<status value="draft" /> <experimental value="false" /> <date value="2024-04-09T00:00:00-08:00" /> <description value="This profile represents the constraints applied to the Medication resource by the PS-CA project to represent a medication in the patient summary. It allows for cross-border and cross-jurisdiction sharing of Medication Summary information." /> <copyright value="Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." /> <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.extension"> <path value="Medication.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </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." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description" /> </type> </element> <element id="Medication.code"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:display" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Medication.code" /> <short value="Medication that was requested/ordered (medication code from any code system)" /> <definition value="Medication that was requested/ordered." /> <comment value="A variety of terminology is used across the Canadian Landscape to codify medications. Various code systems in use in Canada are put forward as examples and using the additional bindings extension. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. In Canada, CCDD is the preferred binding type for medication codes. However, for broader international comprehension, it's recommended that, where mappings exist, implementers also include IPS concepts alongside CCDD. This approach aims to balance national preferences with the need for international interoperability. Additionally, systems have the flexibility to send other Canadian codes, such as SNOMED CT CA, DIN, and NPN." /> <min value="1" /> <type> <code value="CodeableConcept" /> <profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-medication-ca-ps" /> </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="http://terminology.hl7.org/CodeSystem/hc-CCDD" /> <code value="02240105" /> <display value="AVEENO ANTI-ITCH LOTION (calamine 3 % and pramoxine hydrochloride 1 % lotion) JOHNSON & JOHNSON INC" /> </coding> <text value="Aveeno Anti-Itch Lotion" /> </valueCodeableConcept> </example> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/LicensedNaturalHealthProducts" /> </extension> <extension url="documentation"> <valueMarkdown value="All Natural Product Number (NPN) and Homeopathic Medicine Number (DIN-HM) codes that are licensed by Health Canada and present in the Licensed Natural Health Products Database." /> </extension> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" /> </extension> <extension url="documentation"> <valueMarkdown value="WHO ATC classification." /> </extension> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/medication-uv-ips" /> </extension> <extension url="documentation"> <valueMarkdown value="SNOMED CT medications (Medicinal product)" /> </extension> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/DIN" /> </extension> <extension url="documentation"> <valueMarkdown value="Health Canada Drug Identification Number set." /> </extension> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode" /> </extension> <extension url="documentation"> <valueMarkdown value="This is the combination of the PharmaceuticalBiologicProductCode and SubstanceCode subsets." /> </extension> </extension> <strength value="preferred" /> <description value="Canadian Clinical Drug Data Set codes" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" /> </binding> </element> <element id="Medication.form"> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:able-to-populate" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/producer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHALL:no-error" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/obligation"> <extension url="code"> <valueCode value="SHOULD:handle" /> </extension> <extension url="actor"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ActorDefinition/consumer" /> </extension> </extension> <path value="Medication.form" /> <definition value="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 It is known that also alternative jurisdictional and international terminologies are known to be used for this concept domain, as NCI or SNOMED CT." /> <comment value="See additionalBinding extension" /> <type> <code value="CodeableConcept" /> <profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondrugform" /> </extension> <extension url="documentation"> <valueMarkdown value="This binding includes HL7 V3 Codes from the PrescribeIT value set indicating the form in which the drug product is capable of being administered, dispensed, or ordered. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." /> </extension> </extension> <extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/medicine-doseform" /> </extension> <extension url="documentation"> <valueMarkdown value="EDQM Medicine dose forms." /> </extension> </extension> <strength value="preferred" /> <description value="SCTCA Pharmaceutical Dose Form" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode" /> </binding> </element> <element id="Medication.ingredient"> <path value="Medication.ingredient" /> <comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." /> </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> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept"> <path value="Medication.ingredient.item[x]" /> <sliceName value="itemCodeableConcept" /> <comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain this element within the context of their own jurisdictional content." /> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <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.strength"> <path value="Medication.ingredient.strength" /> <comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." /> </element> </differential> </StructureDefinition>