{
  "resourceType": "StructureDefinition",
  "id": "zib-MedicationUse",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse",
  "version": "2.2.11",
  "name": "Zib MedicationUse",
  "title": "HCIM MedicationUse",
  "status": "active",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "This profile is based on the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) MedicationUse version 1.0.1, year 2017.\r\n\r\nMedicationUse is a statement on the historic, current or intended use of a certain medicine.",
  "purpose": "The goal of the medication use is to provide insight into the patient’s pattern of use.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-medicationuse2-v1.0.1-2017EN",
      "uri": "https://zibs.nl/wiki/MedicationUse2-v1.0.1(2017EN)",
      "name": "HCIM MedicationUse2-v1.0.1(2017EN)"
    },
    {
      "identity": "hcim-timeinterval-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/TimeInterval-v1.0(2017EN)",
      "name": "HCIM TimeInterval-v1.0(2017EN)"
    },
    {
      "identity": "hcim-instructionsforuse-v1.1-2017EN",
      "uri": "https://zibs.nl/wiki/InstructionsForUse-v1.1(2017EN)",
      "name": "HCIM InstructionsForUse-v1.1(2017EN)"
    },
    {
      "identity": "hcim-basicelements-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/BasicElements-v1.0(2017EN)",
      "name": "HCIM BasicElements-v1.0(2017EN)"
    },
    {
      "identity": "Medication-Process-v09",
      "uri": "https://decor.nictiz.nl/medicatieproces/mp-html-20181220T121121/ds-2.16.840.1.113883.2.4.3.11.60.20.77.1.3-2016-06-01T000000.html",
      "name": "Medication Process v09",
      "comment": "Language of Medication Process is Dutch."
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "MedicationStatement",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "MedicationStatement",
        "path": "MedicationStatement",
        "short": "MedicationUse",
        "definition": "MedicationUse is a statement on the historic, current or intended use of a certain medicine.",
        "alias": [
          "Medicatiegebruik"
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.21338",
            "comment": "MedicationUse"
          }
        ]
      },
      {
        "id": "MedicationStatement.extension",
        "path": "MedicationStatement.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationStatement.extension:asAgreedIndicator",
        "path": "MedicationStatement.extension",
        "sliceName": "asAgreedIndicator",
        "short": "AsAgreedIndicator",
        "definition": "Is the medicine used as outlined in the medication agreement?",
        "alias": [
          "VolgensAfspraakIndicator"
        ],
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22492",
            "comment": "AsAgreedIndicator"
          }
        ]
      },
      {
        "id": "MedicationStatement.extension:asAgreedIndicator.valueBoolean:valueBoolean",
        "path": "MedicationStatement.extension.valueBoolean",
        "sliceName": "valueBoolean",
        "example": [
          {
            "label": "Example of asAgreed",
            "valueBoolean": true
          }
        ]
      },
      {
        "id": "MedicationStatement.extension:prescriber",
        "path": "MedicationStatement.extension",
        "sliceName": "prescriber",
        "short": "Prescriber",
        "definition": "The health professional that entered the medication agreement with the patient.",
        "comment": "The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.",
        "alias": [
          "Voorschrijver"
        ],
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.23290",
            "comment": "Prescriber"
          }
        ]
      },
      {
        "id": "MedicationStatement.extension:author",
        "path": "MedicationStatement.extension",
        "sliceName": "author",
        "short": "Author",
        "definition": "The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.",
        "comment": "The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.",
        "alias": [
          "Auteur"
        ],
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.7",
            "comment": "Author"
          }
        ]
      },
      {
        "id": "MedicationStatement.extension:medicationTreatment",
        "path": "MedicationStatement.extension",
        "sliceName": "medicationTreatment",
        "short": "Medical Treatment",
        "definition": "This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.",
        "comment": "No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.",
        "alias": [
          "Medicamenteuze Behandeling"
        ],
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment"
          }
        ],
        "mapping": [
          {
            "identity": "Medication-Process-v09",
            "map": "mp-dataelement900-22092",
            "comment": "Medicamenteuze behandeling"
          }
        ]
      },
      {
        "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse",
        "path": "MedicationStatement.extension",
        "sliceName": "reasonForChangeOrDiscontinuationOfUse",
        "short": "ReasonForChangeOrDiscontinuationOfUse",
        "definition": "Reason for changing or discontinuing use of medication.",
        "alias": [
          "RedenWijzigenOfStoppenGebruik",
          "Reden wijzigen of stoppen gebruik"
        ],
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
          }
        ]
      },
      {
        "id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.valueCodeableConcept:valueCodeableConcept",
        "path": "MedicationStatement.extension.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "example": [
          {
            "label": "Example of ReasonForChangeOrDiscontinuationOfUse",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://snomed.info/sct",
                  "code": "79899007",
                  "display": "Drug interaction (finding)"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible"
        },
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22493",
            "comment": "Reden wijzigen of stoppen gebruik"
          }
        ]
      },
      {
        "id": "MedicationStatement.modifierExtension",
        "path": "MedicationStatement.modifierExtension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule",
        "path": "MedicationStatement.modifierExtension",
        "sliceName": "repeatPeriodCyclicalSchedule",
        "label": "HerhaalperiodeCyclischSchema",
        "short": "RepeatPeriodCyclicalSchedule",
        "definition": "The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.\r\n\r\nExamples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days.\r\nRepeatPeriodCyclicalSchedule",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.22505",
            "comment": "RepeatPeriodCyclicalSchedule"
          }
        ]
      },
      {
        "id": "MedicationStatement.identifier",
        "path": "MedicationStatement.identifier",
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.6",
            "comment": "IdentificationNumber"
          }
        ]
      },
      {
        "id": "MedicationStatement.status",
        "path": "MedicationStatement.status",
        "short": "MedicationUseStopType",
        "comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.\r\n\r\nThis element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive).",
        "alias": [
          "MedicatieGebruikStopType"
        ],
        "binding": {
          "strength": "required",
          "description": "Allergy Intolerance critically Code list",
          "valueSetReference": {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
                "valueReference": {
                  "reference": "http://nictiz.nl/fhir/ConceptMap/MedicationUseStopTypeCodeLijst-to-MedicationStatementStatus",
                  "display": "MedicationUseStopTypeCodeLijst-to-MedicationStatementStatus"
                }
              }
            ],
            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-status"
          }
        },
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.23132",
            "comment": "MedicationUseStopType. A ConceptMap (http://nictiz.nl/fhir/ConceptMap/MedicationUseStopTypeCodeLijst-to-MedicationStatementStatus) is available that maps MedicationUseStopTypeCodeLijst to the MedicationStatementStatus value set."
          }
        ]
      },
      {
        "id": "MedicationStatement.category",
        "path": "MedicationStatement.category",
        "min": 1
      },
      {
        "id": "MedicationStatement.category.coding",
        "path": "MedicationStatement.category.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationStatement.category.coding:medicationUseCode",
        "path": "MedicationStatement.category.coding",
        "sliceName": "medicationUseCode",
        "short": "MedicationUseCode",
        "definition": "Category code used for indexing/retrieval of the HCIM MedicationUse. The system and code are stated in the Medication Process v09."
      },
      {
        "id": "MedicationStatement.category.coding:medicationUseCode.system",
        "path": "MedicationStatement.category.coding.system",
        "fixedUri": "urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3"
      },
      {
        "id": "MedicationStatement.category.coding:medicationUseCode.code",
        "path": "MedicationStatement.category.coding.code",
        "fixedCode": "6"
      },
      {
        "id": "MedicationStatement.medication[x]:medicationReference",
        "path": "MedicationStatement.medicationReference",
        "sliceName": "medicationReference",
        "short": "ProductUsed",
        "comment": "-",
        "alias": [
          "Gebruiksproduct"
        ],
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-Product"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.21339",
            "comment": "ProductUsed"
          }
        ]
      },
      {
        "id": "MedicationStatement.effective[x]:effectivePeriod",
        "path": "MedicationStatement.effectivePeriod",
        "sliceName": "effectivePeriod",
        "short": "PeriodOfUse",
        "definition": "Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.\r\n\r\nStart date: This is the time at which the agreement was to take effect (or took effect or will take effect). \r\n\r\nDuration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. \r\n\r\nEnd date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.",
        "alias": [
          "Gebruiksperiode"
        ],
        "type": [
          {
            "code": "Period"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22663",
            "comment": "PeriodOfUse"
          },
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.14",
            "comment": "DateTime"
          }
        ]
      },
      {
        "id": "MedicationStatement.effective[x]:effectivePeriod.extension",
        "path": "MedicationStatement.effectivePeriod.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration",
        "path": "MedicationStatement.effectivePeriod.extension",
        "sliceName": "Duration",
        "short": "Duration",
        "definition": "The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.",
        "alias": [
          "tijdsDuur"
        ],
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
          }
        ]
      },
      {
        "id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.valueDuration:valueDuration",
        "path": "MedicationStatement.effectivePeriod.extension.valueDuration",
        "sliceName": "valueDuration",
        "example": [
          {
            "label": "Example of Duration",
            "valueDuration": {
              "value": 3,
              "unit": "day",
              "system": "http://unitsofmeasure.org",
              "code": "d"
            }
          }
        ]
      },
      {
        "id": "MedicationStatement.effective[x]:effectivePeriod.start",
        "path": "MedicationStatement.effectivePeriod.start",
        "short": "StartDate",
        "definition": "This is the time at which the agreement was to take effect (or took effect or will take effect).",
        "alias": [
          "Ingangsdatum"
        ],
        "mapping": [
          {
            "identity": "hcim-timeinterval-v1.0-2017EN",
            "map": "NL-CM:20.3.2",
            "comment": "startDateTime"
          }
        ]
      },
      {
        "id": "MedicationStatement.effective[x]:effectivePeriod.end",
        "path": "MedicationStatement.effectivePeriod.end",
        "short": "EndDate",
        "definition": "The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.",
        "alias": [
          "Einddatum"
        ],
        "mapping": [
          {
            "identity": "hcim-timeinterval-v1.0-2017EN",
            "map": "NL-CM:20.3.3",
            "comment": "endDateTime"
          }
        ]
      },
      {
        "id": "MedicationStatement.dateAsserted",
        "path": "MedicationStatement.dateAsserted",
        "short": "MedicationUseDateTime",
        "definition": "Date on which this use is entered.",
        "alias": [
          "Registratiedatum"
        ],
        "min": 1,
        "example": [
          {
            "label": "Example of MedicationUseDateTime",
            "valueDateTime": "2017-06-14"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22398",
            "comment": "MedicationUseDateTime"
          }
        ]
      },
      {
        "id": "MedicationStatement.informationSource",
        "path": "MedicationStatement.informationSource",
        "comment": "If a health professional is the informationSource the PractitionerRole reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient"
          },
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner"
          },
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson"
          },
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-organization"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.2",
            "comment": "InformationSource"
          }
        ]
      },
      {
        "id": "MedicationStatement.informationSource.extension",
        "path": "MedicationStatement.informationSource.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationStatement.informationSource.extension:practitionerRole",
        "path": "MedicationStatement.informationSource.extension",
        "sliceName": "practitionerRole",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference"
          }
        ]
      },
      {
        "id": "MedicationStatement.subject",
        "path": "MedicationStatement.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.11",
            "comment": "Subject"
          }
        ]
      },
      {
        "id": "MedicationStatement.taken",
        "path": "MedicationStatement.taken",
        "short": "UseIndicator",
        "definition": "Is this medicine used or not?",
        "alias": [
          "GebruikIndicator"
        ],
        "example": [
          {
            "label": "Example of taken",
            "valueCode": "y"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22399",
            "comment": "UseIndicator"
          }
        ]
      },
      {
        "id": "MedicationStatement.reasonCode.text",
        "path": "MedicationStatement.reasonCode.text",
        "short": "ReasonForUse",
        "definition": "The reason for using the medication, particularly in self-care medicine purchased by the patient themselves.",
        "alias": [
          "RedenGebruik"
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22491",
            "comment": "ReasonForUse"
          }
        ]
      },
      {
        "id": "MedicationStatement.note",
        "path": "MedicationStatement.note",
        "short": "Comment",
        "definition": "Comments on the medication use.",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.21624",
            "comment": "Comment"
          }
        ]
      },
      {
        "id": "MedicationStatement.dosage",
        "path": "MedicationStatement.dosage",
        "type": [
          {
            "code": "Dosage",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-medicationuse2-v1.0.1-2017EN",
            "map": "NL-CM:9.11.22504",
            "comment": "InstructionsForUse"
          }
        ]
      }
    ]
  }
}