This MedicationStatement Resource is a record of a medication that is being consumed by a patient.
CareConnect-MedicationStatement-1 (MedicationStatement) | I | MedicationStatement | There are no (further) constraints on this element Element idMedicationStatement Record of medication being taken by a patient DefinitionA 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. 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.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationStatement.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. |
implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. |
language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible) | |
text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationStatement.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationStatement.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | 0..* | Extension | Element idMedicationStatement.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Mappings
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lastIssueDate | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:lastIssueDate The date a prescription was last issued Alternate namesextensions, user content DefinitionThe date a prescription was last issued. 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.
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changeSummary | I | 0..1 | Extension(Complex) | Element idMedicationStatement.extension:changeSummary Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationChangeSummary-1 Constraints
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dosageLastChanged | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:dosageLastChanged The date when the dosage instructions were last changed Alternate namesextensions, user content DefinitionOnly 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. 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. https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1 Constraints
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prescribingAgency | I | 0..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:prescribingAgency The type of organisation/setting responsible for authorising and issuing a medication outside of the organisation/setting delivering the patient care Alternate namesextensions, user content DefinitionThe type of organisation/setting responsible for authorising and issuing a medication outside of the organisation/setting delivering the patient care. 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. https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationPrescribingAgency-1 Constraints
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modifierExtension | ?! | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationStatement.identifier External identifier DefinitionExternal 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. 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. Identifies the purpose for this identifier, if known . IdentifierUse (required)Mappings
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Mappings
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idMedicationStatement.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference(CareConnect-Organization-1) | Element idMedicationStatement.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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. Reference(CareConnect-Organization-1) Mappings
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basedOn | Σ | 0..* | Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) | Element idMedicationStatement.basedOn Fulfils plan, proposal or order DefinitionA plan, proposal or order that is fulfilled in whole or in part by this event. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) Mappings
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partOf | Σ | 0..* | Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) | Element idMedicationStatement.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. 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. Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) Mappings
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context | Σ | 0..1 | Reference(EpisodeOfCare | CareConnect-Encounter-1) | Element idMedicationStatement.context Encounter / Episode associated with MedicationStatement DefinitionThe encounter or episode of care that establishes the context for this MedicationStatement. Reference(EpisodeOfCare | CareConnect-Encounter-1) Mappings
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.status active | completed | entered-in-error | intended | stopped | on-hold DefinitionA 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. 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. A coded concept indicating the current status of a MedicationStatement. MedicationStatementStatus (required)Mappings
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category | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.category Type of medication usage DefinitionIndicates where type of medication statement and where the medication is expected to be consumed or administered. A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered MedicationStatementCategory (preferred)Mappings
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medication[x] | Σ | 1..1 | Element idMedicationStatement.medication[x] What medication was taken DefinitionIdentifies 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. 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. . A coded concept identifying the substance or product being taken. SNOMED CT Medication Codes (example)Mappings
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medicationCodeableConcept | CodeableConcept | Data type | ||
medicationReference | Reference(CareConnect-Medication-1) | Data type | ||
effective[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.effective[x] The date/time or interval when the medication was taken DefinitionThe 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). 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.
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effectiveDateTime | dateTime | There are no (further) constraints on this element Data type | ||
effectivePeriod | Period | There are no (further) constraints on this element Data type | ||
dateAsserted | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.dateAsserted When the statement was asserted? DefinitionThe date when the medication statement was asserted by the information source.
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informationSource | 0..1 | Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) | Element idMedicationStatement.informationSource Person or organization that provided the information about the taking of this medication DefinitionThe 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. Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) Mappings
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subject | Σ | 1..1 | Reference(Group | CareConnect-Patient-1) | Element idMedicationStatement.subject Who is/was taking the medication DefinitionThe person, animal or group who is/was taking the medication. Reference(Group | CareConnect-Patient-1) Mappings
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derivedFrom | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationStatement.derivedFrom Additional supporting information DefinitionAllows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. 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.
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taken | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.taken y | n | unk | na DefinitionIndicator of the certainty of whether the medication was taken by the patient. This element is labeled as a modifier because it indicates that the medication was not taken. A coded concept identifying level of certainty if patient has taken or has not taken the medication MedicationStatementTaken (required)Mappings
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reasonNotTaken | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonNotTaken True if asserting medication was not given DefinitionA code indicating why the medication was not taken. A coded concept indicating the reason why the medication was not taken SNOMED CT Drugs not taken/completed Codes (example)Mappings
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonCode Reason for why the medication is being/was taken DefinitionA reason for why the medication is being/was taken. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. A coded concept identifying why the medication is being taken. Condition/Problem/Diagnosis Codes (example)Mappings
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reasonReference | 0..* | Reference(CareConnect-Observation-1 | CareConnect-Condition-1) | Element idMedicationStatement.reasonReference Condition or observation that supports why the medication is being/was taken DefinitionCondition or observation that supports why the medication is being/was taken. 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. Reference(CareConnect-Observation-1 | CareConnect-Condition-1) Mappings
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note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationStatement.note Further information about the statement DefinitionProvides extra information about the medication statement that is not conveyed by the other attributes.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.note.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.note.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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author[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation.
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authorString | string | Data type | ||
authorReference | Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1) | Data type Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1) | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.note.text The annotation - text content DefinitionThe text of the annotation.
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dosage | 0..* | Dosage | There are no (further) constraints on this element Element idMedicationStatement.dosage Details of how medication is/was taken or should be taken DefinitionIndicates how the medication is/was or should be taken by the patient. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.dosage.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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sequence | Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationStatement.dosage.sequence The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. 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.
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additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.additionalInstruction Supplemental instruction - e.g. "with meals" DefinitionSupplemental instruction - e.g. "with meals". Additional instruction such as "Swallow with plenty of water" which may or may not be coded. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMED CT Additional Dosage Instructions (example)Mappings
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.patientInstruction Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer.
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timing | Σ | 0..1 | Timing | There are no (further) constraints on this element Element idMedicationStatement.dosage.timing When medication should be administered DefinitionWhen medication should be administered. 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. 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.
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asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.asNeeded[x] Take "as needed" (for x) DefinitionIndicates 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). 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". 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. SNOMED CT Medication As Needed Reason Codes (example)Mappings
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asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
site | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.site Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example)Mappings
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route | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.route How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes (example)Mappings
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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coding | Σ | 0..* | Coding | Element idMedicationStatement.dosage.route.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by system(Value) Mappings
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snomedCT | Σ | 0..1 | Coding | Element idMedicationStatement.dosage.route.coding:snomedCT Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. Care Connect Medication Dosage Route (example)Mappings
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | Element idMedicationStatement.dosage.route.coding:snomedCT.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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snomedCTDescriptionID | I | 0..1 | Extension(Complex) | Element idMedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID The SNOMED CT Description ID for the display Alternate namesextensions, user content DefinitionThe SNOMED CT Description ID for the display. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedicationStatement.dosage.route.coding:snomedCT.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system.
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.method Technique for administering medication DefinitionTechnique for administering medication. 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example)Mappings
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dose[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | There are no (further) constraints on this element Data type | ||
doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
maxDosePerPeriod | Σ | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerPeriod Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. 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".
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maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerAdministration Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
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rate[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateRange | Range | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type |
CareConnect-MedicationStatement-1 (MedicationStatement) | I | MedicationStatement | There are no (further) constraints on this element Element idMedicationStatement Record of medication being taken by a patient DefinitionA 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. 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.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationStatement.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. |
implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. |
language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible) | |
text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationStatement.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationStatement.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | 0..* | Extension | Element idMedicationStatement.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Mappings
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lastIssueDate | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:lastIssueDate The date a prescription was last issued Alternate namesextensions, user content DefinitionThe date a prescription was last issued. 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.
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changeSummary | I | 0..1 | Extension(Complex) | Element idMedicationStatement.extension:changeSummary Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationChangeSummary-1 Constraints
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dosageLastChanged | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:dosageLastChanged The date when the dosage instructions were last changed Alternate namesextensions, user content DefinitionOnly 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. 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. https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1 Constraints
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prescribingAgency | I | 0..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:prescribingAgency The type of organisation/setting responsible for authorising and issuing a medication outside of the organisation/setting delivering the patient care Alternate namesextensions, user content DefinitionThe type of organisation/setting responsible for authorising and issuing a medication outside of the organisation/setting delivering the patient care. 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. https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationPrescribingAgency-1 Constraints
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modifierExtension | ?! | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationStatement.identifier External identifier DefinitionExternal 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. 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. Identifies the purpose for this identifier, if known . IdentifierUse (required)Mappings
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Mappings
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idMedicationStatement.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference(CareConnect-Organization-1) | Element idMedicationStatement.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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. Reference(CareConnect-Organization-1) Mappings
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basedOn | Σ | 0..* | Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) | Element idMedicationStatement.basedOn Fulfils plan, proposal or order DefinitionA plan, proposal or order that is fulfilled in whole or in part by this event. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) Mappings
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partOf | Σ | 0..* | Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) | Element idMedicationStatement.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. 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. Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) Mappings
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context | Σ | 0..1 | Reference(EpisodeOfCare | CareConnect-Encounter-1) | Element idMedicationStatement.context Encounter / Episode associated with MedicationStatement DefinitionThe encounter or episode of care that establishes the context for this MedicationStatement. Reference(EpisodeOfCare | CareConnect-Encounter-1) Mappings
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.status active | completed | entered-in-error | intended | stopped | on-hold DefinitionA 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. 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. A coded concept indicating the current status of a MedicationStatement. MedicationStatementStatus (required)Mappings
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category | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.category Type of medication usage DefinitionIndicates where type of medication statement and where the medication is expected to be consumed or administered. A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered MedicationStatementCategory (preferred)Mappings
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medication[x] | Σ | 1..1 | Element idMedicationStatement.medication[x] What medication was taken DefinitionIdentifies 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. 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. . A coded concept identifying the substance or product being taken. SNOMED CT Medication Codes (example)Mappings
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medicationCodeableConcept | CodeableConcept | Data type | ||
medicationReference | Reference(CareConnect-Medication-1) | Data type | ||
effective[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.effective[x] The date/time or interval when the medication was taken DefinitionThe 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). 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.
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effectiveDateTime | dateTime | There are no (further) constraints on this element Data type | ||
effectivePeriod | Period | There are no (further) constraints on this element Data type | ||
dateAsserted | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.dateAsserted When the statement was asserted? DefinitionThe date when the medication statement was asserted by the information source.
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informationSource | 0..1 | Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) | Element idMedicationStatement.informationSource Person or organization that provided the information about the taking of this medication DefinitionThe 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. Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) Mappings
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subject | Σ | 1..1 | Reference(Group | CareConnect-Patient-1) | Element idMedicationStatement.subject Who is/was taking the medication DefinitionThe person, animal or group who is/was taking the medication. Reference(Group | CareConnect-Patient-1) Mappings
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derivedFrom | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationStatement.derivedFrom Additional supporting information DefinitionAllows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. 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.
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taken | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.taken y | n | unk | na DefinitionIndicator of the certainty of whether the medication was taken by the patient. This element is labeled as a modifier because it indicates that the medication was not taken. A coded concept identifying level of certainty if patient has taken or has not taken the medication MedicationStatementTaken (required)Mappings
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reasonNotTaken | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonNotTaken True if asserting medication was not given DefinitionA code indicating why the medication was not taken. A coded concept indicating the reason why the medication was not taken SNOMED CT Drugs not taken/completed Codes (example)Mappings
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonCode Reason for why the medication is being/was taken DefinitionA reason for why the medication is being/was taken. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. A coded concept identifying why the medication is being taken. Condition/Problem/Diagnosis Codes (example)Mappings
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reasonReference | 0..* | Reference(CareConnect-Observation-1 | CareConnect-Condition-1) | Element idMedicationStatement.reasonReference Condition or observation that supports why the medication is being/was taken DefinitionCondition or observation that supports why the medication is being/was taken. 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. Reference(CareConnect-Observation-1 | CareConnect-Condition-1) Mappings
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note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationStatement.note Further information about the statement DefinitionProvides extra information about the medication statement that is not conveyed by the other attributes.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.note.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.note.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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author[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation.
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authorString | string | Data type | ||
authorReference | Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1) | Data type Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1) | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.note.text The annotation - text content DefinitionThe text of the annotation.
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dosage | 0..* | Dosage | There are no (further) constraints on this element Element idMedicationStatement.dosage Details of how medication is/was taken or should be taken DefinitionIndicates how the medication is/was or should be taken by the patient. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.dosage.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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sequence | Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationStatement.dosage.sequence The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. 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.
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additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.additionalInstruction Supplemental instruction - e.g. "with meals" DefinitionSupplemental instruction - e.g. "with meals". Additional instruction such as "Swallow with plenty of water" which may or may not be coded. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMED CT Additional Dosage Instructions (example)Mappings
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.patientInstruction Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer.
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timing | Σ | 0..1 | Timing | There are no (further) constraints on this element Element idMedicationStatement.dosage.timing When medication should be administered DefinitionWhen medication should be administered. 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. 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.
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asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.asNeeded[x] Take "as needed" (for x) DefinitionIndicates 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). 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". 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. SNOMED CT Medication As Needed Reason Codes (example)Mappings
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asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
site | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.site Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example)Mappings
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route | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.route How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes (example)Mappings
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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coding | Σ | 0..* | Coding | Element idMedicationStatement.dosage.route.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by system(Value) Mappings
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snomedCT | Σ | 0..1 | Coding | Element idMedicationStatement.dosage.route.coding:snomedCT Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. Care Connect Medication Dosage Route (example)Mappings
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | Element idMedicationStatement.dosage.route.coding:snomedCT.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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snomedCTDescriptionID | I | 0..1 | Extension(Complex) | Element idMedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID The SNOMED CT Description ID for the display Alternate namesextensions, user content DefinitionThe SNOMED CT Description ID for the display. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedicationStatement.dosage.route.coding:snomedCT.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system.
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.method Technique for administering medication DefinitionTechnique for administering medication. 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example)Mappings
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dose[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | There are no (further) constraints on this element Data type | ||
doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
maxDosePerPeriod | Σ | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerPeriod Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. 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".
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maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerAdministration Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
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rate[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateRange | Range | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type |
CareConnect-MedicationStatement-1 (MedicationStatement) | I | MedicationStatement | There are no (further) constraints on this element Element idMedicationStatement Record of medication being taken by a patient DefinitionA 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. 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.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationStatement.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationStatement.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. |
implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. |
language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible) | |
text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationStatement.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationStatement.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | 0..* | Extension | Element idMedicationStatement.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Mappings
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lastIssueDate | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:lastIssueDate The date a prescription was last issued Alternate namesextensions, user content DefinitionThe date a prescription was last issued. 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.
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changeSummary | I | 0..1 | Extension(Complex) | Element idMedicationStatement.extension:changeSummary Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationChangeSummary-1 Constraints
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dosageLastChanged | I | 0..1 | Extension(dateTime) | Element idMedicationStatement.extension:dosageLastChanged The date when the dosage instructions were last changed Alternate namesextensions, user content DefinitionOnly 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. 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. https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationDosageLastChanged-1 Constraints
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prescribingAgency | I | 0..1 | Extension(CodeableConcept) | Element idMedicationStatement.extension:prescribingAgency The type of organisation/setting responsible for authorising and issuing a medication outside of the organisation/setting delivering the patient care Alternate namesextensions, user content DefinitionThe type of organisation/setting responsible for authorising and issuing a medication outside of the organisation/setting delivering the patient care. 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. https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationPrescribingAgency-1 Constraints
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modifierExtension | ?! | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationStatement.identifier External identifier DefinitionExternal 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. 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. Identifies the purpose for this identifier, if known . IdentifierUse (required)Mappings
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Mappings
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idMedicationStatement.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idMedicationStatement.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference(CareConnect-Organization-1) | Element idMedicationStatement.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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. Reference(CareConnect-Organization-1) Mappings
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basedOn | Σ | 0..* | Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) | Element idMedicationStatement.basedOn Fulfils plan, proposal or order DefinitionA plan, proposal or order that is fulfilled in whole or in part by this event. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) Mappings
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partOf | Σ | 0..* | Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) | Element idMedicationStatement.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. 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. Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) Mappings
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context | Σ | 0..1 | Reference(EpisodeOfCare | CareConnect-Encounter-1) | Element idMedicationStatement.context Encounter / Episode associated with MedicationStatement DefinitionThe encounter or episode of care that establishes the context for this MedicationStatement. Reference(EpisodeOfCare | CareConnect-Encounter-1) Mappings
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.status active | completed | entered-in-error | intended | stopped | on-hold DefinitionA 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. 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. A coded concept indicating the current status of a MedicationStatement. MedicationStatementStatus (required)Mappings
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category | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationStatement.category Type of medication usage DefinitionIndicates where type of medication statement and where the medication is expected to be consumed or administered. A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered MedicationStatementCategory (preferred)Mappings
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medication[x] | Σ | 1..1 | Element idMedicationStatement.medication[x] What medication was taken DefinitionIdentifies 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. 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. . A coded concept identifying the substance or product being taken. SNOMED CT Medication Codes (example)Mappings
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medicationCodeableConcept | CodeableConcept | Data type | ||
medicationReference | Reference(CareConnect-Medication-1) | Data type | ||
effective[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.effective[x] The date/time or interval when the medication was taken DefinitionThe 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). 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.
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effectiveDateTime | dateTime | There are no (further) constraints on this element Data type | ||
effectivePeriod | Period | There are no (further) constraints on this element Data type | ||
dateAsserted | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.dateAsserted When the statement was asserted? DefinitionThe date when the medication statement was asserted by the information source.
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informationSource | 0..1 | Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) | Element idMedicationStatement.informationSource Person or organization that provided the information about the taking of this medication DefinitionThe 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. Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) Mappings
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subject | Σ | 1..1 | Reference(Group | CareConnect-Patient-1) | Element idMedicationStatement.subject Who is/was taking the medication DefinitionThe person, animal or group who is/was taking the medication. Reference(Group | CareConnect-Patient-1) Mappings
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derivedFrom | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationStatement.derivedFrom Additional supporting information DefinitionAllows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. 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.
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taken | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationStatement.taken y | n | unk | na DefinitionIndicator of the certainty of whether the medication was taken by the patient. This element is labeled as a modifier because it indicates that the medication was not taken. A coded concept identifying level of certainty if patient has taken or has not taken the medication MedicationStatementTaken (required)Mappings
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reasonNotTaken | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonNotTaken True if asserting medication was not given DefinitionA code indicating why the medication was not taken. A coded concept indicating the reason why the medication was not taken SNOMED CT Drugs not taken/completed Codes (example)Mappings
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.reasonCode Reason for why the medication is being/was taken DefinitionA reason for why the medication is being/was taken. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. A coded concept identifying why the medication is being taken. Condition/Problem/Diagnosis Codes (example)Mappings
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reasonReference | 0..* | Reference(CareConnect-Observation-1 | CareConnect-Condition-1) | Element idMedicationStatement.reasonReference Condition or observation that supports why the medication is being/was taken DefinitionCondition or observation that supports why the medication is being/was taken. 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. Reference(CareConnect-Observation-1 | CareConnect-Condition-1) Mappings
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note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationStatement.note Further information about the statement DefinitionProvides extra information about the medication statement that is not conveyed by the other attributes.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.note.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.note.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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author[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation.
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authorString | string | Data type | ||
authorReference | Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1) | Data type Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1) | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationStatement.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.note.text The annotation - text content DefinitionThe text of the annotation.
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dosage | 0..* | Dosage | There are no (further) constraints on this element Element idMedicationStatement.dosage Details of how medication is/was taken or should be taken DefinitionIndicates how the medication is/was or should be taken by the patient. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.dosage.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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sequence | Σ | 0..1 | integer | There are no (further) constraints on this element Element idMedicationStatement.dosage.sequence The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. 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.
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additionalInstruction | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.additionalInstruction Supplemental instruction - e.g. "with meals" DefinitionSupplemental instruction - e.g. "with meals". Additional instruction such as "Swallow with plenty of water" which may or may not be coded. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMED CT Additional Dosage Instructions (example)Mappings
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.patientInstruction Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer.
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timing | Σ | 0..1 | Timing | There are no (further) constraints on this element Element idMedicationStatement.dosage.timing When medication should be administered DefinitionWhen medication should be administered. 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. 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.
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asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.asNeeded[x] Take "as needed" (for x) DefinitionIndicates 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). 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". 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. SNOMED CT Medication As Needed Reason Codes (example)Mappings
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asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
site | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.site Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example)Mappings
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route | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.route How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes (example)Mappings
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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coding | Σ | 0..* | Coding | Element idMedicationStatement.dosage.route.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by system(Value) Mappings
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snomedCT | Σ | 0..1 | Coding | Element idMedicationStatement.dosage.route.coding:snomedCT Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. Care Connect Medication Dosage Route (example)Mappings
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | 0..* | Extension | Element idMedicationStatement.dosage.route.coding:snomedCT.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings
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snomedCTDescriptionID | I | 0..1 | Extension(Complex) | Element idMedicationStatement.dosage.route.coding:snomedCT.extension:snomedCTDescriptionID The SNOMED CT Description ID for the display Alternate namesextensions, user content DefinitionThe SNOMED CT Description ID for the display. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints
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system | Σ | 1..1 | uriFixed Value | Element idMedicationStatement.dosage.route.coding:snomedCT.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system.
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display | Σ | 1..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.coding:snomedCT.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationStatement.dosage.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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method | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationStatement.dosage.method Technique for administering medication DefinitionTechnique for administering medication. 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example)Mappings
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dose[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | There are no (further) constraints on this element Data type | ||
doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
maxDosePerPeriod | Σ | 0..1 | Ratio | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerPeriod Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. 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".
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maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerAdministration Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationStatement.dosage.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
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rate[x] | Σ | 0..1 | There are no (further) constraints on this element Element idMedicationStatement.dosage.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateRange | Range | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type |
MedicationStatement | .. | |
MedicationStatement.extension | 0.. | |
MedicationStatement.extension | Extension | 0..1 |
MedicationStatement.extension | Extension | 0.. |
MedicationStatement.extension | Extension | 0..1 |
MedicationStatement.extension | Extension | 0.. |
MedicationStatement.identifier | .. | |
MedicationStatement.identifier.system | 1.. | |
MedicationStatement.identifier.value | 1.. | |
MedicationStatement.identifier.assigner | Reference(CareConnect-Organization-1) | .. |
MedicationStatement.basedOn | Reference(CarePlan | ProcedureRequest | ReferralRequest | CareConnect-MedicationRequest-1) | .. |
MedicationStatement.partOf | Reference(MedicationAdministration | CareConnect-Procedure-1 | CareConnect-Observation-1 | CareConnect-MedicationStatement-1 | CareConnect-MedicationDispense-1) | .. |
MedicationStatement.context | Reference(EpisodeOfCare | CareConnect-Encounter-1) | .. |
MedicationStatement.medication[x] | Reference(CareConnect-Medication-1), CodeableConcept | .. |
MedicationStatement.informationSource | Reference(RelatedPerson | CareConnect-Organization-1 | CareConnect-Patient-1 | CareConnect-Practitioner-1) | .. |
MedicationStatement.subject | Reference(Group | CareConnect-Patient-1) | .. |
MedicationStatement.reasonReference | Reference(CareConnect-Observation-1 | CareConnect-Condition-1) | .. |
MedicationStatement.note | .. | |
MedicationStatement.note.author[x] | Reference(RelatedPerson | CareConnect-Patient-1 | CareConnect-Practitioner-1), string | .. |
MedicationStatement.dosage | .. | |
MedicationStatement.dosage.route | .. | |
MedicationStatement.dosage.route.coding | .. | |
MedicationStatement.dosage.route.coding | ..1 | |
MedicationStatement.dosage.route.coding.extension | 0.. | |
MedicationStatement.dosage.route.coding.extension | Extension | 0.. |
MedicationStatement.dosage.route.coding.system | 1.. | |
MedicationStatement.dosage.route.coding.code | 1.. | |
MedicationStatement.dosage.route.coding.display | 1.. |
There is no specific guidance for this profile.