||
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.code | |||
Short | Symbol in syntax defined by the system | ||
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). | ||
Cardinality | 1..1 | ||
Type | code | ||
Summary | True | ||
Requirements | Need to refer to a particular code in the system. | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.display | |||
Short | Representation defined by the system | ||
Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||
Cardinality | 1..1 | ||
Type | string | ||
Summary | True | ||
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||
Mappings |
| ||
MedicationStatement.dosage.route.coding:snomedCT.userSelected | |||
Short | If this coding was chosen directly by the user | ||
Definition | Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). | ||
Cardinality | 0..1 | ||
Type | boolean | ||
Summary | True | ||
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||
Mappings |
| ||
MedicationStatement.dosage.route.text | |||
Short | Plain text representation of the concept | ||
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||
Cardinality | 0..1 | ||
Type | string | ||
Summary | True | ||
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||
Comments | Very often the text is the same as a displayName of one of the codings. | ||
Mappings |
| ||
MedicationStatement.dosage.method | |||
Short | Technique for administering medication | ||
Definition | Technique for administering medication. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded concept describing the technique by which the medicine is administered. | ||
Summary | True | ||
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. | ||
Mappings |
| ||
MedicationStatement.dosage.dose[x] | |||
Short | Amount of medication per dose | ||
Definition | Amount of medication per dose. | ||
Cardinality | 0..1 | ||
Type | Range, SimpleQuantity | ||
Summary | True | ||
Requirements | The amount of therapeutic or other substance given at one administration event. | ||
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. | ||
Mappings |
| ||
MedicationStatement.dosage.maxDosePerPeriod | |||
Short | Upper limit on medication per unit of time | ||
Definition | Upper limit on medication per unit of time. | ||
Cardinality | 0..1 | ||
Type | Ratio | ||
Summary | True | ||
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". | ||
Mappings |
| ||
MedicationStatement.dosage.maxDosePerAdministration | |||
Short | Upper limit on medication per administration | ||
Definition | Upper limit on medication per administration. | ||
Cardinality | 0..1 | ||
Type | SimpleQuantity | ||
Summary | True | ||
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. | ||
Mappings |
| ||
MedicationStatement.dosage.maxDosePerLifetime | |||
Short | Upper limit on medication per lifetime of the patient | ||
Definition | Upper limit on medication per lifetime of the patient. | ||
Cardinality | 0..1 | ||
Type | SimpleQuantity | ||
Summary | True | ||
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. | ||
Mappings |
| ||
MedicationStatement.dosage.rate[x] | |||
Short | Amount of medication per unit of time | ||
Definition | Amount of medication per unit of time. | ||
Cardinality | 0..1 | ||
Type | Ratio, Range, SimpleQuantity | ||
Summary | True | ||
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. | ||
Mappings |
|
Related links
DAPB4013: Medicine and Allergy/Intolerance Data Transfer
CareConnect-MedicationStatement-1
CareConnect-GPC-MedicationStatement-1
Background
What is a MedicationStatement?
A MedicationStatement
(despite the potentially confusing name) is not a statement in the traditional sense of a list of items (such as bank statement), and in FHIR R5 it is going to be renamed to MedicationUsage
.
The definition of a MedicationStatement
from hl7.org is as follows:
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.
A MedicationStatement
resource will contain a single line-item of medication, and may contain information from the original MedicationRequest
, MedicationDispense
or MedicationAdministration
if the system populating the resource knows about them.
It is possible; however, to create the resource without this information.
Example
In the diagram below there are three active medications, one completed medication, and a stopped medication.
MedicationStatement
- each with varying data-sources.
Potential data-sources for the MedicationStatement
resource
- Pharmacy System -
MedicationRequest
- Dispensing System -
MedicationDispense
- Patient self-declared -
MedicationAdministration
- ICS Shared Record -
MedicationStatement
Data model element usage
Element | Use | CareConnect (STU3) | UK Core (R4) |
---|---|---|---|
id | |||
meta.versionId | |||
meta.lastUpdated | |||
meta.profile | |||
meta.security | |||
meta.tag | |||
extension(lastIssueDate) | |||
extension(changeSummary) | |||
extension(prescribingAgency) | |||
extension(dosageLastChanged) | |||
extension(medicationTradeFamily) | |||
identifier | |||
basedOn | |||
partOf | |||
context | |||
status | |||
category | |||
medicationR | |||
effective[x] | |||
dateAsserted | |||
informationSource | |||
subject | |||
derivedFrom | |||
taken | |||
reasonNotTaken | |||
reasonCode | |||
reasonReference | |||
note | |||
dosage |
id
Usage
Optional
Guidance
The id
is the logical identifier for the CareConnect-GPC-Observation-1
profile.
Example
<id value="bfa6215a-e433-4729-9e41-510730df6423" />
meta.versionId
Usage
Optional
Guidance
The population of the meta.versionId
element could be useful if sending an adendum of something previously sent to help the consumer (receiver) in understanding there is a "newer" version.
Example
<meta> <versionId value="1" /> </meta>
meta.lastUpdated
Usage
Optional
Guidance
The meta.lastUpdated
element could be useful alongside the meta.versionId
element could be useful if sending an adendum of something previously sent to help the consumer (receiver) in understanding there is a "newer" version.
Example
<meta> <lastUpdated value="2022-10-28T08:06:00+00:00" /> </meta>
meta.profile
Usage
Mandatory
Guidance
The meta.profile
contains a fixed value of the URL for the CareConnect-GPC-MedicationStatement-1
profile.
Example
<meta> <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1" /> </meta>
meta.security
Usage
Optional
Guidance
The security label(s) applicable to the resource.
See Resources not to be disclosed to a patient for more details on how to populate the element.
Example
<meta> <security> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="NOPAT"/> <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/> </security> </meta>
meta.tag
Usage
Optional
Guidance
A use-case for the meta.tag
element within GP Connect has not been defined.
Example
<meta> <tag> <coding> <system value="http://hl7.org/fhir/common-tags" /> <code value="actionable" /> <display value="Actionable" /> </coding> </tag> </meta>
extension(lastIssueDate)
Usage
Required
Guidance
The date when the latest prescription under this plan was issued (signed).
Example
<extension> <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationStatementLastIssueDate-1" /> <valueDateTime value="2022-07-07T14:07:48+00:00Z" /> </extension>
extension(changeSummary)
Usage
Optional
Guidance
The extension.changeSummary
does not need to be populated.
Example
<extension> <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-MedicationChangeSummary-1" /> <extension> <id value="4095fcc9-c0ae-4f05-b5db-1fb648fe7bda" /> <url value="https://fhir.nhs.uk/STU3/ValueSet/CareConnect-MedicationChangeStatus-1" /> <valueCode value="Amended" /> </extension> <extension> <id value="4095fcc9-c0ae-4f05-b5db-1fb648fe7bda" /> <url value="indicationForChange" /> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="294091000119104" /> <display value="Headache caused by drug (finding)" /> </coding> </valueCodeableConcept> </extension> <extension> <id value="4095fcc9-c0ae-4f05-b5db-1fb648fe7bda" /> <url value="dateChanged" /> <valueDateTime value="2022-02-23T14:07:48+00:00" /> </extension> <extension> <id value="4095fcc9-c0ae-4f05-b5db-1fb648fe7bda" /> <url value="detailsOfAmendment" /> <valueString value="Amended as patient reported side-effects of headaches" /> </extension> </extension>
extension(prescribingAgency)
Usage
Mandatory
Guidance
This details the care setting in which the medication or medical device was prescribed taken from the CareConnect Prescribing Agency ValueSet.
Currently this field will only support two coded entries, indicating whether the medication / medical device was prescribed by the GP practice or by another organisation. If the providing organisation has more details about the type of prescribing organisation (for example, that it was a dental practice or hospital), this MUST be included in the CodeableConcept.text
field.
In the future, the coded valueset will be built on to be more specific about where a medication / medical device was prescribed. For instance, if the patient was prescribed a medication by a hospital or bought a medication over the counter then this would be coded as well as in the text.
For repeat and repeat dispensed medications / medical devices, the value identifies the care setting where the medication plan (rather than any specific issue in the plan) was authorised.
Example
<extension> <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescribingAgency-1" /> <valueCodeableConcept> <system value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-PrescribingAgency-1" /> <coding value="prescribed-at-gp-practice"> <text value="Prescribed at GP practice" /> </valueCodeableConcept> </extension>
extension(dosageLastChanged)
Usage
Optional
Guidance
The extension.dosageLastChanged
does not need to be populated.
Example
<extension> <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1" /> <valueDateTime value="2022-10-28T10:57:00+00:00Z" /> </extension>
identifier
Usage
Mandatory
Guidance
The identifier
element MUST be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data). This MUST be scoped by a provider specific namespace for the identifier.
Where consuming systems are integrating data from this resource to their local system, they MUST also persist this identifier at the same time.
Example
<identifier> <system value="https://tools.ietf.org/html/rfc4122" /> <value value="653c0790-a509-4eed-99f3-f42f3683cf2e" /> </identifier>
basedOn
Usage
Required
Guidance
This element should normally be used to link to a MedicationRequest
which authorised the medication.
This element could also potentially reference all medication requests relating to the medication or relevant instances of CarePlan or ServiceRequest.
This should not be confused with MedicationStatement.derivedFrom
which should only be used to reference information that can’t be referenced here.
MedicationRequest
with intent
set to plan
.
Example
<basedOn> <reference value="medication-request-5485984" /> </basedOn>
partOf
Usage
Optional
Guidance
This should not be used as the use-case and purpose is ambiguous.
Example
<partOf> <reference value="medication-administration-07637tys" /> </partOf>
context
Usage
Required
Guidance
A reference (if known) to either a CareConnect:
Example
<context> <reference value="encounter-0012345" /> </context>
status
Usage
Mandatory
Guidance
MedicationStatement
after the Medication
.
It provides the consumer with information to determine if the medication is relevant for their use case.
For example: whether the medication deemed 'current' (or active
).
Status | FHIR Definition | Recommendation |
---|---|---|
active |
The medication is still being taken. | It is believed the medication is active in the patients system. |
completed |
The medication is no longer being taken. | A course of medication has been completed and the medication is not active in the patients system. |
entered-in-error |
The statement was recorded incorrectly. |
Indicates the MedicationStatement is INVALID. It is not expected that a MedicationStatement with this status to be included in exchanges.
|
intended |
The medication may be taken at some time in the future. |
It is intended that the medication will be given to the patient. When this is used effective[x] MUST indicate when it is intended that the medication to be taken.
|
stopped |
Actions implied by the statement have been permanently halted, before all of them occurred. |
Medication has been stopped before the completion of the prescribed course and there is no plan to restart it. When used the reason MUST be indicated in statusReason .
|
on-hold |
Actions implied by the statement have been temporarily halted, but are expected to continue later. May also be called "suspended". |
Medication has been temporarily stopped.
When used the reason MUST be indicated in statusReason .
Where it is known when it is indented to restart it this may be indicated in statusReason .
|
unknown |
Not implemented within STU3 | The patient may have had some encounter with this medication, but the current status is unknown. It is not expected that this status be avoided. |
not-taken |
Not implemented within STU3 | The patient has not taken the medication as prescribed. |
Statuses expanded
The status will need to be calculated if the basedOn
or partOf
elements within the profile are defined.
A MedicationStatement
represents a snapshot in time of a patient medication - and if the status has not been provided, then the following business rule may apply to compute the state.
Status | How it can be determined |
---|---|
active |
|
completed |
|
Example
<status value="active" />
category
Usage
Required
Guidance
A value taken from the UKCoreMedicationStatementCategory valueset
Example
<category> <system value="http://hl7.org/fhir/medication-statement-category" /> <code value ="inpatient" /> <display value="Inpatient" /> </category>
medication
Usage
Mandatory
Guidance
When the MedicationRequest
and MedicationDispense
are known
If the basedOn
(medication request) and partOf
(medication dispense) elements are known, and defined within the MedicationStatement
, then care should be taken as to how the medication[x]
element is populated.
If substitution
is allowed within the MedicationRequest
resource then the medicine dispensed may differ to the request. In this case, this element must reflect the dispensed medication in the MedicationDispense
resource.
Also note that the dosageInstruction
may differ from what was originally requested.
Even if substution
is not allowed, it may be prudent to check that medication requested is equal to what was dispensed.
When the MedicataionRequest
or MedicationDispsnese
are not known
The medication component should be constructed by the information provided from the source.
Example
<medication> <coding> <system value="http://snomed.info/sct" /> <code value="195967001" /> <display value="Penicillin" /> </coding> </medication>
effective[x]
Usage (Conditional)
Required
Guidance
The period the medication or medical device is authorised under this medication/medical device plan. For items that are repeats and repeat dispensed this refers to the entire cycle of prescriptions made under the authorisation. For acutes, this refers to the period of the prescription issue.
This element is especially required when the status
is intended
.
Either:
effectiveDateTime
a date time at which the medication started or should starteffectivePeriod
the period over which the patient has taken or should take the medication
The use of effectivePeriod
is to be preferred, and should start when the medication started in any preceding episode of care.
The date / time format allows various degrees of date resolution; year, year/month and exact date so an approximate date can be used when the exact date is not known.
This could be either backdated or future dated.
Examples
<effectiveDateTime value="2022-09-23T09:04:00Z" />
<effectivePeriod> <start value="2022-09-23T09:04:00Z" /> <end value="2022-09-30T23:59:59Z" /> </effectivePeriod>
dateAsserted
Usage
Mandatory
Guidance
This is the audit trail date/time for when the authorisation was entered onto the record.
Example
<dateAsserted value="2022-09-23T09:11:00Z" />
informationSource
Usage
Required
Guidance
Referencing an `Organization resource is likely to be more useful than a person, as a Practitioner resource, as people’s work patterns and employers may be variable while the care setting organisation will be constantly available.
When referencing an organisation - the following must be provided:
Oraganization.contact.name
Organization.contact.telecom
Organisation.identifier.odsOrganizationCode
orOrganization.identifier.odsSiteCode
Where the organisation is an Acute Trust, an ODS Site Code may be more useful than the parent Trust-wide ODS organisation code.
Example
<informationSource> <reference value="oraganization-1234" /> </informationSource>
subject
Usage
Mandatory
Guidance
A refernce to the patient that the medication statement relates to.
Profile: CareConnect-GPC-Patient-1
Example
<subject> <reference value="patient-7890" /> </subject>
derivedFrom
Usage
Optional
Guidance
A use-case for populating the derivedFrom
element within GP Connect has not been defined, as it is expected that the the basedOn
element will suffice.
derivedFrom
and baseOn
elements should be avoided as potentially confusing.
Example
<derivedFrom> <reference value="resource-any-11ks8f" /> </derivedFrom>
taken
Usage
Mandatory
Guidance
A mandatory element that needs to be supplied due to the cardinality if using STU3 / CareConnect.
It is expected that, in most cases, the administration of medication cannot be confirmed and will be the following code: unk
(Unknown) from the MedicationStatementTaken ValueSet.
Example
<taken value="unk" />
reasonNotTaken
Usage
Optional
Guidance
It's expected that in most cases that this value WILL NOT be populated. This is due to the information not necessarily being known in the GP system.
This element would typically be populated if the value in the taken
element is n
(Negative assertion that patient has not taken medication).
Example
<reasonNotTaken> <system value="http://snomed.info/sct" /> <value value="182864000" /> <display value="Drug not taken - side-effects" /> </reasonNotTaken>
reasonCode
Usage
Optional
Guidance
The indication(s) for the medicine as a CodableConcept More detail could be provided by the use or ReasonReference from the SNOMED-CT hierarchy as a descendant of the concept 404684003 | Clinical finding (finding) |.
Example
<reasonCode> <coding> <system value="http://snomed.info/sct" /> <code value="1685005" /> <display value="Rat bite fever" /> </coding> </reasonCode>
reasonReference
Usage
Optional
Guidance
Example
<reasonReference> <reference value="condition-85624" /> </reasonReference>
note
Usage
Required
Guidance
All notes that are associated with this medication / medical device record.
Example
<note> <author> <reference value="practitioner-00134" /> </author> <time value="2022-10-19T10:12:00Z" /> <text> First Issue | Prescriber notes: Lorem ipsum dolor sit amet, consectetur adipiscing... | Patient notes: Ut enim ad minim veniam, quis nostrud exercitation... </text> </note>
dosage
Usage
Mandatory
Guidance
Complete dosage instructions as text.
Where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan append the following warning text to end of the dosage instructions:
WARNING – Dosage has changed during the effective period. The latest change was made on DD-Mmm-YYYY
- where DD-Mmm-YYYY
is the date the dosage was last changed.
In exceptional cases where for legacy data there is no dosage recorded in the system then this MUST be populated with the text: No information available
.
The patientInstruction
elemement MAY provide additional instructions to the patient, this is, RHS of the prescription label.
GP Connect providers may uplift to the Information Standards Notice outlined above at different times so please account for both textual and structured representations.
See Medication and Medical Device interoperability for additional information.
Example
Legacy (free text):
<dosageInstruction> <text value="2 tablet - every 4 hours - up to a maximum of 6 dose in 24 hours - when migraine recurs" /> <patientInstruction value="when migraine recurs" /> </dosageInstruction>
Structured dose syntax:
<dosageInstruction> <text value="2 tablet - every 4 hours - up to a maximum of 6 dose in 24 hours - when migraine recurs" /> <patientInstruction value="when migraine recurs" /> <timing> <repeat> <frequency value="1" /> <period value="4" /> <periodUnit value="h" /> </repeat> </timing> <doseQuantity> <value value="2" /> <unit value="tablet" /> <system value="http://snomed.info/sct" /> <code value="428673006" /> </doseQuantity> <maxDosePerPeriod> <numerator> <value value="6" /> <unit value="dose" /> <system value="http://snomed.info/sct" /> <code value="3317411000001100" /> </numerator> <denominator> <value value="24" /> <unit value="hour" /> <system value="http://unitsofmeasure.org/" /> <code value="h" /> </denominator> </maxDosePerPeriod> </dosageInstruction>