R4 Ballot #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.5.0: R4 Ballot #2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

11.4 Resource MedicationStatement - Content

Pharmacy Work GroupMaturity Level: 3 Trial Use Compartments: Patient, Practitioner, RelatedPerson

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. The 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.

11.4.1 Scope and Usage

Common usage includes:

  • the recording of non-prescription and/or recreational drugs
  • the recording of an intake medication list upon admission to hospital
  • the summarization of a patient's "active medications" in a patient profile

A MedicationStatement may be used to record substance abuse or the use of other agents such as tobacco or alcohol. This would typically be done if these substances are intended to be included in clinical decision support checking (for example, interaction checking) and as part of an active medication list. If the intent is to populate social history and/or to include additional information (for example, desire to quit, amount per day, negative health effects), then it is better to record as an Observation that could then be used to populate Social History.

This resource does not produce a medication list, but it does produce individual medication statements that may be used in the List resource to construct various types of medication lists. Note that other medication lists can also be constructed from the other Pharmacy resources (e.g., MedicationRequest, MedicationAdministration).

A medication statement is not a part of the prescribe -> dispense -> administer sequence, but is a report by a patient, significant other or a clinician that one or more of the prescribe, dispense or administer actions has occurred, resulting is a belief that the patient is, has, or will be using a particular medication.

MedicationStatement is an event resource from a FHIR workflow perspective - see Workflow Event

11.4.2 Boundaries and Relationships

The MedicationStatement resource is used to record a medications or substances that the patient reports as being taken, not taking, have taken in the past or may take in the future. It can also be used to record medication use that is derived from other records such as a MedicationRequest. The statement is not used to request or order a medication, supply or device. When requesting medication, supplies or devices when there is a patient focus or instructions regarding their use, a MedicationRequest, SupplyRequest or DeviceRequest should be used instead

The Medication domain includes a number of related resources

MedicationRequest An order for both supply of the medication and the instructions for administration of the medicine to a patient.
MedicationDispense Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription).
MedicationAdministration When a patient actually consumes a medicine, or it is otherwise administered to them
MedicationStatement This is a record of a medication being taken by a patient or that a medication has been given to a patient, where the record is the result of a report from the patient or another clinician, or derived from supporting information (for example, Claim, Observation or MedicationRequest). A medication statement is not a part of the prescribe->dispense->administer sequence, but is a report that such a sequence (or at least a part of it) did take place, resulting in a belief that the patient has received a particular medication.

This resource is distinct from MedicationRequest, MedicationDispense and MedicationAdministration. Each of those resources refers to specific events - an individual order, an individual provisioning of medication or an individual dosing. MedicationStatement is a broader assertion covering a wider timespan and is independent of specific events. The existence of resource instances of any of the preceding three types may be used to infer a medication statement. However, medication statements can also be captured on the basis of other information, including an assertion by the patient or a care-giver, the results of a lab test, etc.

This resource is referenced by AdverseEvent, Goal, itself and Observation

11.4.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement TUDomainResourceRecord of medication being taken by a patient
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
MedicationStatementStatus (Required)
... statusReason 0..*CodeableConceptReason for current status
SNOMED CT Drug Therapy Status codes (Example)
... category Σ0..1CodeableConceptType of medication usage
MedicationStatementCategory (Preferred)
... medication[x] Σ1..1What medication was taken
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject Σ1..1Reference(Patient | Group)Who is/was taking the medication
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] Σ0..1The date/time or interval when the medication is/was/will taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the statement was asserted?
... informationSource 0..1Reference(Patient | Practitioner | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... derivedFrom 0..*Reference(Any)Additional supporting information
... reasonCode 0..*CodeableConceptReason for why the medication is being/was taken
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationFurther information about the statement
... dosage 0..*DosageDetails of how medication is/was taken or should be taken

doco Documentation for this format

UML Diagram (Legend)

MedicationStatement (DomainResource)External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updatedidentifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] « MedicationRequest|CarePlan| ServiceRequest »A larger event of which this particular event is a component or steppartOf : Reference [0..*] « MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation »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 (this element modifies the meaning of other elements)status : code [1..1] « A coded concept indicating the current status of a MedicationStatement. (Strength=Required)MedicationStatementStatus! »Captures the reason for the current state of the MedicationStatementstatusReason : CodeableConcept [0..*] « A coded concept indicating the reason for the status of the statement. (Strength=Example) SNOMEDCTDrugTherapyStatusCodes?? »Indicates where the medication is expected to be consumed or administeredcategory : CodeableConcept [0..1] « A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered. (Strength=Preferred)MedicationStatementCategory? »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 medicationsmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication); A coded concept identifying the substance or product being taken. (Strength=Example) SNOMEDCTMedicationCodes?? »The person, animal or group who is/was taking the medicationsubject : Reference [1..1] « Patient|Group »The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] « Encounter|EpisodeOfCare »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)effective[x] : Type [0..1] « dateTime|Period »The date when the medication statement was asserted by the information sourcedateAsserted : dateTime [0..1]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 MedicationRequestinformationSource : Reference [0..1] « Patient|Practitioner| RelatedPerson|Organization »Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatementderivedFrom : Reference [0..*] « Any »A reason for why the medication is being/was takenreasonCode : CodeableConcept [0..*] « A coded concept identifying why the medication is being taken. (Strength=Example) Condition/Problem/DiagnosisCo...?? »Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport »Provides extra information about the medication statement that is not conveyed by the other attributesnote : Annotation [0..*]Indicates how the medication is/was or should be taken by the patientdosage : Dosage [0..*]

XML Template

<MedicationStatement xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External identifier --></identifier>
 <basedOn><!-- 0..* Reference(MedicationRequest|CarePlan|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was taken --></medication[x]>
 <subject><!-- 1..1 Reference(Patient|Group) Who is/was taking  the medication --></subject>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication is/was/will taken --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 When the statement was asserted? -->
 <informationSource><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson|
   Organization) Person or organization that provided the information about the taking of this medication --></informationSource>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <reasonCode><!-- 0..* CodeableConcept Reason for why the medication is being/was taken --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport) Condition or observation that supports why the medication is being/was taken --></reasonReference>
 <note><!-- 0..* Annotation Further information about the statement --></note>
 <dosage><!-- 0..* Dosage Details of how medication is/was taken or should be taken --></dosage>
</MedicationStatement>

JSON Template

{doco
  "resourceType" : "MedicationStatement",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "basedOn" : [{ Reference(MedicationRequest|CarePlan|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: What medication was taken. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Patient|Group) }, // R!  Who is/was taking  the medication
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  // effective[x]: The date/time or interval when the medication is/was/will taken. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // When the statement was asserted?
  "informationSource" : { Reference(Patient|Practitioner|RelatedPerson|
   Organization) }, // Person or organization that provided the information about the taking of this medication
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "reasonCode" : [{ CodeableConcept }], // Reason for why the medication is being/was taken
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport) }], // Condition or observation that supports why the medication is being/was taken
  "note" : [{ Annotation }], // Further information about the statement
  "dosage" : [{ Dosage }] // Details of how medication is/was taken or should be taken
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationStatement;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationStatement.identifier [ Identifier ], ... ; # 0..* External identifier
  fhir:MedicationStatement.basedOn [ Reference(MedicationRequest|CarePlan|ServiceRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  fhir:MedicationStatement.statusReason [ CodeableConcept ], ... ; # 0..* Reason for current status
  fhir:MedicationStatement.category [ CodeableConcept ]; # 0..1 Type of medication usage
  # MedicationStatement.medication[x] : 1..1 What medication was taken. One of these 2
    fhir:MedicationStatement.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationStatement.medicationReference [ Reference(Medication) ]
  fhir:MedicationStatement.subject [ Reference(Patient|Group) ]; # 1..1 Who is/was taking  the medication
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication is/was/will taken. One of these 2
    fhir:MedicationStatement.effectiveDateTime [ dateTime ]
    fhir:MedicationStatement.effectivePeriod [ Period ]
  fhir:MedicationStatement.dateAsserted [ dateTime ]; # 0..1 When the statement was asserted?
  fhir:MedicationStatement.informationSource [ Reference(Patient|Practitioner|RelatedPerson|Organization) ]; # 0..1 Person or organization that provided the information about the taking of this medication
  fhir:MedicationStatement.derivedFrom [ Reference(Any) ], ... ; # 0..* Additional supporting information
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Reason for why the medication is being/was taken
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation|DiagnosticReport) ], ... ; # 0..* Condition or observation that supports why the medication is being/was taken
  fhir:MedicationStatement.note [ Annotation ], ... ; # 0..* Further information about the statement
  fhir:MedicationStatement.dosage [ Dosage ], ... ; # 0..* Details of how medication is/was taken or should be taken
]

Changes since R3

MedicationStatement
MedicationStatement.basedOn
  • Type changed from Reference(MedicationRequest|CarePlan|ProcedureRequest|ReferralRequest) to Reference(MedicationRequest|CarePlan|ServiceRequest)
MedicationStatement.statusReason
  • Added Element
MedicationStatement.medication[x]
  • Remove Reference(Medication), Add Reference(Medication)
MedicationStatement.reasonReference
  • Type changed from Reference(Condition|Observation) to Reference(Condition|Observation|DiagnosticReport)
MedicationStatement.taken
  • deleted
MedicationStatement.reasonNotTaken
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 7 tests of which 3 fail to execute. 4 fail round-trip testing and 4 r3 resources are invalid (0 errors).)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement TUDomainResourceRecord of medication being taken by a patient
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
MedicationStatementStatus (Required)
... statusReason 0..*CodeableConceptReason for current status
SNOMED CT Drug Therapy Status codes (Example)
... category Σ0..1CodeableConceptType of medication usage
MedicationStatementCategory (Preferred)
... medication[x] Σ1..1What medication was taken
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject Σ1..1Reference(Patient | Group)Who is/was taking the medication
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] Σ0..1The date/time or interval when the medication is/was/will taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the statement was asserted?
... informationSource 0..1Reference(Patient | Practitioner | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... derivedFrom 0..*Reference(Any)Additional supporting information
... reasonCode 0..*CodeableConceptReason for why the medication is being/was taken
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationFurther information about the statement
... dosage 0..*DosageDetails of how medication is/was taken or should be taken

doco Documentation for this format

UML Diagram (Legend)

MedicationStatement (DomainResource)External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updatedidentifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] « MedicationRequest|CarePlan| ServiceRequest »A larger event of which this particular event is a component or steppartOf : Reference [0..*] « MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation »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 (this element modifies the meaning of other elements)status : code [1..1] « A coded concept indicating the current status of a MedicationStatement. (Strength=Required)MedicationStatementStatus! »Captures the reason for the current state of the MedicationStatementstatusReason : CodeableConcept [0..*] « A coded concept indicating the reason for the status of the statement. (Strength=Example) SNOMEDCTDrugTherapyStatusCodes?? »Indicates where the medication is expected to be consumed or administeredcategory : CodeableConcept [0..1] « A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered. (Strength=Preferred)MedicationStatementCategory? »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 medicationsmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication); A coded concept identifying the substance or product being taken. (Strength=Example) SNOMEDCTMedicationCodes?? »The person, animal or group who is/was taking the medicationsubject : Reference [1..1] « Patient|Group »The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] « Encounter|EpisodeOfCare »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)effective[x] : Type [0..1] « dateTime|Period »The date when the medication statement was asserted by the information sourcedateAsserted : dateTime [0..1]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 MedicationRequestinformationSource : Reference [0..1] « Patient|Practitioner| RelatedPerson|Organization »Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatementderivedFrom : Reference [0..*] « Any »A reason for why the medication is being/was takenreasonCode : CodeableConcept [0..*] « A coded concept identifying why the medication is being taken. (Strength=Example) Condition/Problem/DiagnosisCo...?? »Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport »Provides extra information about the medication statement that is not conveyed by the other attributesnote : Annotation [0..*]Indicates how the medication is/was or should be taken by the patientdosage : Dosage [0..*]

XML Template

<MedicationStatement xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External identifier --></identifier>
 <basedOn><!-- 0..* Reference(MedicationRequest|CarePlan|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was taken --></medication[x]>
 <subject><!-- 1..1 Reference(Patient|Group) Who is/was taking  the medication --></subject>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication is/was/will taken --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 When the statement was asserted? -->
 <informationSource><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson|
   Organization) Person or organization that provided the information about the taking of this medication --></informationSource>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <reasonCode><!-- 0..* CodeableConcept Reason for why the medication is being/was taken --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport) Condition or observation that supports why the medication is being/was taken --></reasonReference>
 <note><!-- 0..* Annotation Further information about the statement --></note>
 <dosage><!-- 0..* Dosage Details of how medication is/was taken or should be taken --></dosage>
</MedicationStatement>

JSON Template

{doco
  "resourceType" : "MedicationStatement",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "basedOn" : [{ Reference(MedicationRequest|CarePlan|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: What medication was taken. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Patient|Group) }, // R!  Who is/was taking  the medication
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  // effective[x]: The date/time or interval when the medication is/was/will taken. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // When the statement was asserted?
  "informationSource" : { Reference(Patient|Practitioner|RelatedPerson|
   Organization) }, // Person or organization that provided the information about the taking of this medication
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "reasonCode" : [{ CodeableConcept }], // Reason for why the medication is being/was taken
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport) }], // Condition or observation that supports why the medication is being/was taken
  "note" : [{ Annotation }], // Further information about the statement
  "dosage" : [{ Dosage }] // Details of how medication is/was taken or should be taken
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationStatement;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationStatement.identifier [ Identifier ], ... ; # 0..* External identifier
  fhir:MedicationStatement.basedOn [ Reference(MedicationRequest|CarePlan|ServiceRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  fhir:MedicationStatement.statusReason [ CodeableConcept ], ... ; # 0..* Reason for current status
  fhir:MedicationStatement.category [ CodeableConcept ]; # 0..1 Type of medication usage
  # MedicationStatement.medication[x] : 1..1 What medication was taken. One of these 2
    fhir:MedicationStatement.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationStatement.medicationReference [ Reference(Medication) ]
  fhir:MedicationStatement.subject [ Reference(Patient|Group) ]; # 1..1 Who is/was taking  the medication
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication is/was/will taken. One of these 2
    fhir:MedicationStatement.effectiveDateTime [ dateTime ]
    fhir:MedicationStatement.effectivePeriod [ Period ]
  fhir:MedicationStatement.dateAsserted [ dateTime ]; # 0..1 When the statement was asserted?
  fhir:MedicationStatement.informationSource [ Reference(Patient|Practitioner|RelatedPerson|Organization) ]; # 0..1 Person or organization that provided the information about the taking of this medication
  fhir:MedicationStatement.derivedFrom [ Reference(Any) ], ... ; # 0..* Additional supporting information
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Reason for why the medication is being/was taken
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation|DiagnosticReport) ], ... ; # 0..* Condition or observation that supports why the medication is being/was taken
  fhir:MedicationStatement.note [ Annotation ], ... ; # 0..* Further information about the statement
  fhir:MedicationStatement.dosage [ Dosage ], ... ; # 0..* Details of how medication is/was taken or should be taken
]

Changes since Release 3

MedicationStatement
MedicationStatement.basedOn
  • Type changed from Reference(MedicationRequest|CarePlan|ProcedureRequest|ReferralRequest) to Reference(MedicationRequest|CarePlan|ServiceRequest)
MedicationStatement.statusReason
  • Added Element
MedicationStatement.medication[x]
  • Remove Reference(Medication), Add Reference(Medication)
MedicationStatement.reasonReference
  • Type changed from Reference(Condition|Observation) to Reference(Condition|Observation|DiagnosticReport)
MedicationStatement.taken
  • deleted
MedicationStatement.reasonNotTaken
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 7 tests of which 3 fail to execute. 4 fail round-trip testing and 4 r3 resources are invalid (0 errors).)

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

11.4.3.1 Terminology Bindings

PathDefinitionTypeReference
MedicationStatement.status A coded concept indicating the current status of a MedicationStatement.RequiredMedicationStatementStatus
MedicationStatement.statusReason A coded concept indicating the reason for the status of the statement.ExampleSNOMEDCTDrugTherapyStatusCodes
MedicationStatement.category A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.PreferredMedicationStatementCategory
MedicationStatement.medication[x] A coded concept identifying the substance or product being taken.ExampleSNOMEDCTMedicationCodes
MedicationStatement.reasonCode A coded concept identifying why the medication is being taken.ExampleCondition/Problem/DiagnosisCodes

11.4.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
categorytokenReturns statements of this category of medicationstatementMedicationStatement.category
codetokenReturn statements of this medication code(MedicationStatement.medication as CodeableConcept)13 Resources
contextreferenceReturns statements for a specific context (episode or episode of Care).MedicationStatement.context
(EpisodeOfCare, Encounter)
effectivedateDate when patient was taking (or not taking) the medicationMedicationStatement.effective
identifiertokenReturn statements with this external identifierMedicationStatement.identifier30 Resources
medicationreferenceReturn statements of this medication reference(MedicationStatement.medication as Reference)
(Medication)		3 Resources
part-ofreferenceReturns statements that are part of another event.MedicationStatement.partOf
(MedicationDispense, Observation, MedicationAdministration, Procedure, MedicationStatement)
patientreferenceReturns statements for a specific patient.MedicationStatement.subject.where(resolve() is Patient)
(Patient)
sourcereferenceWho or where the information in the statement came fromMedicationStatement.informationSource
(Practitioner, Organization, Patient, RelatedPerson)
statustokenReturn statements that match the given statusMedicationStatement.status3 Resources
subjectreferenceThe identity of a patient, animal or group to list statements forMedicationStatement.subject
(Group, Patient)