{ "resourceType": "StructureDefinition", "id": "GPPFS-MedicationStatement", "url": "https://fhir.hl7.org.uk/StructureDefinition/GPPFS-MedicationStatement", "version": "2.1.0", "name": "GPPFS-MedicationStatement", "title": "GPPFS-MedicationStatement", "status": "active", "date": "2021-09-10", "publisher": "HL7 UK", "contact": [ { "name": "HL7 UK", "telecom": [ { "system": "email", "value": "secretariat@hl7.org.uk", "use": "work", "rank": 1 } ] }, { "name": "NHS Digital", "telecom": [ { "system": "email", "value": "interoperabilityteam@nhs.net", "use": "work", "rank": 2 } ] } ], "description": "Defines the UK Core constraints and extensions on the MedicationStatement resource for the minimal set of data to query and retrieve medication statement information.", "purpose": "This profile allows exchange of a record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the individual 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 individual, significant other (such as a family member or spouse), or a clinician.", "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.", "fhirVersion": "4.0.1", "mapping": [ { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" } ], "kind": "resource", "abstract": false, "type": "MedicationStatement", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement", "derivation": "constraint", "differential": { "element": [ { "id": "MedicationStatement.extension", "path": "MedicationStatement.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "MedicationStatement.extension:medicationCourseOfTherapyType", "path": "MedicationStatement.extension", "sliceName": "medicationCourseOfTherapyType", "short": "A course of therapy for a medication request", "definition": "The description of the course of therapy for a medication request.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "https://example.org/fhir/StructureDefinition/Extension-UKCore-CourseOfTherapyType" ] } ], "isModifier": false, "binding": { "strength": "extensible", "description": "Identifies the overall pattern of medication administration.", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationRequestCourseOfTherapy" } }, { "id": "MedicationStatement.reasonReference", "path": "MedicationStatement.reasonReference", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Condition", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" ] } ] }, { "id": "MedicationStatement.extension:pharmacistVerifiedIndicator", "path": "MedicationStatement.extension", "sliceName": "pharmacistVerifiedIndicator", "short": "Indicates whether a pharmacist verified a medication", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PharmacistVerifiedIndicator" ] } ] }, { "id": "MedicationStatement.extension:medicationPrescribingOrganization", "path": "MedicationStatement.extension", "sliceName": "medicationPrescribingOrganization", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationPrescribingOrganization" ] } ] }, { "id": "MedicationStatement.extension:medicationStatementLastIssueDate", "path": "MedicationStatement.extension", "sliceName": "medicationStatementLastIssueDate", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationStatementLastIssueDate" ] } ] }, { "id": "MedicationStatement.identifier.system", "path": "MedicationStatement.identifier.system", "min": 1 }, { "id": "MedicationStatement.identifier.value", "path": "MedicationStatement.identifier.value", "min": 1 }, { "id": "MedicationStatement.identifier.assigner", "path": "MedicationStatement.identifier.assigner", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" ] } ] }, { "id": "MedicationStatement.basedOn", "path": "MedicationStatement.basedOn", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest" ] } ] }, { "id": "MedicationStatement.basedOn.identifier.assigner", "path": "MedicationStatement.basedOn.identifier.assigner", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" ] } ] }, { "id": "MedicationStatement.partOf", "path": "MedicationStatement.partOf", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration" ] } ] }, { "id": "MedicationStatement.partOf.identifier.assigner", "path": "MedicationStatement.partOf.identifier.assigner", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" ] } ] }, { "id": "MedicationStatement.status", "path": "MedicationStatement.status", "short": "active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken", "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.", "comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\\n\\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.", "min": 1, "max": "1", "base": { "path": "MedicationStatement.status", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementStatus" } ], "strength": "required", "description": "A coded concept indicating the current status of a MedicationStatement.", "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1" }, "mapping": [ { "identity": "workflow", "map": "Event.status" }, { "identity": "w5", "map": "FiveWs.status" }, { "identity": "rim", "map": ".statusCode" } ] }, { "id": "MedicationStatement.statusReason", "path": "MedicationStatement.statusReason", "short": "Reason for current status", "definition": "Captures the reason for the current state of the MedicationStatement.", "comment": "This is generally only used for \"exception\" statuses such as \"not-taken\", \"on-hold\", \"cancelled\" or \"entered-in-error\". The reason for performing the event at all is captured in reasonCode, not here.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.statusReason", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementStatusReason" } ], "strength": "example", "description": "A coded concept indicating the reason for the status of the statement.", "valueSet": "http://hl7.org/fhir/ValueSet/reason-medication-status-codes" }, "mapping": [ { "identity": "workflow", "map": "Event.statusReason" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" } ] }, { "id": "MedicationStatement.category", "path": "MedicationStatement.category", "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationStatementCategory" } }, { "id": "MedicationStatement.medication[x]", "path": "MedicationStatement.medication[x]", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" ] } ], "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode" } }, { "id": "MedicationStatement.subject", "path": "MedicationStatement.subject", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Group", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" ] } ] }, { "id": "MedicationStatement.subject.identifier.assigner", "path": "MedicationStatement.subject.identifier.assigner", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" ] } ] }, { "id": "MedicationStatement.context", "path": "MedicationStatement.context", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-EpisodeOfCare", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" ] } ] }, { "id": "MedicationStatement.effective[x]", "path": "MedicationStatement.effective[x]", "short": "The date/time or interval when the medication is/was/will be taken", "definition": "The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).", "comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.effective[x]", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" }, { "code": "Period" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.occurrence[x]" }, { "identity": "w5", "map": "FiveWs.done[x]" }, { "identity": "rim", "map": ".effectiveTime" } ] }, { "id": "MedicationStatement.dateAsserted", "path": "MedicationStatement.dateAsserted", "short": "When the statement was asserted?", "definition": "The date when the medication statement was asserted by the information source.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.dateAsserted", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "w5", "map": "FiveWs.recorded" }, { "identity": "rim", "map": ".participation[typeCode=AUT].time" } ] }, { "id": "MedicationStatement.informationSource", "path": "MedicationStatement.informationSource", "short": "Person or organization that provided the information about the taking of this medication", "definition": "The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.informationSource", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Organization" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "w5", "map": "FiveWs.source" }, { "identity": "rim", "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)" } ] }, { "id": "MedicationStatement.derivedFrom", "path": "MedicationStatement.derivedFrom", "short": "Additional supporting information", "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.", "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.derivedFrom", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" } ] }, { "id": "MedicationStatement.reasonCode", "path": "MedicationStatement.reasonCode", "short": "Reason for why the medication is being/was taken", "definition": "A reason for why the medication is being/was taken.", "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonCode", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationReason" } ], "strength": "example", "description": "A coded concept identifying why the medication is being taken.", "valueSet": "http://hl7.org/fhir/ValueSet/condition-code" }, "mapping": [ { "identity": "workflow", "map": "Event.reasonCode" }, { "identity": "w5", "map": "FiveWs.why[x]" }, { "identity": "rim", "map": ".reasonCode" } ] }, { "id": "MedicationStatement.reasonReference", "path": "MedicationStatement.reasonReference", "short": "Condition or observation that supports why the medication is being/was taken", "definition": "Condition or observation that supports why the medication is being/was taken.", "comment": "This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonReference", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition", "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.reasonReference" }, { "identity": "w5", "map": "FiveWs.why[x]" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value" } ] }, { "id": "MedicationStatement.context.identifier.assigner", "path": "MedicationStatement.context.identifier.assigner", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" ] } ] }, { "id": "MedicationStatement.note", "path": "MedicationStatement.note", "short": "Further information about the statement", "definition": "Provides extra information about the medication statement that is not conveyed by the other attributes.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.note", "min": 0, "max": "*" }, "type": [ { "code": "Annotation" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.note" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value" } ] }, { "id": "MedicationStatement.dosage", "path": "MedicationStatement.dosage", "short": "Details of how medication is/was taken or should be taken", "definition": "Indicates how the medication is/was or should be taken by the patient.", "comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\" It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.dosage", "min": 0, "max": "*" }, "type": [ { "code": "Dosage" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "refer dosageInstruction mapping" } ] }, { "id": "MedicationStatement.reasonReference.identifier.assigner", "path": "MedicationStatement.reasonReference.identifier.assigner", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" ] } ] }, { "id": "MedicationStatement.note.author[x]", "path": "MedicationStatement.note.author[x]", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner", "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" ] }, { "code": "string" } ] }, { "id": "MedicationStatement.dosage.asNeeded[x]", "path": "MedicationStatement.dosage.asNeeded[x]", "binding": { "strength": "extensible", "description": "A set of codes that define a precondition for taking a medication", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationPrecondition" } }, { "id": "MedicationStatement.dosage.site", "path": "MedicationStatement.dosage.site", "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite" } }, { "id": "MedicationStatement.dosage.route", "path": "MedicationStatement.dosage.route", "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" } }, { "id": "MedicationStatement.dosage.method", "path": "MedicationStatement.dosage.method", "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod" } } ] } }