<status value="active" /> <date value="2022-10-15T12:00:00+00:00" /> <publisher value="Ontario Health" /> <description value="This profile defines a set of constraints to the FHIR Medication resource for use in Ontario Patient Summaries (PS-ON). It refines constraints applied to the Medication resource by the PS-CA project to represent a medication in the patient summary. It is informed by the constraints of the [Medication-UV-IPS profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Medication-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-medication.html) to allow for cross-border and cross-jurisdiction sharing of Medication Summary information." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Medication" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Medication" /> <derivation value="constraint" /> <differential> <element id="Medication.meta"> <path value="Medication.meta" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Medication.meta.profile"> <path value="Medication.meta.profile" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Medication.extension:strength"> <path value="Medication.extension" /> <sliceName value="strength" /> <short value="Extension for representing overall medication strength." /> <definition value="The overall medication strength, rather than the strength of a specific ingredient ." /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description" /> </type> </element> <element id="Medication.extension:strength.url"> <path value="Medication.extension.url" /> <fixedUri value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description" /> </element> <element id="Medication.code"> <path value="Medication.code" /> <short value="Medication that was administered or was to be administered (medication code from any code system)" /> <definition value="Medication that was administered or was to be administered. IPS-UV Note: Several kinds of medication coding could be provided as: 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept; 2. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept; 3. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example: Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept; 4. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept 5. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept. 6. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package. 7. Any other kind of code that that identifies, classifies or cluster the administered product (e.g. the medicinal product or the product class) The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available." /> <min value="1" /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <example> <label value="DIN" /> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/NamingSystem/ca-hc-din" /> <code value="02247611" /> <display value="Acetaminophen 325mg (Jamieson Laboratories Ltd.)" /> </coding> <text value="ACETAMINOPHEN 325MG" /> </valueCodeableConcept> </example> <example> <label value="NPN" /> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/v3-hc-npn" /> <code value="80016551" /> <display value="Echinacea with Garlic and Ginger (Jamieson Laboratories Ltd.)" /> </coding> <text value="Echinacea with Garlic and Ginger" /> </valueCodeableConcept> </example> <example> <label value="CCDD" /> <valueCodeableConcept> <coding> <system value="https://fhir.infoway-inforoute.ca/CodeSystem/canadianclinicaldrugdataset" /> <code value="02240105" /> <display value="AVEENO ANTI-ITCH LOTION (calamine 3 % and pramoxine hydrochloride 1 % lotion) JOHNSON &amp; JOHNSON INC" /> </coding> <text value="Aveeno Anti-Itch Lotion" /> </valueCodeableConcept> </example> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="Canadian Clinical Drug Data Set codes" /> <valueSet value="http://ehealthontario.ca/fhir/ValueSet/canadianclinicaldrugdataset-CCDD" /> </binding> </element> <element id="Medication.code.coding"> <path value="Medication.code.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <description value="Discriminated by value set" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Medication.code.coding.display.extension:translation"> <path value="Medication.code.coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.code.coding.display.extension:translation.extension"> <path value="Medication.code.coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.code.coding:codeSCT"> <path value="Medication.code.coding" /> <sliceName value="codeSCT" /> <short value="Optional slice for representing SNOMED CT medications" /> <definition value="SNOMED CT medications (Pharmaceutical / biologic product)" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips" /> </binding> </element> <element id="Medication.code.coding:codeSCT.display.extension:translation"> <path value="Medication.code.coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.code.coding:codeSCT.display.extension:translation.extension"> <path value="Medication.code.coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.code.coding:codeCCDD"> <path value="Medication.code.coding" /> <sliceName value="codeCCDD" /> <short value="Slice for representing Canadian Clinical Drug Data Set codes" /> <definition value="Value set consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time." /> <mustSupport value="true" /> <binding> <strength value="required" /> <valueSet value="http://ehealthontario.ca/fhir/ValueSet/canadianclinicaldrugdataset-CCDD" /> </binding> </element> <element id="Medication.code.coding:codeCCDD.display.extension:translation"> <path value="Medication.code.coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.code.coding:codeCCDD.display.extension:translation.extension"> <path value="Medication.code.coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.code.coding:codeLNHP"> <path value="Medication.code.coding" /> <sliceName value="codeLNHP" /> <short value="Optional slice for representing NPN and DIN-HM codes in the Licensed Natural Health Products Database" /> <definition value="Value set consisting of all Natural Product Number (NPN) and Homepathic Medicine Number (DIN-HM) codes that are licensed by Health Canada and present in the Licensed Natural Health Products Database." /> <binding> <strength value="required" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/LicensedNaturalHealthProducts" /> </binding> </element> <element id="Medication.code.coding:codeLNHP.display.extension:translation"> <path value="Medication.code.coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.code.coding:codeLNHP.display.extension:translation.extension"> <path value="Medication.code.coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.form"> <path value="Medication.form" /> <definition value="Describes the form of the item. Powder; tablets; capsule. Administrable Pharmaceutical Dose Form. This code represents the form of the medication (e.g. tablet, capsule, liquid) Since the EDQM Standards Terms, together with UCUM, is one of the IDMP terminologies actually available for usage, this code system has been selected as reference terminology for representing Pharmaceutical Dose forms; Packages and Route of Administration. Alternative jurisdictional and international terminologies are known to be used for this concept domain, such as NCI or SNOMED CT." /> <comment value="Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element." /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="SCTCA Pharmaceutical Dose Form" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode" /> </binding> </element> <element id="Medication.form.coding"> <path value="Medication.form.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <description value="Discriminated by value set" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Medication.form.coding.display.extension:translation"> <path value="Medication.form.coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.form.coding.display.extension:translation.extension"> <path value="Medication.form.coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.form.coding:formSCTCA"> <path value="Medication.form.coding" /> <sliceName value="formSCTCA" /> <short value="Optional slice for representing SNOMED CT Canadian edition dose forms" /> <definition value="SNOMED CT Canadian edition dose forms" /> <binding> <strength value="required" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode" /> </binding> </element> <element id="Medication.form.coding:formSCTCA.display.extension:translation"> <path value="Medication.form.coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.form.coding:formSCTCA.display.extension:translation.extension"> <path value="Medication.form.coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.ingredient"> <path value="Medication.ingredient" /> <mustSupport value="true" /> </element> <element id="Medication.ingredient.item[x]"> <path value="Medication.ingredient.item[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept"> <path value="Medication.ingredient.item[x]" /> <sliceName value="itemCodeableConcept" /> <comment value="IPS UV Note: The IDMP ISO 11238 standard addresses the identification and exchange of regulated information on substances. \n The Global Ingredient Archival System (GInAS) will provide a common global identifier for all of the substances used in medicinal products, providing a definition of substances globally consistent with this standard.\n Those identifiers however are yet available for concrete usage, therefore in this version of the template, SNOMED CT has been chosen as reference terminology also for the active substances.\n This choice will be revised based on the availability and the maturity of GInAS." /> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="SNOMED CT CA drug substances" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/drugormedicamentsubstancecode" /> </binding> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding"> <path value="Medication.ingredient.item[x].coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <description value="Discriminated by value set" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding.display.extension:translation"> <path value="Medication.ingredient.item[x].coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding.display.extension:translation.extension"> <path value="Medication.ingredient.item[x].coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding:ingredientSCTCA"> <path value="Medication.ingredient.item[x].coding" /> <sliceName value="ingredientSCTCA" /> <short value="Optional slice for representing SNOMED CT Canadian edition drug active substances" /> <definition value="SNOMED CT Canadian edition drug active substances" /> <mustSupport value="true" /> <binding> <strength value="required" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/drugormedicamentsubstancecode" /> </binding> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding:ingredientSCTCA.display.extension:translation"> <path value="Medication.ingredient.item[x].coding.display.extension" /> <sliceName value="translation" /> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding:ingredientSCTCA.display.extension:translation.extension"> <path value="Medication.ingredient.item[x].coding.display.extension.extension" /> <min value="2" /> </element> <element id="Medication.ingredient.strength"> <path value="Medication.ingredient.strength" /> <type> <code value="Ratio" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-ratio" /> </type> <mustSupport value="true" /> </element> </differential> </StructureDefinition>