{ "resourceType": "StructureDefinition", "id": "profile-DwMedicationStatement", "text": { "status": "extensions", "div": "

Generated Narrative: StructureDefinition profile-DwMedicationStatement

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\" MedicationStatement 0..*MedicationStatementRecord of medication being taken by a patient
\".\"\".\"\".\" id S1..1idLogical id of this artifact
\".\"\".\"\".\" meta
\".\"\".\"\".\"\".\" lastUpdated 1..1instantWhen the resource version last changed
\".\"\".\"\".\"\".\" source 1..1uriIdentifies where the resource comes from
\".\"\".\"\".\"\".\" security 0..*CodingSecurity Labels applied to this resource
\".\"\".\"\".\" text S1..1NarrativeText summary of the resource, for human interpretation
\".\"\".\"\".\" Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
\".\"\".\"\".\"\".\" extension:RenderedDosageInstruction S0..1stringExtension
URL: http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction
\".\"\".\"\".\" identifier S1..1IdentifierExternal identifier
\".\"\".\"\".\"\".\" system 1..1uriThe namespace for the identifier value
\".\"\".\"\".\"\".\" value 1..1stringThe value that is unique
\".\"\".\"\".\" basedOn 0..*Reference(DwMedicationRequest)Fulfills plan, proposal or order
\".\"\".\"\".\" partOf S0..*Reference(DwMedicationAdministration | DwMedicationStatement | DwProcedure | DwObservationResults)Part of referenced event
\".\"\".\"\".\" status S1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
\".\"\".\"\".\" statusReason S0..*CodeableConceptReason for current status
\".\"\".\"\".\" Slices for medication[x] S1..1CodeableConcept, Reference(Medication)What medication was taken
Slice: Unordered, Open by type:$this
\".\"\".\"\".\"\".\" medication[x]:medicationReference S0..1Reference(DwMedication)What medication was taken
\".\"\".\"\".\"\".\" medication[x]:medicationCodeableConcept S0..1CodeableConceptWhat medication was taken
Binding: Absent or Unknown Medications - IPS (preferred)
\".\"\".\"\".\"\".\"\".\" coding
\".\"\".\"\".\"\".\"\".\"\".\" system S0..1uriIdentity of the terminology system
\".\"\".\"\".\"\".\"\".\"\".\" code S0..1codeSymbol in syntax defined by the system
\".\"\".\"\".\"\".\"\".\"\".\" display S0..1stringRepresentation defined by the system
\".\"\".\"\".\"\".\"\".\" text S0..1stringPlain text representation of the concept
\".\"\".\"\".\" subject 1..1Reference(DwPatient)Who is/was taking the medication
\".\"\".\"\".\" context S0..1Reference(DwEncounter)Encounter / Episode associated with MedicationStatement
\".\"\".\"\".\" effective[x] S1..1dateTime, PeriodThe date/time or interval when the medication is/was/will be taken
\".\"\".\"\".\" dateAsserted S0..1dateTimeWhen the statement was asserted?
\".\"\".\"\".\" reasonCode S0..*CodeableConceptReason for why the medication is being/was taken
\".\"\".\"\".\" reasonReference S0..*Reference(DwCondition | DwObservationResults | DwDiagnosticReport)Condition or observation that supports why the medication is being/was taken
\".\"\".\"\".\" note S0..*AnnotationFurther information about the statement
\".\"\".\"\".\" dosage S0..*DosageDetails of how medication is/was taken or should be taken
\".\"\".\"\".\"\".\" sequence S0..1integerThe order of the dosage instructions
\".\"\".\"\".\"\".\" text S0..1stringFree text dosage instructions e.g. SIG
\".\"\".\"\".\"\".\" additionalInstruction S0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
\".\"\".\"\".\"\".\" patientInstruction S0..1stringPatient or consumer oriented instructions
\".\"\".\"\".\"\".\" timing S0..1TimingWhen medication should be administered
\".\"\".\"\".\"\".\"\".\" repeat 0..1ElementWhen the event is to occur
\".\"\".\"\".\"\".\"\".\" code S0..1CodeableConceptBID | TID | QID | AM | PM | QD | QOD | +
\".\"\".\"\".\"\".\"\".\"\".\" text S0..1stringPlain text representation of the concept
\".\"\".\"\".\"\".\" asNeeded[x] S0..1boolean, CodeableConceptTake "as needed" (for x)
\".\"\".\"\".\"\".\" route S0..1CodeableConceptHow drug should enter body
\".\"\".\"\".\"\".\"\".\" Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
\".\"\".\"\".\"\".\"\".\"\".\" coding:routeSCTCA 0..*CodingCode defined by a terminology system
Binding: Route Of Administration (required)
\".\"\".\"\".\"\".\"\".\"\".\"\".\" system S0..1uriIdentity of the terminology system
\".\"\".\"\".\"\".\"\".\"\".\"\".\" code S0..1codeSymbol in syntax defined by the system
\".\"\".\"\".\"\".\"\".\"\".\"\".\" display S0..1stringRepresentation defined by the system
\".\"\".\"\".\"\".\"\".\"\".\" coding:routeEMR S0..*CodingCode defined by a terminology system
\".\"\".\"\".\"\".\"\".\"\".\"\".\" system S0..1uriIdentity of the terminology system
\".\"\".\"\".\"\".\"\".\"\".\"\".\" code S0..1codeSymbol in syntax defined by the system
\".\"\".\"\".\"\".\"\".\"\".\"\".\" display S0..1stringRepresentation defined by the system
\".\"\".\"\".\"\".\"\".\" text S0..1stringPlain text representation of the concept
\".\"\".\"\".\"\".\" doseAndRate
\".\"\".\"\".\"\".\"\".\" dose[x] S0..1Range, SimpleQuantity(4.0.1)Amount of medication per dose

\"doco\" Documentation for this format
" }, "url": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationStatement", "version": "2.0.0", "name": "DwMedicationStatement", "status": "draft", "date": "2026-05-19", "publisher": "TELUS Health", "contact": [ { "name": "TELUS Health", "telecom": [ { "system": "url", "value": "https://www.telus.com/health" } ] }, { "name": "TELUS Health", "telecom": [ { "system": "url", "value": "https://www.telus.com/health" } ] } ], "description": "**CHR:** Current medications are managed in the **Medications** section of the patient chart (tabs: All / Current / Past / External). New medications are added via the New Medication action and can be linked to a prescription.", "jurisdiction": [ { "coding": [ { "system": "urn:iso:std:iso:3166", "code": "CA", "display": "Canada" } ] } ], "copyright": "Copyright © 2026 TELUS Health. All rights reserved.", "fhirVersion": "4.0.1", "mapping": [ { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" } ], "kind": "resource", "abstract": false, "type": "MedicationStatement", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement", "derivation": "constraint", "snapshot": { "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version", "valueString": "4.0.1" } ], "element": [ { "id": "MedicationStatement", "path": "MedicationStatement", "short": "Record of medication being taken by a patient", "definition": "A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. \n\nThe primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.", "comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.", "min": 0, "max": "*", "base": { "path": "MedicationStatement", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-3", "severity": "error", "human": "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": "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": "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": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-5", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a security label", "expression": "contained.meta.security.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:security))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation", "valueMarkdown": "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." } ], "key": "dom-6", "severity": "warning", "human": "A resource should have narrative for robust management", "expression": "text.`div`.exists()", "xpath": "exists(f:text/h:div)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "workflow", "map": "Event" }, { "identity": "rim", "map": "SubstanceAdministration" } ] }, { "id": "MedicationStatement.id", "path": "MedicationStatement.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mustSupport": true, "isModifier": false, "isSummary": true }, { "id": "MedicationStatement.meta", "path": "MedicationStatement.meta", "short": "Metadata about the resource", "definition": "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": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "MedicationStatement.meta.id", "path": "MedicationStatement.meta.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.meta.extension", "path": "MedicationStatement.meta.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.meta.versionId", "path": "MedicationStatement.meta.versionId", "short": "Version specific identifier", "definition": "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": "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": 0, "max": "1", "base": { "path": "Meta.versionId", "min": 0, "max": "1" }, "type": [ { "code": "id" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "MedicationStatement.meta.lastUpdated", "path": "MedicationStatement.meta.lastUpdated", "short": "When the resource version last changed", "definition": "When the resource last changed - e.g. when the version changed.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.updated_at", "min": 1, "max": "1", "base": { "path": "Meta.lastUpdated", "min": 0, "max": "1" }, "type": [ { "code": "instant" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "MedicationStatement.meta.source", "path": "MedicationStatement.meta.source", "short": "Identifies where the resource comes from", "definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/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": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1, "max": "1", "base": { "path": "Meta.source", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "MedicationStatement.meta.profile", "path": "MedicationStatement.meta.profile", "short": "Profiles this resource claims to conform to", "definition": "A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).", "comment": "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": 0, "max": "*", "base": { "path": "Meta.profile", "min": 0, "max": "*" }, "type": [ { "code": "canonical", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "MedicationStatement.meta.security", "path": "MedicationStatement.meta.security", "short": "Security Labels applied to this resource", "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: Populated when respondents.restriction_owner_id or encounters.restriction_owner_id is set.", "min": 0, "max": "*", "base": { "path": "Meta.security", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "SecurityLabels" } ], "strength": "extensible", "description": "Security Labels from the Healthcare Privacy and Security Classification System.", "valueSet": "http://hl7.org/fhir/ValueSet/security-labels|4.0.1" } }, { "id": "MedicationStatement.meta.tag", "path": "MedicationStatement.meta.tag", "short": "Tags applied to this resource", "definition": "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": "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": 0, "max": "*", "base": { "path": "Meta.tag", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Tags" } ], "strength": "example", "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".", "valueSet": "http://hl7.org/fhir/ValueSet/common-tags|4.0.1" } }, { "id": "MedicationStatement.implicitRules", "path": "MedicationStatement.implicitRules", "short": "A set of rules under which this content was created", "definition": "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": "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": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation", "isSummary": true }, { "id": "MedicationStatement.language", "path": "MedicationStatement.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "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": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" } ], "strength": "preferred", "description": "A human language.", "valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1" } }, { "id": "MedicationStatement.text", "path": "MedicationStatement.text", "short": "Text summary of the resource, for human interpretation", "definition": "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": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 1, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "MedicationStatement.contained", "path": "MedicationStatement.contained", "short": "Contained, inline Resources", "definition": "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": "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": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.extension", "path": "MedicationStatement.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" }, "short": "Extension", "definition": "An Extension", "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false }, { "id": "MedicationStatement.extension:RenderedDosageInstruction", "path": "MedicationStatement.extension", "sliceName": "RenderedDosageInstruction", "short": "Extension", "definition": "An Extension", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.dosage_data or respondent_medications.name.", "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mustSupport": true, "isModifier": false, "isSummary": false }, { "id": "MedicationStatement.modifierExtension", "path": "MedicationStatement.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "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": "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them", "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.identifier", "path": "MedicationStatement.identifier", "short": "External identifier", "definition": "Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1, "max": "1", "base": { "path": "MedicationStatement.identifier", "min": 0, "max": "*" }, "type": [ { "code": "Identifier" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.identifier" }, { "identity": "w5", "map": "FiveWs.identifier" }, { "identity": "rim", "map": ".id" } ] }, { "id": "MedicationStatement.identifier.id", "path": "MedicationStatement.identifier.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.identifier.extension", "path": "MedicationStatement.identifier.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.identifier.use", "path": "MedicationStatement.identifier.use", "short": "usual | official | temp | secondary | old (If known)", "definition": "The purpose of this identifier.", "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.", "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.", "min": 0, "max": "1", "base": { "path": "Identifier.use", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "IdentifierUse" } ], "strength": "required", "description": "Identifies the purpose for this identifier, if known .", "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" }, "mapping": [ { "identity": "v2", "map": "N/A" }, { "identity": "rim", "map": "Role.code or implied by context" } ] }, { "id": "MedicationStatement.identifier.type", "path": "MedicationStatement.identifier.type", "short": "Description of identifier", "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.", "comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.", "requirements": "Allows users to make use of identifiers when the identifier system is not known.", "min": 0, "max": "1", "base": { "path": "Identifier.type", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "IdentifierType" } ], "strength": "extensible", "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.", "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type|4.0.1" }, "mapping": [ { "identity": "v2", "map": "CX.5" }, { "identity": "rim", "map": "Role.code or implied by context" } ] }, { "id": "MedicationStatement.identifier.system", "path": "MedicationStatement.identifier.system", "short": "The namespace for the identifier value", "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nurn:telus:emr:*:*:medicationstatement\r\nIdentifier.system is always case sensitive.", "requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.", "min": 1, "max": "1", "base": { "path": "Identifier.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "example": [ { "label": "General", "valueUri": "http://www.acme.com/identifiers/patient" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.4 / EI-2-4" }, { "identity": "rim", "map": "II.root or Role.id.root" }, { "identity": "servd", "map": "./IdentifierType" } ] }, { "id": "MedicationStatement.identifier.value", "path": "MedicationStatement.identifier.value", "short": "The value that is unique", "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.id", "min": 1, "max": "1", "base": { "path": "Identifier.value", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "example": [ { "label": "General", "valueString": "123456" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.1 / EI.1" }, { "identity": "rim", "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" }, { "identity": "servd", "map": "./Value" } ] }, { "id": "MedicationStatement.identifier.period", "path": "MedicationStatement.identifier.period", "short": "Time period when id is/was valid for use", "definition": "Time period during which identifier is/was valid for use.", "min": 0, "max": "1", "base": { "path": "Identifier.period", "min": 0, "max": "1" }, "type": [ { "code": "Period" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.7 + CX.8" }, { "identity": "rim", "map": "Role.effectiveTime or implied by context" }, { "identity": "servd", "map": "./StartDate and ./EndDate" } ] }, { "id": "MedicationStatement.identifier.assigner", "path": "MedicationStatement.identifier.assigner", "short": "Organization that issued id (may be just text)", "definition": "Organization that issued/manages the identifier.", "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.", "min": 0, "max": "1", "base": { "path": "Identifier.assigner", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.4 / (CX.4,CX.9,CX.10)" }, { "identity": "rim", "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" }, { "identity": "servd", "map": "./IdentifierIssuingAuthority" } ] }, { "id": "MedicationStatement.basedOn", "path": "MedicationStatement.basedOn", "short": "Fulfills plan, proposal or order", "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported", "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.basedOn", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.basedOn" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]" } ] }, { "id": "MedicationStatement.partOf", "path": "MedicationStatement.partOf", "short": "Part of referenced event", "definition": "A larger event of which this particular event is a component or step.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported", "requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.partOf", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationAdministration", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationStatement", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwProcedure", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.partOf" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]" } ] }, { "id": "MedicationStatement.status", "path": "MedicationStatement.status", "short": "active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken", "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR status derived from respondent_medications:\n- active: archived=false, no stop/cancel dates, continuous or future end date\n- completed: archived=false, continuous=false, past end_at\n- stopped: archived=false, has cancellation_at/stop date\n- entered-in-error: deleted record\n\nUsage note: Status of the current and past medication on a patient's chart in the EMR \r\n\r\nMedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\r\rThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.", "min": 1, "max": "1", "base": { "path": "MedicationStatement.status", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": true, "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementStatus" } ], "strength": "required", "description": "A coded concept indicating the current status of a MedicationStatement.", "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1" }, "mapping": [ { "identity": "workflow", "map": "Event.status" }, { "identity": "w5", "map": "FiveWs.status" }, { "identity": "rim", "map": ".statusCode" } ] }, { "id": "MedicationStatement.statusReason", "path": "MedicationStatement.statusReason", "short": "Reason for current status", "definition": "Captures the reason for the current state of the MedicationStatement.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.cancellation_note when present.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.statusReason", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementStatusReason" } ], "strength": "example", "description": "A coded concept indicating the reason for the status of the statement.", "valueSet": "http://hl7.org/fhir/ValueSet/reason-medication-status-codes|4.0.1" }, "mapping": [ { "identity": "workflow", "map": "Event.statusReason" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" } ] }, { "id": "MedicationStatement.category", "path": "MedicationStatement.category", "short": "Type of medication usage", "definition": "Indicates where the medication is expected to be consumed or administered.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.category", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationStatementCategory" } ], "strength": "preferred", "description": "A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.", "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-category|4.0.1" }, "mapping": [ { "identity": "w5", "map": "FiveWs.class" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value" } ] }, { "id": "MedicationStatement.medication[x]", "path": "MedicationStatement.medication[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "closed" }, "short": "What medication was taken", "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Either medicationReference (when DIN/product record available) or medicationCodeableConcept (when no medication on record).", "min": 1, "max": "1", "base": { "path": "MedicationStatement.medication[x]", "min": 1, "max": "1" }, "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationCode" } ], "strength": "example", "description": "A coded concept identifying the substance or product being taken.", "valueSet": "http://hl7.org/fhir/ValueSet/medication-codes|4.0.1" }, "mapping": [ { "identity": "workflow", "map": "Event.code" }, { "identity": "w5", "map": "FiveWs.what[x]" }, { "identity": "rim", "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]" } ] }, { "id": "MedicationStatement.medication[x]:medicationReference", "path": "MedicationStatement.medication[x]", "sliceName": "medicationReference", "short": "What medication was taken", "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: medication/ when a product record with DIN exists.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.medication[x]", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedication" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.code" }, { "identity": "w5", "map": "FiveWs.what[x]" }, { "identity": "rim", "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept", "path": "MedicationStatement.medication[x]", "sliceName": "medicationCodeableConcept", "short": "What medication was taken", "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: no-medication-info or no-known-medications when no specific medication is on record.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.medication[x]", "min": 1, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "binding": { "strength": "preferred", "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-medications-uv-ips" }, "mapping": [ { "identity": "workflow", "map": "Event.code" }, { "identity": "w5", "map": "FiveWs.what[x]" }, { "identity": "rim", "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.id", "path": "MedicationStatement.medication[x].id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.extension", "path": "MedicationStatement.medication[x].extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding", "path": "MedicationStatement.medication[x].coding", "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.id", "path": "MedicationStatement.medication[x].coding.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.extension", "path": "MedicationStatement.medication[x].coding.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system", "path": "MedicationStatement.medication[x].coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 0, "max": "1", "base": { "path": "Coding.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.version", "path": "MedicationStatement.medication[x].coding.version", "short": "Version of the system - if relevant", "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.", "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.", "min": 0, "max": "1", "base": { "path": "Coding.version", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.7" }, { "identity": "rim", "map": "./codeSystemVersion" }, { "identity": "orim", "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.code", "path": "MedicationStatement.medication[x].coding.code", "short": "Symbol in syntax defined by the system", "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to refer to a particular code in the system.", "min": 0, "max": "1", "base": { "path": "Coding.code", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.medication[x].coding.display", "short": "Representation defined by the system", "definition": "A representation of the meaning of the code in the system, following the rules of the system.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.", "min": 0, "max": "1", "base": { "path": "Coding.display", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.2 - but note this is not well followed" }, { "identity": "rim", "map": "CV.displayName" }, { "identity": "orim", "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.userSelected", "path": "MedicationStatement.medication[x].coding.userSelected", "short": "If this coding was chosen directly by the user", "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).", "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.", "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.", "min": 0, "max": "1", "base": { "path": "Coding.userSelected", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "Sometimes implied by being first" }, { "identity": "rim", "map": "CD.codingRationale" }, { "identity": "orim", "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]" } ] }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.medication[x].text", "short": "Plain text representation of the concept", "definition": "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": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "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": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "MedicationStatement.subject", "path": "MedicationStatement.subject", "short": "Who is/was taking the medication", "definition": "The person, animal or group who is/was taking the medication.", "min": 1, "max": "1", "base": { "path": "MedicationStatement.subject", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.subject" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "v2", "map": "PID-3-Patient ID List" }, { "identity": "rim", "map": ".participation[typeCode=SBJ].role[classCode=PAT]" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "MedicationStatement.context", "path": "MedicationStatement.context", "short": "Encounter / Episode associated with MedicationStatement", "definition": "The encounter or episode of care that establishes the context for this MedicationStatement.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_prescriptions.encounter_id", "min": 0, "max": "1", "base": { "path": "MedicationStatement.context", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwEncounter" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.context" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]" } ] }, { "id": "MedicationStatement.effective[x]", "path": "MedicationStatement.effective[x]", "short": "The date/time or interval when the medication is/was/will be taken", "definition": "The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: effectivePeriod.start ← respondent_medications.start_at; effectivePeriod.end ← respondent_medications.end_at\n\nUsage note:\r\nProvide effective.period with start and end date\r\nIf the medication is current and does not have an end date in the EMR then provide the effective.period with just the start date. \r\n\r\n\r\nThis attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.", "min": 1, "max": "1", "base": { "path": "MedicationStatement.effective[x]", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" }, { "code": "Period" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.occurrence[x]" }, { "identity": "w5", "map": "FiveWs.done[x]" }, { "identity": "rim", "map": ".effectiveTime" } ] }, { "id": "MedicationStatement.dateAsserted", "path": "MedicationStatement.dateAsserted", "short": "When the statement was asserted?", "definition": "The date when the medication statement was asserted by the information source.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.created_at", "min": 0, "max": "1", "base": { "path": "MedicationStatement.dateAsserted", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "w5", "map": "FiveWs.recorded" }, { "identity": "rim", "map": ".participation[typeCode=AUT].time" } ] }, { "id": "MedicationStatement.informationSource", "path": "MedicationStatement.informationSource", "short": "Person or organization that provided the information about the taking of this medication", "definition": "The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.", "min": 0, "max": "1", "base": { "path": "MedicationStatement.informationSource", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "w5", "map": "FiveWs.source" }, { "identity": "rim", "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)" } ] }, { "id": "MedicationStatement.derivedFrom", "path": "MedicationStatement.derivedFrom", "short": "Additional supporting information", "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.", "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.derivedFrom", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" } ] }, { "id": "MedicationStatement.reasonCode", "path": "MedicationStatement.reasonCode", "short": "Reason for why the medication is being/was taken", "definition": "A reason for why the medication is being/was taken.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: reasonCode.coding from diagnoses linked to medication (diagnoses.code, diagnoses.description); reasonCode.text from respondent_medications.conditions", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonCode", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationReason" } ], "strength": "example", "description": "A coded concept identifying why the medication is being taken.", "valueSet": "http://hl7.org/fhir/ValueSet/condition-code|4.0.1" }, "mapping": [ { "identity": "workflow", "map": "Event.reasonCode" }, { "identity": "w5", "map": "FiveWs.why[x]" }, { "identity": "rim", "map": ".reasonCode" } ] }, { "id": "MedicationStatement.reasonReference", "path": "MedicationStatement.reasonReference", "short": "Condition or observation that supports why the medication is being/was taken", "definition": "Condition or observation that supports why the medication is being/was taken.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: MA and PSS - indication identified in the prescription\r\n\r\nThis is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.", "min": 0, "max": "*", "base": { "path": "MedicationStatement.reasonReference", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwCondition", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwDiagnosticReport" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.reasonReference" }, { "identity": "w5", "map": "FiveWs.why[x]" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value" } ] }, { "id": "MedicationStatement.note", "path": "MedicationStatement.note", "short": "Further information about the statement", "definition": "Provides extra information about the medication statement that is not conveyed by the other attributes.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.additional_instructions", "min": 0, "max": "*", "base": { "path": "MedicationStatement.note", "min": 0, "max": "*" }, "type": [ { "code": "Annotation" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.note" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value" } ] }, { "id": "MedicationStatement.dosage", "path": "MedicationStatement.dosage", "short": "Details of how medication is/was taken or should be taken", "definition": "Indicates how the medication is/was or should be taken by the patient.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Structured dosage from respondent_medications.dosages_data (YAML) including route, additionalInstruction, and timing. A rendered dosage string is also available via extension[RenderedDosageInstruction].", "min": 0, "max": "*", "base": { "path": "MedicationStatement.dosage", "min": 0, "max": "*" }, "type": [ { "code": "Dosage" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "refer dosageInstruction mapping" } ] }, { "id": "MedicationStatement.dosage.id", "path": "MedicationStatement.dosage.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.extension", "path": "MedicationStatement.dosage.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.modifierExtension", "path": "MedicationStatement.dosage.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "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": "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.dosage.sequence", "path": "MedicationStatement.dosage.sequence", "short": "The order of the dosage instructions", "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.\r\n\r\n32 bit number; for values larger than this, use decimal", "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.", "min": 0, "max": "1", "base": { "path": "Dosage.sequence", "min": 0, "max": "1" }, "type": [ { "code": "integer" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "TQ1-1" }, { "identity": "rim", "map": ".text" } ] }, { "id": "MedicationStatement.dosage.text", "path": "MedicationStatement.dosage.text", "short": "Free text dosage instructions e.g. SIG", "definition": "Free text dosage instructions e.g. SIG.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.", "min": 0, "max": "1", "base": { "path": "Dosage.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "RXO-6; RXE-21" }, { "identity": "rim", "map": ".text" } ] }, { "id": "MedicationStatement.dosage.additionalInstruction", "path": "MedicationStatement.dosage.additionalInstruction", "short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"", "definition": "Supplemental instructions to the patient on how to take the medication (e.g. \"with meals\" or\"take half to one hour before food\") or warnings for the patient about the medication (e.g. \"may cause drowsiness\" or \"avoid exposure of skin to direct sunlight or sunlamps\").", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.additional_instructions\n\nUsage Note:: To convey explicit instructions to the Pharmacist/dispenser related to this medication order.\r\n\r\nInformation about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.", "requirements": "Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, \"Swallow with plenty of water\" which might or might not be coded.", "min": 0, "max": "*", "base": { "path": "Dosage.additionalInstruction", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdditionalInstruction" } ], "strength": "example", "description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\".", "valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1" }, "mapping": [ { "identity": "v2", "map": "RXO-7" }, { "identity": "rim", "map": ".text" } ] }, { "id": "MedicationStatement.dosage.patientInstruction", "path": "MedicationStatement.dosage.patientInstruction", "short": "Patient or consumer oriented instructions", "definition": "Instructions in terms that are understood by the patient or consumer.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nPSS: Label Instruction. Note: this is also part of text. Note, with meals\", \"may cause drowsiness are included here but FHIR shows under additional instructions.\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size", "min": 0, "max": "1", "base": { "path": "Dosage.patientInstruction", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "RXO-7" }, { "identity": "rim", "map": ".text" } ] }, { "id": "MedicationStatement.dosage.timing", "path": "MedicationStatement.dosage.timing", "short": "When medication should be administered", "definition": "When medication should be administered.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: dosage.timing.repeat.duration from respondent_medications.total_days", "requirements": "The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "min": 0, "max": "1", "base": { "path": "Dosage.timing", "min": 0, "max": "1" }, "type": [ { "code": "Timing" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": ".effectiveTime" } ] }, { "id": "MedicationStatement.dosage.timing.id", "path": "MedicationStatement.dosage.timing.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.extension", "path": "MedicationStatement.dosage.timing.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.modifierExtension", "path": "MedicationStatement.dosage.timing.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "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": "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationStatement.dosage.timing.event", "path": "MedicationStatement.dosage.timing.event", "short": "When the event occurs", "definition": "Identifies specific times when the event occurs.", "requirements": "In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.", "min": 0, "max": "*", "base": { "path": "Timing.event", "min": 0, "max": "*" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "QLIST" } ] }, { "id": "MedicationStatement.dosage.timing.repeat", "path": "MedicationStatement.dosage.timing.repeat", "short": "When the event is to occur", "definition": "A set of rules that describe when the event is scheduled.", "requirements": "Many timing schedules are determined by regular repetitions.", "min": 0, "max": "1", "base": { "path": "Timing.repeat", "min": 0, "max": "1" }, "type": [ { "code": "Element" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "tim-1", "severity": "error", "human": "if there's a duration, there needs to be duration units", "expression": "duration.empty() or durationUnit.exists()", "xpath": "not(exists(f:duration)) or exists(f:durationUnit)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-2", "severity": "error", "human": "if there's a period, there needs to be period units", "expression": "period.empty() or periodUnit.exists()", "xpath": "not(exists(f:period)) or exists(f:periodUnit)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-4", "severity": "error", "human": "duration SHALL be a non-negative value", "expression": "duration.exists() implies duration >= 0", "xpath": "f:duration/@value >= 0 or not(f:duration/@value)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-5", "severity": "error", "human": "period SHALL be a non-negative value", "expression": "period.exists() implies period >= 0", "xpath": "f:period/@value >= 0 or not(f:period/@value)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-6", "severity": "error", "human": "If there's a periodMax, there must be a period", "expression": "periodMax.empty() or period.exists()", "xpath": "not(exists(f:periodMax)) or exists(f:period)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-7", "severity": "error", "human": "If there's a durationMax, there must be a duration", "expression": "durationMax.empty() or duration.exists()", "xpath": "not(exists(f:durationMax)) or exists(f:duration)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-8", "severity": "error", "human": "If there's a countMax, there must be a count", "expression": "countMax.empty() or count.exists()", "xpath": "not(exists(f:countMax)) or exists(f:count)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-9", "severity": "error", "human": "If there's an offset, there must be a when (and not C, CM, CD, CV)", "expression": "offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))", "xpath": "not(exists(f:offset)) or exists(f:when)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" }, { "key": "tim-10", "severity": "error", "human": "If there's a timeOfDay, there cannot be a when, or vice versa", "expression": "timeOfDay.empty() or when.empty()", "xpath": "not(exists(f:timeOfDay)) or not(exists(f:when))", "source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "Implies PIVL or EIVL" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.id", "path": "MedicationStatement.dosage.timing.repeat.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.extension", "path": "MedicationStatement.dosage.timing.repeat.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.bounds[x]", "path": "MedicationStatement.dosage.timing.repeat.bounds[x]", "short": "Length/Range of lengths, or (Start and/or end) limits", "definition": "Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.bounds[x]", "min": 0, "max": "1" }, "type": [ { "code": "Duration" }, { "code": "Range" }, { "code": "Period" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "IVL(TS) used in a QSI" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.count", "path": "MedicationStatement.dosage.timing.repeat.count", "short": "Number of times to repeat", "definition": "A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.", "comment": "If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.", "requirements": "Repetitions may be limited by end time or total occurrences.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.count", "min": 0, "max": "1" }, "type": [ { "code": "positiveInt" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.count" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.countMax", "path": "MedicationStatement.dosage.timing.repeat.countMax", "short": "Maximum number of times to repeat", "definition": "If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.countMax", "min": 0, "max": "1" }, "type": [ { "code": "positiveInt" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.count" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.duration", "path": "MedicationStatement.dosage.timing.repeat.duration", "short": "How long when it happens", "definition": "How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.", "comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).", "requirements": "Some activities are not instantaneous and need to be maintained for a period of time.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.duration", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.durationMax", "path": "MedicationStatement.dosage.timing.repeat.durationMax", "short": "How long when it happens (Max)", "definition": "If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.", "comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).", "requirements": "Some activities are not instantaneous and need to be maintained for a period of time.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.durationMax", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.durationUnit", "path": "MedicationStatement.dosage.timing.repeat.durationUnit", "short": "s | min | h | d | wk | mo | a - unit of time (UCUM)", "definition": "The units of time for the duration, in UCUM units.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.durationUnit", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "UnitsOfTime" } ], "strength": "required", "description": "A unit of time (units from UCUM).", "valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.1" }, "mapping": [ { "identity": "rim", "map": "PIVL.phase.unit" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.frequency", "path": "MedicationStatement.dosage.timing.repeat.frequency", "short": "Event occurs frequency times per period", "definition": "The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.frequency", "min": 0, "max": "1" }, "type": [ { "code": "positiveInt" } ], "meaningWhenMissing": "If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this", "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.frequencyMax", "path": "MedicationStatement.dosage.timing.repeat.frequencyMax", "short": "Event occurs up to frequencyMax times per period", "definition": "If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.frequencyMax", "min": 0, "max": "1" }, "type": [ { "code": "positiveInt" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.period", "path": "MedicationStatement.dosage.timing.repeat.period", "short": "Event occurs frequency times per period", "definition": "Indicates the duration of time over which repetitions are to occur; e.g. to express \"3 times per day\", 3 would be the frequency and \"1 day\" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.period", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.periodMax", "path": "MedicationStatement.dosage.timing.repeat.periodMax", "short": "Upper limit of period (3-4 hours)", "definition": "If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as \"do this once every 3-5 days.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.periodMax", "min": 0, "max": "1" }, "type": [ { "code": "decimal" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "PIVL.phase" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.periodUnit", "path": "MedicationStatement.dosage.timing.repeat.periodUnit", "short": "s | min | h | d | wk | mo | a - unit of time (UCUM)", "definition": "The units of time for the period in UCUM units.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.periodUnit", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "UnitsOfTime" } ], "strength": "required", "description": "A unit of time (units from UCUM).", "valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.1" }, "mapping": [ { "identity": "rim", "map": "PIVL.phase.unit" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.dayOfWeek", "path": "MedicationStatement.dosage.timing.repeat.dayOfWeek", "short": "mon | tue | wed | thu | fri | sat | sun", "definition": "If one or more days of week is provided, then the action happens only on the specified day(s).", "comment": "If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.", "min": 0, "max": "*", "base": { "path": "Timing.repeat.dayOfWeek", "min": 0, "max": "*" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "DayOfWeek" } ], "strength": "required", "valueSet": "http://hl7.org/fhir/ValueSet/days-of-week|4.0.1" }, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.timeOfDay", "path": "MedicationStatement.dosage.timing.repeat.timeOfDay", "short": "Time of day for action", "definition": "Specified time of day for action to take place.", "comment": "When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.", "min": 0, "max": "*", "base": { "path": "Timing.repeat.timeOfDay", "min": 0, "max": "*" }, "type": [ { "code": "time" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.when", "path": "MedicationStatement.dosage.timing.repeat.when", "short": "Code for time period of occurrence", "definition": "An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.", "comment": "When more than one event is listed, the event is tied to the union of the specified events.", "requirements": "Timings are frequently determined by occurrences such as waking, eating and sleep.", "min": 0, "max": "*", "base": { "path": "Timing.repeat.when", "min": 0, "max": "*" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "EventTiming" } ], "strength": "required", "description": "Real world event relating to the schedule.", "valueSet": "http://hl7.org/fhir/ValueSet/event-timing|4.0.1" }, "mapping": [ { "identity": "rim", "map": "EIVL.event" } ] }, { "id": "MedicationStatement.dosage.timing.repeat.offset", "path": "MedicationStatement.dosage.timing.repeat.offset", "short": "Minutes from event (before or after)", "definition": "The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.", "min": 0, "max": "1", "base": { "path": "Timing.repeat.offset", "min": 0, "max": "1" }, "type": [ { "code": "unsignedInt" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "EIVL.offset" } ] }, { "id": "MedicationStatement.dosage.timing.code", "path": "MedicationStatement.dosage.timing.code", "short": "BID | TID | QID | AM | PM | QD | QOD | +", "definition": "A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 0, "max": "1", "base": { "path": "Timing.code", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "TimingAbbreviation" } ], "strength": "preferred", "description": "Code for a known / defined timing pattern.", "valueSet": "http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1" }, "mapping": [ { "identity": "rim", "map": "QSC.code" } ] }, { "id": "MedicationStatement.dosage.timing.code.id", "path": "MedicationStatement.dosage.timing.code.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.code.extension", "path": "MedicationStatement.dosage.timing.code.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.timing.code.coding", "path": "MedicationStatement.dosage.timing.code.coding", "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.dosage.timing.code.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.dosage.timing.code.text", "short": "Plain text representation of the concept", "definition": "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": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "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": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "MedicationStatement.dosage.asNeeded[x]", "path": "MedicationStatement.dosage.asNeeded[x]", "short": "Take \"as needed\" (for x)", "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 0, "max": "1", "base": { "path": "Dosage.asNeeded[x]", "min": 0, "max": "1" }, "type": [ { "code": "boolean" }, { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationAsNeededReason" } ], "strength": "example", "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.", "valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1" }, "mapping": [ { "identity": "v2", "map": "TQ1-9" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept" } ] }, { "id": "MedicationStatement.dosage.site", "path": "MedicationStatement.dosage.site", "short": "Body site to administer to", "definition": "Body site to administer to.", "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both.", "requirements": "A coded specification of the anatomic site where the medication first enters the body.", "min": 0, "max": "1", "base": { "path": "Dosage.site", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationAdministrationSite" } ], "strength": "example", "description": "A coded concept describing the site location the medicine enters into or onto the body.", "valueSet": "http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1" }, "mapping": [ { "identity": "v2", "map": "RXR-2" }, { "identity": "rim", "map": ".approachSiteCode" } ] }, { "id": "MedicationStatement.dosage.route", "path": "MedicationStatement.dosage.route", "short": "How drug should enter body", "definition": "How drug should enter body.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.route mapped to SNOMED CT CA (routeSCTCA) and EMR-specific codes (routeEMR)", "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.", "min": 0, "max": "1", "base": { "path": "Dosage.route", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "RouteOfAdministration" } ], "strength": "example", "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.", "valueSet": "http://hl7.org/fhir/ValueSet/route-codes|4.0.1" }, "mapping": [ { "identity": "v2", "map": "RXR-1" }, { "identity": "rim", "map": ".routeCode" } ] }, { "id": "MedicationStatement.dosage.route.id", "path": "MedicationStatement.dosage.route.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.route.extension", "path": "MedicationStatement.dosage.route.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.route.coding", "path": "MedicationStatement.dosage.route.coding", "slicing": { "discriminator": [ { "type": "value", "path": "system" } ], "rules": "open" }, "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA", "path": "MedicationStatement.dosage.route.coding", "sliceName": "routeSCTCA", "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.route mapped to https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "strength": "required", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration" }, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.id", "path": "MedicationStatement.dosage.route.coding.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.extension", "path": "MedicationStatement.dosage.route.coding.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.system", "path": "MedicationStatement.dosage.route.coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 0, "max": "1", "base": { "path": "Coding.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.version", "path": "MedicationStatement.dosage.route.coding.version", "short": "Version of the system - if relevant", "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.", "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.", "min": 0, "max": "1", "base": { "path": "Coding.version", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.7" }, { "identity": "rim", "map": "./codeSystemVersion" }, { "identity": "orim", "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.code", "path": "MedicationStatement.dosage.route.coding.code", "short": "Symbol in syntax defined by the system", "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to refer to a particular code in the system.", "min": 0, "max": "1", "base": { "path": "Coding.code", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.dosage.route.coding.display", "short": "Representation defined by the system", "definition": "A representation of the meaning of the code in the system, following the rules of the system.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.", "min": 0, "max": "1", "base": { "path": "Coding.display", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.2 - but note this is not well followed" }, { "identity": "rim", "map": "CV.displayName" }, { "identity": "orim", "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.userSelected", "path": "MedicationStatement.dosage.route.coding.userSelected", "short": "If this coding was chosen directly by the user", "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).", "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.", "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.", "min": 0, "max": "1", "base": { "path": "Coding.userSelected", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "Sometimes implied by being first" }, { "identity": "rim", "map": "CD.codingRationale" }, { "identity": "orim", "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR", "path": "MedicationStatement.dosage.route.coding", "sliceName": "routeEMR", "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: EMR-specific route code from respondent_medications.route\n\nUsage Note: this will provide the EMR specific route codes \r\n\r\nCodes 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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.id", "path": "MedicationStatement.dosage.route.coding.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.extension", "path": "MedicationStatement.dosage.route.coding.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.system", "path": "MedicationStatement.dosage.route.coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 0, "max": "1", "base": { "path": "Coding.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.version", "path": "MedicationStatement.dosage.route.coding.version", "short": "Version of the system - if relevant", "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.", "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.", "min": 0, "max": "1", "base": { "path": "Coding.version", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.7" }, { "identity": "rim", "map": "./codeSystemVersion" }, { "identity": "orim", "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.code", "path": "MedicationStatement.dosage.route.coding.code", "short": "Symbol in syntax defined by the system", "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to refer to a particular code in the system.", "min": 0, "max": "1", "base": { "path": "Coding.code", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.dosage.route.coding.display", "short": "Representation defined by the system", "definition": "A representation of the meaning of the code in the system, following the rules of the system.", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.", "min": 0, "max": "1", "base": { "path": "Coding.display", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.2 - but note this is not well followed" }, { "identity": "rim", "map": "CV.displayName" }, { "identity": "orim", "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" } ] }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.userSelected", "path": "MedicationStatement.dosage.route.coding.userSelected", "short": "If this coding was chosen directly by the user", "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).", "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.", "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.", "min": 0, "max": "1", "base": { "path": "Coding.userSelected", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "Sometimes implied by being first" }, { "identity": "rim", "map": "CD.codingRationale" }, { "identity": "orim", "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]" } ] }, { "id": "MedicationStatement.dosage.route.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "MedicationStatement.dosage.route.text", "short": "Plain text representation of the concept", "definition": "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": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.route (free-text route value)", "requirements": "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": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "MedicationStatement.dosage.method", "path": "MedicationStatement.dosage.method", "short": "Technique for administering medication", "definition": "Technique for administering medication.", "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.", "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.", "min": 0, "max": "1", "base": { "path": "Dosage.method", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationAdministrationMethod" } ], "strength": "example", "description": "A coded concept describing the technique by which the medicine is administered.", "valueSet": "http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1" }, "mapping": [ { "identity": "v2", "map": "RXR-4" }, { "identity": "rim", "map": ".doseQuantity" } ] }, { "id": "MedicationStatement.dosage.doseAndRate", "path": "MedicationStatement.dosage.doseAndRate", "short": "Amount of medication administered", "definition": "The amount of medication administered.", "min": 0, "max": "*", "base": { "path": "Dosage.doseAndRate", "min": 0, "max": "*" }, "type": [ { "code": "Element" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "TQ1-2" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.id", "path": "MedicationStatement.dosage.doseAndRate.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.extension", "path": "MedicationStatement.dosage.doseAndRate.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.type", "path": "MedicationStatement.dosage.doseAndRate.type", "short": "The kind of dose or rate specified", "definition": "The kind of dose or rate specified, for example, ordered or calculated.", "requirements": "If the type is not populated, assume to be \"ordered\".", "min": 0, "max": "1", "base": { "path": "Dosage.doseAndRate.type", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "DoseAndRateType" } ], "strength": "example", "description": "The kind of dose or rate specified.", "valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1" }, "mapping": [ { "identity": "v2", "map": "RXO-21; RXE-23" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.dose[x]", "path": "MedicationStatement.dosage.doseAndRate.dose[x]", "short": "Amount of medication per dose", "definition": "Amount of medication per dose.", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "requirements": "The amount of therapeutic or other substance given at one administration event.", "min": 0, "max": "1", "base": { "path": "Dosage.doseAndRate.dose[x]", "min": 0, "max": "1" }, "type": [ { "code": "Range" }, { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "RXO-2, RXE-3" }, { "identity": "rim", "map": ".doseQuantity" } ] }, { "id": "MedicationStatement.dosage.doseAndRate.rate[x]", "path": "MedicationStatement.dosage.doseAndRate.rate[x]", "short": "Amount of medication per unit of time", "definition": "Amount of medication per unit of time.", "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\r\rIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.", "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "min": 0, "max": "1", "base": { "path": "Dosage.doseAndRate.rate[x]", "min": 0, "max": "1" }, "type": [ { "code": "Ratio" }, { "code": "Range" }, { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "RXE22, RXE23, RXE-24" }, { "identity": "rim", "map": ".rateQuantity" } ] }, { "id": "MedicationStatement.dosage.maxDosePerPeriod", "path": "MedicationStatement.dosage.maxDosePerPeriod", "short": "Upper limit on medication per unit of time", "definition": "Upper limit on medication per unit of time.", "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example \"2 tablets every 4 hours to a maximum of 8/day\".", "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.", "min": 0, "max": "1", "base": { "path": "Dosage.maxDosePerPeriod", "min": 0, "max": "1" }, "type": [ { "code": "Ratio" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "RXO-23, RXE-19" }, { "identity": "rim", "map": ".maxDoseQuantity" } ] }, { "id": "MedicationStatement.dosage.maxDosePerAdministration", "path": "MedicationStatement.dosage.maxDosePerAdministration", "short": "Upper limit on medication per administration", "definition": "Upper limit on medication per administration.", "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.", "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.", "min": 0, "max": "1", "base": { "path": "Dosage.maxDosePerAdministration", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "not supported" } ] }, { "id": "MedicationStatement.dosage.maxDosePerLifetime", "path": "MedicationStatement.dosage.maxDosePerLifetime", "short": "Upper limit on medication per lifetime of the patient", "definition": "Upper limit on medication per lifetime of the patient.", "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.", "min": 0, "max": "1", "base": { "path": "Dosage.maxDosePerLifetime", "min": 0, "max": "1" }, "type": [ { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "not supported" } ] } ] }, "differential": { "element": [ { "id": "MedicationStatement", "path": "MedicationStatement" }, { "id": "MedicationStatement.id", "path": "MedicationStatement.id", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1, "mustSupport": true }, { "id": "MedicationStatement.meta.lastUpdated", "path": "MedicationStatement.meta.lastUpdated", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.updated_at", "min": 1 }, { "id": "MedicationStatement.meta.source", "path": "MedicationStatement.meta.source", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1 }, { "id": "MedicationStatement.meta.security", "path": "MedicationStatement.meta.security", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: Populated when respondents.restriction_owner_id or encounters.restriction_owner_id is set." }, { "id": "MedicationStatement.text", "path": "MedicationStatement.text", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1, "mustSupport": true }, { "id": "MedicationStatement.extension", "path": "MedicationStatement.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" } }, { "id": "MedicationStatement.extension:RenderedDosageInstruction", "path": "MedicationStatement.extension", "sliceName": "RenderedDosageInstruction", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.dosage_data or respondent_medications.name.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction" ] } ], "mustSupport": true }, { "id": "MedicationStatement.identifier", "path": "MedicationStatement.identifier", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "min": 1, "max": "1", "mustSupport": true }, { "id": "MedicationStatement.identifier.system", "path": "MedicationStatement.identifier.system", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nurn:telus:emr:*:*:medicationstatement\r\nIdentifier.system is always case sensitive.", "min": 1 }, { "id": "MedicationStatement.identifier.value", "path": "MedicationStatement.identifier.value", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.id", "min": 1 }, { "id": "MedicationStatement.basedOn", "path": "MedicationStatement.basedOn", "short": "Fulfills plan, proposal or order", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported", "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest" ] } ] }, { "id": "MedicationStatement.partOf", "path": "MedicationStatement.partOf", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported", "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationAdministration", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationStatement", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwProcedure", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults" ] } ], "mustSupport": true }, { "id": "MedicationStatement.status", "path": "MedicationStatement.status", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR status derived from respondent_medications:\n- active: archived=false, no stop/cancel dates, continuous or future end date\n- completed: archived=false, continuous=false, past end_at\n- stopped: archived=false, has cancellation_at/stop date\n- entered-in-error: deleted record\n\nUsage note: Status of the current and past medication on a patient's chart in the EMR \r\n\r\nMedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\r\rThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.", "mustSupport": true }, { "id": "MedicationStatement.statusReason", "path": "MedicationStatement.statusReason", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.cancellation_note when present.", "mustSupport": true }, { "id": "MedicationStatement.medication[x]", "path": "MedicationStatement.medication[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "rules": "open" }, "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Either medicationReference (when DIN/product record available) or medicationCodeableConcept (when no medication on record).", "mustSupport": true }, { "id": "MedicationStatement.medication[x]:medicationReference", "path": "MedicationStatement.medication[x]", "sliceName": "medicationReference", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: medication/ when a product record with DIN exists.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedication" ] } ], "mustSupport": true }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept", "path": "MedicationStatement.medication[x]", "sliceName": "medicationCodeableConcept", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: no-medication-info or no-known-medications when no specific medication is on record.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "binding": { "strength": "preferred", "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-medications-uv-ips" } }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system", "path": "MedicationStatement.medication[x].coding.system", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.code", "path": "MedicationStatement.medication[x].coding.code", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display", "path": "MedicationStatement.medication[x].coding.display", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.medication[x]:medicationCodeableConcept.text", "path": "MedicationStatement.medication[x].text", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.subject", "path": "MedicationStatement.subject", "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient" ] } ] }, { "id": "MedicationStatement.context", "path": "MedicationStatement.context", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_prescriptions.encounter_id", "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwEncounter" ] } ], "mustSupport": true }, { "id": "MedicationStatement.effective[x]", "path": "MedicationStatement.effective[x]", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: effectivePeriod.start ← respondent_medications.start_at; effectivePeriod.end ← respondent_medications.end_at\n\nUsage note:\r\nProvide effective.period with start and end date\r\nIf the medication is current and does not have an end date in the EMR then provide the effective.period with just the start date. \r\n\r\n\r\nThis attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.", "min": 1, "mustSupport": true }, { "id": "MedicationStatement.dateAsserted", "path": "MedicationStatement.dateAsserted", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.created_at", "mustSupport": true }, { "id": "MedicationStatement.reasonCode", "path": "MedicationStatement.reasonCode", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: reasonCode.coding from diagnoses linked to medication (diagnoses.code, diagnoses.description); reasonCode.text from respondent_medications.conditions", "mustSupport": true }, { "id": "MedicationStatement.reasonReference", "path": "MedicationStatement.reasonReference", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: MA and PSS - indication identified in the prescription\r\n\r\nThis is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.", "type": [ { "code": "Reference", "targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwCondition", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwDiagnosticReport" ] } ], "mustSupport": true }, { "id": "MedicationStatement.note", "path": "MedicationStatement.note", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.additional_instructions", "mustSupport": true }, { "id": "MedicationStatement.dosage", "path": "MedicationStatement.dosage", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Structured dosage from respondent_medications.dosages_data (YAML) including route, additionalInstruction, and timing. A rendered dosage string is also available via extension[RenderedDosageInstruction].", "mustSupport": true }, { "id": "MedicationStatement.dosage.sequence", "path": "MedicationStatement.dosage.sequence", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.\r\n\r\n32 bit number; for values larger than this, use decimal", "mustSupport": true }, { "id": "MedicationStatement.dosage.text", "path": "MedicationStatement.dosage.text", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.additionalInstruction", "path": "MedicationStatement.dosage.additionalInstruction", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.additional_instructions\n\nUsage Note:: To convey explicit instructions to the Pharmacist/dispenser related to this medication order.\r\n\r\nInformation about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.", "mustSupport": true }, { "id": "MedicationStatement.dosage.patientInstruction", "path": "MedicationStatement.dosage.patientInstruction", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nPSS: Label Instruction. Note: this is also part of text. Note, with meals\", \"may cause drowsiness are included here but FHIR shows under additional instructions.\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size", "mustSupport": true }, { "id": "MedicationStatement.dosage.timing", "path": "MedicationStatement.dosage.timing", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: dosage.timing.repeat.duration from respondent_medications.total_days", "mustSupport": true }, { "id": "MedicationStatement.dosage.timing.repeat", "path": "MedicationStatement.dosage.timing.repeat", "mustSupport": false }, { "id": "MedicationStatement.dosage.timing.code", "path": "MedicationStatement.dosage.timing.code", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.timing.code.text", "path": "MedicationStatement.dosage.timing.code.text", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.asNeeded[x]", "path": "MedicationStatement.dosage.asNeeded[x]", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route", "path": "MedicationStatement.dosage.route", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.route mapped to SNOMED CT CA (routeSCTCA) and EMR-specific codes (routeEMR)", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding", "path": "MedicationStatement.dosage.route.coding", "slicing": { "discriminator": [ { "type": "value", "path": "system" } ], "rules": "open" } }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA", "path": "MedicationStatement.dosage.route.coding", "sliceName": "routeSCTCA", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.route mapped to https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration", "min": 0, "max": "*", "binding": { "strength": "required", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration" } }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.system", "path": "MedicationStatement.dosage.route.coding.system", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.code", "path": "MedicationStatement.dosage.route.coding.code", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding:routeSCTCA.display", "path": "MedicationStatement.dosage.route.coding.display", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding:routeEMR", "path": "MedicationStatement.dosage.route.coding", "sliceName": "routeEMR", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: EMR-specific route code from respondent_medications.route\n\nUsage Note: this will provide the EMR specific route codes \r\n\r\nCodes 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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "min": 0, "max": "*", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.system", "path": "MedicationStatement.dosage.route.coding.system", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.code", "path": "MedicationStatement.dosage.route.coding.code", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.coding:routeEMR.display", "path": "MedicationStatement.dosage.route.coding.display", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true }, { "id": "MedicationStatement.dosage.route.text", "path": "MedicationStatement.dosage.route.text", "comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: respondent_medications.route (free-text route value)", "mustSupport": true }, { "id": "MedicationStatement.dosage.doseAndRate.dose[x]", "path": "MedicationStatement.dosage.doseAndRate.dose[x]", "comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known", "mustSupport": true } ] } }