<status value="draft" /> <date value="2024-02-01T19:39:15.322061+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" /> <snapshot> <element id="Medication"> <path value="Medication" /> <short value="Definition of a Medication" /> <definition value="This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use." /> <min value="0" /> <max value="*" /> <base> <path value="Medication" /> <min value="0" /> <max value="*" /> </base> <constraint> <key value="dom-2" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" /> <expression value="contained.contained.empty()" /> <xpath value="not(parent::f:contained and f:contained)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-4" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" /> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-3" /> <severity value="error" /> <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" /> <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" /> <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." /> </extension> <key value="dom-6" /> <severity value="warning" /> <human value="A resource should have narrative for robust management" /> <expression value="text.`div`.exists()" /> <xpath value="exists(f:text/h:div)" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <constraint> <key value="dom-5" /> <severity value="error" /> <human value="If a resource is contained in another resource, it SHALL NOT have a security label" /> <expression value="contained.meta.security.empty()" /> <xpath value="not(exists(f:contained/*/f:meta/f:security))" /> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" /> </constraint> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="script10.6" /> <map value="NewRx/MedicationPrescribed -or- RxFill/MedicationDispensed -or- RxHistoryResponse/MedicationDispensed -or- RxHistoryResponse/MedicationPrescribed" /> </mapping> <mapping> <identity value="rim" /> <map value="ManufacturedProduct[classCode=ADMM]" /> </mapping> </element> <element id="Medication.id"> <path value="Medication.id" /> <short value="Logical id of this artifact" /> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." /> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <isSummary value="true" /> </element> <element id="Medication.meta"> <path value="Medication.meta" /> <short value="Metadata about the resource" /> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." /> <min value="1" /> <max value="1" /> <base> <path value="Resource.meta" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Meta" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.meta.id"> <path value="Medication.meta.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.meta.extension"> <path value="Medication.meta.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.meta.versionId"> <path value="Medication.meta.versionId" /> <short value="Version specific identifier" /> <definition value="The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted." /> <comment value="The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes." /> <min value="0" /> <max value="1" /> <base> <path value="Meta.versionId" /> <min value="0" /> <max value="1" /> </base> <type> <code value="id" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.meta.lastUpdated"> <path value="Medication.meta.lastUpdated" /> <short value="When the resource version last changed" /> <definition value="When the resource last changed - e.g. when the version changed." /> <comment value="This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http.html#read) interaction." /> <min value="0" /> <max value="1" /> <base> <path value="Meta.lastUpdated" /> <min value="0" /> <max value="1" /> </base> <type> <code value="instant" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.meta.source"> <path value="Medication.meta.source" /> <short value="Identifies where the resource comes from" /> <definition value="A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc." /> <comment value="In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL." /> <min value="0" /> <max value="1" /> <base> <path value="Meta.source" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.meta.profile"> <path value="Medication.meta.profile" /> <short value="Profiles this resource claims to conform to" /> <definition value="A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url)." /> <comment value="It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set." /> <min value="1" /> <max value="*" /> <base> <path value="Meta.profile" /> <min value="0" /> <max value="*" /> </base> <type> <code value="canonical" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/StructureDefinition" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.meta.security"> <path value="Medication.meta.security" /> <short value="Security Labels applied to this resource" /> <definition value="Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure." /> <comment value="The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored." /> <min value="0" /> <max value="*" /> <base> <path value="Meta.security" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SecurityLabels" /> </extension> <strength value="extensible" /> <description value="Security Labels from the Healthcare Privacy and Security Classification System." /> <valueSet value="http://hl7.org/fhir/ValueSet/security-labels" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> </element> <element id="Medication.meta.tag"> <path value="Medication.meta.tag" /> <short value="Tags applied to this resource" /> <definition value="Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource." /> <comment value="The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored." /> <min value="0" /> <max value="*" /> <base> <path value="Meta.tag" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Tags" /> </extension> <strength value="example" /> <description value="Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"." /> <valueSet value="http://hl7.org/fhir/ValueSet/common-tags" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> </element> <element id="Medication.implicitRules"> <path value="Medication.implicitRules" /> <short value="A set of rules under which this content was created" /> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." /> <comment value="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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.implicitRules" /> <min value="0" /> <max value="1" /> </base> <type> <code value="uri" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isModifier value="true" /> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.language"> <path value="Medication.language" /> <short value="Language of the resource content" /> <definition value="The base language in which the resource is written." /> <comment value="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)." /> <min value="0" /> <max value="1" /> <base> <path value="Resource.language" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language" /> </extension> <strength value="preferred" /> <description value="A human language." /> <valueSet value="http://hl7.org/fhir/ValueSet/languages" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.text"> <path value="Medication.text" /> <short value="Text summary of the resource, for human interpretation" /> <definition value="A human-readable narrative that contains a summary of the resource and can 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." /> <comment value="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 information is added later." /> <alias value="narrative" /> <alias value="html" /> <alias value="xhtml" /> <alias value="display" /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Narrative" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="Act.text?" /> </mapping> </element> <element id="Medication.contained"> <path value="Medication.contained" /> <short value="Contained, inline Resources" /> <definition value="These 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." /> <comment value="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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." /> <alias value="inline resources" /> <alias value="anonymous resources" /> <alias value="contained resources" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.contained" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Resource" /> </type> <mapping> <identity value="rim" /> <map value="Entity. Role, or Act" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.extension"> <path value="Medication.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </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 ." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="1" /> <base> <path value="DomainResource.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> <profile value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.modifierExtension"> <path value="Medication.modifierExtension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Extensions that cannot be ignored" /> <definition value="May 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="DomainResource.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.identifier"> <path value="Medication.identifier" /> <short value="Business identifier for this medication" /> <definition value="Business identifier for this medication." /> <comment value="The serial number could be included as an identifier." /> <min value="0" /> <max value="*" /> <base> <path value="Medication.identifier" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Identifier" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" /> </mapping> <mapping> <identity value="rim" /> <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" /> </mapping> <mapping> <identity value="servd" /> <map value="Identifier" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.identifier" /> </mapping> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> </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." /> <comment value="For all CodeableConcepts, at least one of coding or text must be present. If coding contains only a display value (no code) then CodeableConcept must include text." /> <min value="1" /> <max value="1" /> <base> <path value="Medication.code" /> <min value="0" /> <max value="1" /> </base> <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> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationFormalRepresentation" /> </extension> <strength value="preferred" /> <description value="Canadian Clinical Drug Data Set codes" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="script10.6" /> <map value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(*,MedicationType)/DrugDescription" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.class" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-1.1-Requested Give Code.code / RXE-2.1-Give Code.code / RXD-2.1-Dispense/Give Code.code / RXG-4.1-Give Code.code /RXA-5.1-Administered Code.code / RXC-2.1 Component Code" /> </mapping> <mapping> <identity value="rim" /> <map value=".code" /> </mapping> </element> <element id="Medication.code.id"> <path value="Medication.code.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.code.extension"> <path value="Medication.code.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </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> <short value="A reference to a code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Medication.code.coding:atcClass"> <path value="Medication.code.coding" /> <sliceName value="atcClass" /> <short value="Optional slice for representing WHO ATC classification" /> <definition value="WHO ATC classification" /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </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)" /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </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." /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <binding> <strength value="required" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </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." /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <strength value="required" /> <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/LicensedNaturalHealthProducts" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Medication.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Medication.code.text" /> <short value="Plain text representation of the concept" /> <definition value="A 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." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="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." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Medication.status"> <path value="Medication.status" /> <short value="active | inactive | entered-in-error" /> <definition value="A code to indicate if the medication is in active use." /> <comment value="This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.status" /> <min value="0" /> <max value="1" /> </base> <type> <code value="code" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isModifier value="true" /> <isModifierReason value="This element changes the interpretation of all descriptive attributes." /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationStatus" /> </extension> <strength value="required" /> <description value="A coded concept defining if the medication is in active use." /> <valueSet value="http://hl7.org/fhir/ValueSet/medication-status|4.0.1" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value=".statusCode" /> </mapping> </element> <element id="Medication.manufacturer"> <path value="Medication.manufacturer" /> <short value="Manufacturer of the item" /> <definition value="Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product." /> <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.manufacturer" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ref-1" /> <severity value="error" /> <human value="SHALL have a contained resource if a local reference is provided" /> <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" /> <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Reference" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" /> </mapping> <mapping> <identity value="script10.6" /> <map value="no mapping" /> </mapping> <mapping> <identity value="w5" /> <map value="FiveWs.actor" /> </mapping> <mapping> <identity value="v2" /> <map value="RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name" /> </mapping> <mapping> <identity value="rim" /> <map value=".player.scopingRole[typeCode=MANU].scoper" /> </mapping> </element> <element id="Medication.form"> <path value="Medication.form" /> <short value="Concept - reference to a terminology or just text" /> <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." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.form" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationForm" /> </extension> <strength value="preferred" /> <description value="SCTCA Pharmaceutical Dose Form" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="script10.6" /> <map value="coding.code = //element(*,DrugCodedType)/FormCode coding.system = //element(*,DrugCodedType)/FormSourceCode" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-5-Requested Dosage Form / RXE-6-Give Dosage Form / RXD-6-Actual Dosage Form / RXG-8-Give Dosage Form / RXA-8-Administered Dosage Form" /> </mapping> <mapping> <identity value="rim" /> <map value=".formCode" /> </mapping> </element> <element id="Medication.form.id"> <path value="Medication.form.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.form.extension"> <path value="Medication.form.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </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> <short value="A reference to a code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </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" /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <strength value="required" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Medication.form.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Medication.form.text" /> <short value="Plain text representation of the concept" /> <definition value="A 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." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="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." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Medication.amount"> <path value="Medication.amount" /> <short value="Amount of drug in package" /> <definition value="Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)." /> <comment value="The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.amount" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Ratio" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="rat-1" /> <severity value="error" /> <human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" /> <expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" /> <xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))" /> <source value="http://hl7.org/fhir/StructureDefinition/Ratio" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="RTO" /> </mapping> <mapping> <identity value="rim" /> <map value=".quantity" /> </mapping> </element> <element id="Medication.ingredient"> <path value="Medication.ingredient" /> <short value="Active or inactive ingredient" /> <definition value="Identifies a particular constituent of interest in the product." /> <comment value="The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients." /> <min value="0" /> <max value="*" /> <base> <path value="Medication.ingredient" /> <min value="0" /> <max value="*" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value=".scopesRole[typeCode=INGR]" /> </mapping> </element> <element id="Medication.ingredient.id"> <path value="Medication.ingredient.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.ingredient.extension"> <path value="Medication.ingredient.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.ingredient.modifierExtension"> <path value="Medication.ingredient.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </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> <short value="The actual ingredient or content" /> <definition value="The actual ingredient - either a substance (simple ingredient) or another medication of a medication." /> <requirements value="The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base)." /> <min value="1" /> <max value="1" /> <base> <path value="Medication.ingredient.item[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="script10.6" /> <map value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(*,MedicationType)/DrugDescription" /> </mapping> <mapping> <identity value="v2" /> <map value="RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code" /> </mapping> <mapping> <identity value="rim" /> <map value=".player" /> </mapping> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept"> <path value="Medication.ingredient.itemCodeableConcept" /> <sliceName value="itemCodeableConcept" /> <short value="Concept - reference to a terminology or just text" /> <definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." /> <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." /> <requirements value="The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base)." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.ingredient.item[x]" /> <min value="1" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="SNOMED CT CA drug substances" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/drugormedicamentsubstancecode" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="script10.6" /> <map value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(*,MedicationType)/DrugDescription" /> </mapping> <mapping> <identity value="v2" /> <map value="RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code" /> </mapping> <mapping> <identity value="rim" /> <map value=".player" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.id"> <path value="Medication.ingredient.itemCodeableConcept.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.extension"> <path value="Medication.ingredient.itemCodeableConcept.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding"> <path value="Medication.ingredient.itemCodeableConcept.coding" /> <slicing> <discriminator> <type value="pattern" /> <path value="$this" /> </discriminator> <description value="Discriminated by value set" /> <rules value="open" /> </slicing> <short value="A reference to a code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.coding:ingredientSCTCA"> <path value="Medication.ingredient.itemCodeableConcept.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" /> <comment value="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." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <binding> <strength value="required" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/drugormedicamentsubstancecode" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Medication.ingredient.itemCodeableConcept.text" /> <short value="Plain text representation of the concept" /> <definition value="A 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." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="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." /> <min value="0" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Medication.ingredient.isActive"> <path value="Medication.ingredient.isActive" /> <short value="Active ingredient indicator" /> <definition value="Indication of whether this ingredient affects the therapeutic action of the drug." /> <requirements value="True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive)." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.ingredient.isActive" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="NA" /> </mapping> </element> <element id="Medication.ingredient.strength"> <path value="Medication.ingredient.strength" /> <short value="A ratio of two Quantity values - a numerator and a denominator" /> <definition value="A relationship of two Quantity values - expressed as a numerator and a denominator." /> <comment value="The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.ingredient.strength" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Ratio" /> <profile value="http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-ratio" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="rat-1" /> <severity value="error" /> <human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" /> <expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" /> <xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))" /> <source value="http://hl7.org/fhir/StructureDefinition/Ratio" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="RTO" /> </mapping> <mapping> <identity value="script10.6" /> <map value="//element(*,DrugCodedType)/Strength" /> </mapping> <mapping> <identity value="v2" /> <map value="RXC-3-Component Amount & RXC-4-Component Units if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units" /> </mapping> <mapping> <identity value="rim" /> <map value=".quantity" /> </mapping> </element> <element id="Medication.batch"> <path value="Medication.batch" /> <short value="Details about packaged medications" /> <definition value="Information that only applies to packages (not products)." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.batch" /> <min value="0" /> <max value="1" /> </base> <type> <code value="BackboneElement" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="script10.6" /> <map value="no mapping" /> </mapping> <mapping> <identity value="rim" /> <map value=".player[classCode=CONT]" /> </mapping> </element> <element id="Medication.batch.id"> <path value="Medication.batch.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Medication.batch.extension"> <path value="Medication.batch.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.batch.modifierExtension"> <path value="Medication.batch.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Medication.batch.lotNumber"> <path value="Medication.batch.lotNumber" /> <short value="Identifier assigned to batch" /> <definition value="The assigned lot number of a batch of the specified product." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Medication.batch.lotNumber" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="script10.6" /> <map value="no mapping" /> </mapping> <mapping> <identity value="v2" /> <map value="RXA-15 Substance Lot Number / RXG-19 Substance Lot Number" /> </mapping> <mapping> <identity value="rim" /> <map value=".id" /> </mapping> </element> <element id="Medication.batch.expirationDate"> <path value="Medication.batch.expirationDate" /> <short value="When batch will expire" /> <definition value="When this specific batch of product will expire." /> <min value="0" /> <max value="1" /> <base> <path value="Medication.batch.expirationDate" /> <min value="0" /> <max value="1" /> </base> <type> <code value="dateTime" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="script10.6" /> <map value="no mapping" /> </mapping> <mapping> <identity value="v2" /> <map value="RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date" /> </mapping> <mapping> <identity value="rim" /> <map value="participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime" /> </mapping> </element> </snapshot> <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"> <path value="Medication.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> <min value="0" /> </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"> <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="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" /> </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:atcClass"> <path value="Medication.code.coding" /> <sliceName value="atcClass" /> <short value="Optional slice for representing WHO ATC classification" /> <definition value="WHO ATC classification" /> <binding> <strength value="required" /> <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips" /> </binding> </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: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="https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct" /> </binding> </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.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="$this" /> </discriminator> <description value="Discriminated by value set" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Medication.form.coding:formSCTCA"> <path value="Medication.form.coding" /> <sliceName value="formSCTCA" /> <short value="Optional slice for representing SNOMED CT Canadian edition dose forms" /> <definition value="SNOMED CT Canadian edition dose forms" /> <binding> <strength value="required" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticaldoseformcode" /> </binding> </element> <element id="Medication.ingredient"> <path value="Medication.ingredient" /> <mustSupport value="true" /> </element> <element id="Medication.ingredient.item[x]"> <path value="Medication.ingredient.item[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="Medication.ingredient.item[x]:itemCodeableConcept"> <path value="Medication.ingredient.itemCodeableConcept" /> <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.itemCodeableConcept.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:ingredientSCTCA"> <path value="Medication.ingredient.itemCodeableConcept.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.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>