Snapshot 3: Connectathon 32 Base

This page is part of the FHIR Specification (v5.0.0-snapshot3: R5 Snapshot #3, to support Connectathon 32). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

11.4 Resource MedicationUsage - Content

Pharmacy icon Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner, RelatedPerson

A record of a medication that is being consumed by a patient. A MedicationUsage 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 medicationusage and a medicationadministration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medicationusage 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 Usage 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.

The MedicationUsage resource was previously called MedicationStatement.

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 MedicationUsage 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.

MedicationUsage includes an adherence element. Note that this adherence is specific to that instance of MedicationUsage. If MedicationUsage.adherence is being tracked over time, then instances of MedicationUsage would report adherence for the interval noted in effectivePeriod.

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

11.4.2 Boundaries and Relationships

The MedicationUsage 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
MedicationUsage 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. MedicationUsage 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.

11.4.3 References to this Resource

11.4.4 Resource Content

Structure

Name iconFlags iconCard. iconType iconDescription & Constraints icondoco icon
.. MedicationUsage TUDomainResourceRecord of medication being taken by a patient

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier

... partOf 0..*Reference(Procedure)Part of referenced event

... status ?!Σ1..1coderecorded | entered-in-error | draft
MedicationUsage Status Codes (Required)
... medication Σ1..1CodeableReference(Medication)What medication was taken
SNOMED CT Medication Codes (Example)
... subject Σ1..1Reference(Patient | Group)Who is/was taking the medication
... encounter Σ0..1Reference(Encounter)Encounter associated with MedicationUsage
... effective[x] Σ0..1The date/time or interval when the medication is/was/will be taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the usage was asserted?
... informationSource 0..*Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication

... derivedFrom 0..*Reference(Any)Link to information used to derive the MedicationUsage

... reason 0..*CodeableReference(Condition | Observation | DiagnosticReport)Reason for why the medication is being/was taken
Condition/Problem/Diagnosis Codes (Example)

... note 0..*AnnotationFurther information about the usage

... relatedClinicalInformation 0..*Reference(Observation | Condition)Link to information relevant to the usage of a medication

... renderedDosageInstruction 0..1stringFull representation of the dosage instructions
... dosage 0..*DosageDetails of how medication is/was taken or should be taken

... adherence Σ0..1BackboneElementIndicates if the medication is being consumed or administered as instructed
.... code Σ1..1CodeableConceptType of adherence
MedicationUsage Adherence Codes (Example)
.... reason 0..1CodeableConceptDetails of the reason for the current use of the medication
SNOMED CT Drug Therapy Status codes (Example)

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

MedicationUsage (DomainResource)Identifiers associated with this Medication Usage 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 serveridentifier : Identifier [0..*]A larger event of which this particular MedicationUsage is a component or steppartOf : Reference [0..*] « Procedure »A code representing the status of recording the medication usage (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)MedicationUsageStatusCodes! »Type of medication usage (for example, drug classification like ATC, where meds would be administered, legal category of the medication.)category : CodeableConcept [0..*] « null (Strength=Example)MedicationRequestAdministrati...?? »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 : CodeableReference [1..1] « Medication; null (Strength=Example) SNOMEDCTMedicationCodes?? »The person, animal or group who is/was taking the medicationsubject : Reference [1..1] « Patient|Group »The encounter that establishes the context for this MedicationUsageencounter : Reference [0..1] « Encounter »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 MedicationUsage.adherence element is Not Taking)effective[x] : DataType [0..1] « dateTime|Period »The date when the Medication Usage 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 MedicationUsage is derived from other resources, e.g. Claim or MedicationRequestinformationSource : Reference [0..*] « Patient|Practitioner| PractitionerRole|RelatedPerson|Organization »Allows linking the MedicationUsage to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationUsagederivedFrom : Reference [0..*] « Any »A concept, Condition or observation that supports why the medication is being/was takenreason : CodeableReference [0..*] « Condition|Observation| DiagnosticReport; null (Strength=Example)ConditionProblemDiagnosisCodes?? »Provides extra information about the Medication Usage that is not conveyed by the other attributesnote : Annotation [0..*]Link to information that is relevant to a medication usage, for example, illicit drug use, gestational age, etcrelatedClinicalInformation : Reference [0..*] « Observation| Condition »The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering dosesrenderedDosageInstruction : string [0..1]Indicates how the medication is/was or should be taken by the patientdosage : Dosage [0..*]AdherenceType of the adherence for the medicationcode : CodeableConcept [1..1] « null (Strength=Example)MedicationUsageAdherenceCodes?? »Captures the reason for the current use or adherence of a medicationreason : CodeableConcept [0..1] « null (Strength=Example)SNOMEDCTDrugTherapyStatusCodes?? »Indicates if the medication is being consumed or administered as instructedadherence[0..1]

XML Template

<MedicationUsage 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>
 <partOf><!-- 0..* Reference(Procedure) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 recorded | entered-in-error | draft -->
 <category><!-- 0..* CodeableConcept Type of medication usage --></category>
 <medication><!-- 1..1 CodeableReference(Medication) What medication was taken --></medication>
 <subject><!-- 1..1 Reference(Group|Patient) Who is/was taking  the medication --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with MedicationUsage --></encounter>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication is/was/will be taken --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 When the usage was asserted? -->
 <informationSource><!-- 0..* Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Person or organization that provided the information about the taking of this medication --></informationSource>
 <derivedFrom><!-- 0..* Reference(Any) Link to information used to derive the MedicationUsage --></derivedFrom>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|Observation) Reason for why the medication is being/was taken --></reason>
 <note><!-- 0..* Annotation Further information about the usage --></note>
 <relatedClinicalInformation><!-- 0..* Reference(Condition|Observation) Link to information relevant to the usage of a medication --></relatedClinicalInformation>
 <renderedDosageInstruction value="[string]"/><!-- 0..1 Full representation of the dosage instructions -->
 <dosage><!-- 0..* Dosage Details of how medication is/was taken or should be taken --></dosage>
 <adherence>  <!-- 0..1 Indicates if the medication is being consumed or administered as instructed -->
  <code><!-- 1..1 CodeableConcept Type of adherence --></code>
  <reason><!-- 0..1 CodeableConcept Details of the reason for the current use of the medication --></reason>
 </adherence>
</MedicationUsage>

JSON Template

{doco
  "resourceType" : "MedicationUsage",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "partOf" : [{ Reference(Procedure) }], // Part of referenced event
  "status" : "<code>", // R!  recorded | entered-in-error | draft
  "category" : [{ CodeableConcept }], // Type of medication usage
  "medication" : { CodeableReference(Medication) }, // R!  What medication was taken
  "subject" : { Reference(Group|Patient) }, // R!  Who is/was taking  the medication
  "encounter" : { Reference(Encounter) }, // Encounter associated with MedicationUsage
  // effective[x]: The date/time or interval when the medication is/was/will be taken. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // When the usage was asserted?
  "informationSource" : [{ Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }], // Person or organization that provided the information about the taking of this medication
  "derivedFrom" : [{ Reference(Any) }], // Link to information used to derive the MedicationUsage
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|Observation) }], // Reason for why the medication is being/was taken
  "note" : [{ Annotation }], // Further information about the usage
  "relatedClinicalInformation" : [{ Reference(Condition|Observation) }], // Link to information relevant to the usage of a medication
  "renderedDosageInstruction" : "<string>", // Full representation of the dosage instructions
  "dosage" : [{ Dosage }], // Details of how medication is/was taken or should be taken
  "adherence" : { // Indicates if the medication is being consumed or administered as instructed
    "code" : { CodeableConcept }, // R!  Type of adherence
    "reason" : { CodeableConcept } // Details of the reason for the current use of the medication
  }
}

Turtle Template

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


[ a fhir:MedicationUsage;
  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:MedicationUsage.identifier [ Identifier ], ... ; # 0..* External identifier
  fhir:MedicationUsage.partOf [ Reference(Procedure) ], ... ; # 0..* Part of referenced event
  fhir:MedicationUsage.status [ code ]; # 1..1 recorded | entered-in-error | draft
  fhir:MedicationUsage.category [ CodeableConcept ], ... ; # 0..* Type of medication usage
  fhir:MedicationUsage.medication [ CodeableReference(Medication) ]; # 1..1 What medication was taken
  fhir:MedicationUsage.subject [ Reference(Group|Patient) ]; # 1..1 Who is/was taking  the medication
  fhir:MedicationUsage.encounter [ Reference(Encounter) ]; # 0..1 Encounter associated with MedicationUsage
  # MedicationUsage.effective[x] : 0..1 The date/time or interval when the medication is/was/will be taken. One of these 2
    fhir:MedicationUsage.effectiveDateTime [ dateTime ]
    fhir:MedicationUsage.effectivePeriod [ Period ]
  fhir:MedicationUsage.dateAsserted [ dateTime ]; # 0..1 When the usage was asserted?
  fhir:MedicationUsage.informationSource [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ], ... ; # 0..* Person or organization that provided the information about the taking of this medication
  fhir:MedicationUsage.derivedFrom [ Reference(Any) ], ... ; # 0..* Link to information used to derive the MedicationUsage
  fhir:MedicationUsage.reason [ CodeableReference(Condition|DiagnosticReport|Observation) ], ... ; # 0..* Reason for why the medication is being/was taken
  fhir:MedicationUsage.note [ Annotation ], ... ; # 0..* Further information about the usage
  fhir:MedicationUsage.relatedClinicalInformation [ Reference(Condition|Observation) ], ... ; # 0..* Link to information relevant to the usage of a medication
  fhir:MedicationUsage.renderedDosageInstruction [ string ]; # 0..1 Full representation of the dosage instructions
  fhir:MedicationUsage.dosage [ Dosage ], ... ; # 0..* Details of how medication is/was taken or should be taken
  fhir:MedicationUsage.adherence [ # 0..1 Indicates if the medication is being consumed or administered as instructed
    fhir:MedicationUsage.adherence.code [ CodeableConcept ]; # 1..1 Type of adherence
    fhir:MedicationUsage.adherence.reason [ CodeableConcept ]; # 0..1 Details of the reason for the current use of the medication
  ];
]

Changes since R4

This resource did not exist in Release 3

This analysis is available as XML or JSON.

Structure

Name iconFlags iconCard. iconType iconDescription & Constraints icondoco icon
.. MedicationUsage TUDomainResourceRecord of medication being taken by a patient

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier

... partOf 0..*Reference(Procedure)Part of referenced event

... status ?!Σ1..1coderecorded | entered-in-error | draft
MedicationUsage Status Codes (Required)
... medication Σ1..1CodeableReference(Medication)What medication was taken
SNOMED CT Medication Codes (Example)
... subject Σ1..1Reference(Patient | Group)Who is/was taking the medication
... encounter Σ0..1Reference(Encounter)Encounter associated with MedicationUsage
... effective[x] Σ0..1The date/time or interval when the medication is/was/will be taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the usage was asserted?
... informationSource 0..*Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication

... derivedFrom 0..*Reference(Any)Link to information used to derive the MedicationUsage

... reason 0..*CodeableReference(Condition | Observation | DiagnosticReport)Reason for why the medication is being/was taken
Condition/Problem/Diagnosis Codes (Example)

... note 0..*AnnotationFurther information about the usage

... relatedClinicalInformation 0..*Reference(Observation | Condition)Link to information relevant to the usage of a medication

... renderedDosageInstruction 0..1stringFull representation of the dosage instructions
... dosage 0..*DosageDetails of how medication is/was taken or should be taken

... adherence Σ0..1BackboneElementIndicates if the medication is being consumed or administered as instructed
.... code Σ1..1CodeableConceptType of adherence
MedicationUsage Adherence Codes (Example)
.... reason 0..1CodeableConceptDetails of the reason for the current use of the medication
SNOMED CT Drug Therapy Status codes (Example)

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

MedicationUsage (DomainResource)Identifiers associated with this Medication Usage 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 serveridentifier : Identifier [0..*]A larger event of which this particular MedicationUsage is a component or steppartOf : Reference [0..*] « Procedure »A code representing the status of recording the medication usage (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)MedicationUsageStatusCodes! »Type of medication usage (for example, drug classification like ATC, where meds would be administered, legal category of the medication.)category : CodeableConcept [0..*] « null (Strength=Example)MedicationRequestAdministrati...?? »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 : CodeableReference [1..1] « Medication; null (Strength=Example) SNOMEDCTMedicationCodes?? »The person, animal or group who is/was taking the medicationsubject : Reference [1..1] « Patient|Group »The encounter that establishes the context for this MedicationUsageencounter : Reference [0..1] « Encounter »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 MedicationUsage.adherence element is Not Taking)effective[x] : DataType [0..1] « dateTime|Period »The date when the Medication Usage 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 MedicationUsage is derived from other resources, e.g. Claim or MedicationRequestinformationSource : Reference [0..*] « Patient|Practitioner| PractitionerRole|RelatedPerson|Organization »Allows linking the MedicationUsage to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationUsagederivedFrom : Reference [0..*] « Any »A concept, Condition or observation that supports why the medication is being/was takenreason : CodeableReference [0..*] « Condition|Observation| DiagnosticReport; null (Strength=Example)ConditionProblemDiagnosisCodes?? »Provides extra information about the Medication Usage that is not conveyed by the other attributesnote : Annotation [0..*]Link to information that is relevant to a medication usage, for example, illicit drug use, gestational age, etcrelatedClinicalInformation : Reference [0..*] « Observation| Condition »The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering dosesrenderedDosageInstruction : string [0..1]Indicates how the medication is/was or should be taken by the patientdosage : Dosage [0..*]AdherenceType of the adherence for the medicationcode : CodeableConcept [1..1] « null (Strength=Example)MedicationUsageAdherenceCodes?? »Captures the reason for the current use or adherence of a medicationreason : CodeableConcept [0..1] « null (Strength=Example)SNOMEDCTDrugTherapyStatusCodes?? »Indicates if the medication is being consumed or administered as instructedadherence[0..1]

XML Template

<MedicationUsage 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>
 <partOf><!-- 0..* Reference(Procedure) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 recorded | entered-in-error | draft -->
 <category><!-- 0..* CodeableConcept Type of medication usage --></category>
 <medication><!-- 1..1 CodeableReference(Medication) What medication was taken --></medication>
 <subject><!-- 1..1 Reference(Group|Patient) Who is/was taking  the medication --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with MedicationUsage --></encounter>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication is/was/will be taken --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 When the usage was asserted? -->
 <informationSource><!-- 0..* Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Person or organization that provided the information about the taking of this medication --></informationSource>
 <derivedFrom><!-- 0..* Reference(Any) Link to information used to derive the MedicationUsage --></derivedFrom>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|Observation) Reason for why the medication is being/was taken --></reason>
 <note><!-- 0..* Annotation Further information about the usage --></note>
 <relatedClinicalInformation><!-- 0..* Reference(Condition|Observation) Link to information relevant to the usage of a medication --></relatedClinicalInformation>
 <renderedDosageInstruction value="[string]"/><!-- 0..1 Full representation of the dosage instructions -->
 <dosage><!-- 0..* Dosage Details of how medication is/was taken or should be taken --></dosage>
 <adherence>  <!-- 0..1 Indicates if the medication is being consumed or administered as instructed -->
  <code><!-- 1..1 CodeableConcept Type of adherence --></code>
  <reason><!-- 0..1 CodeableConcept Details of the reason for the current use of the medication --></reason>
 </adherence>
</MedicationUsage>

JSON Template

{doco
  "resourceType" : "MedicationUsage",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "partOf" : [{ Reference(Procedure) }], // Part of referenced event
  "status" : "<code>", // R!  recorded | entered-in-error | draft
  "category" : [{ CodeableConcept }], // Type of medication usage
  "medication" : { CodeableReference(Medication) }, // R!  What medication was taken
  "subject" : { Reference(Group|Patient) }, // R!  Who is/was taking  the medication
  "encounter" : { Reference(Encounter) }, // Encounter associated with MedicationUsage
  // effective[x]: The date/time or interval when the medication is/was/will be taken. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // When the usage was asserted?
  "informationSource" : [{ Reference(Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }], // Person or organization that provided the information about the taking of this medication
  "derivedFrom" : [{ Reference(Any) }], // Link to information used to derive the MedicationUsage
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|Observation) }], // Reason for why the medication is being/was taken
  "note" : [{ Annotation }], // Further information about the usage
  "relatedClinicalInformation" : [{ Reference(Condition|Observation) }], // Link to information relevant to the usage of a medication
  "renderedDosageInstruction" : "<string>", // Full representation of the dosage instructions
  "dosage" : [{ Dosage }], // Details of how medication is/was taken or should be taken
  "adherence" : { // Indicates if the medication is being consumed or administered as instructed
    "code" : { CodeableConcept }, // R!  Type of adherence
    "reason" : { CodeableConcept } // Details of the reason for the current use of the medication
  }
}

Turtle Template

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


[ a fhir:MedicationUsage;
  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:MedicationUsage.identifier [ Identifier ], ... ; # 0..* External identifier
  fhir:MedicationUsage.partOf [ Reference(Procedure) ], ... ; # 0..* Part of referenced event
  fhir:MedicationUsage.status [ code ]; # 1..1 recorded | entered-in-error | draft
  fhir:MedicationUsage.category [ CodeableConcept ], ... ; # 0..* Type of medication usage
  fhir:MedicationUsage.medication [ CodeableReference(Medication) ]; # 1..1 What medication was taken
  fhir:MedicationUsage.subject [ Reference(Group|Patient) ]; # 1..1 Who is/was taking  the medication
  fhir:MedicationUsage.encounter [ Reference(Encounter) ]; # 0..1 Encounter associated with MedicationUsage
  # MedicationUsage.effective[x] : 0..1 The date/time or interval when the medication is/was/will be taken. One of these 2
    fhir:MedicationUsage.effectiveDateTime [ dateTime ]
    fhir:MedicationUsage.effectivePeriod [ Period ]
  fhir:MedicationUsage.dateAsserted [ dateTime ]; # 0..1 When the usage was asserted?
  fhir:MedicationUsage.informationSource [ Reference(Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ], ... ; # 0..* Person or organization that provided the information about the taking of this medication
  fhir:MedicationUsage.derivedFrom [ Reference(Any) ], ... ; # 0..* Link to information used to derive the MedicationUsage
  fhir:MedicationUsage.reason [ CodeableReference(Condition|DiagnosticReport|Observation) ], ... ; # 0..* Reason for why the medication is being/was taken
  fhir:MedicationUsage.note [ Annotation ], ... ; # 0..* Further information about the usage
  fhir:MedicationUsage.relatedClinicalInformation [ Reference(Condition|Observation) ], ... ; # 0..* Link to information relevant to the usage of a medication
  fhir:MedicationUsage.renderedDosageInstruction [ string ]; # 0..1 Full representation of the dosage instructions
  fhir:MedicationUsage.dosage [ Dosage ], ... ; # 0..* Details of how medication is/was taken or should be taken
  fhir:MedicationUsage.adherence [ # 0..1 Indicates if the medication is being consumed or administered as instructed
    fhir:MedicationUsage.adherence.code [ CodeableConcept ]; # 1..1 Type of adherence
    fhir:MedicationUsage.adherence.reason [ CodeableConcept ]; # 0..1 Details of the reason for the current use of the medication
  ];
]

Changes since Release 4

This resource did not exist in Release 3

This analysis is available as XML or JSON.

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

11.4.4.1 Terminology Bindings

PathDefinitionTypeReference
MedicationUsage.status

MedicationUsage Status Codes

RequiredMedicationUsageStatusCodes
MedicationUsage.category

MedicationRequest Administration Location Codes

ExampleMedicationRequestAdministrationLocationCodes
MedicationUsage.medication

This value set includes all drug or medicament substance codes and all pharmaceutical/biologic products from SNOMED CT - provided as an exemplar value set.

ExampleSNOMEDCTMedicationCodes
MedicationUsage.reason

Example value set for Condition/Problem/Diagnosis codes.

ExampleConditionProblemDiagnosisCodes
MedicationUsage.adherence.code

MedicationUsage Adherence Codes

ExampleMedicationUsageAdherenceCodes
MedicationUsage.adherence.reason

This value set includes some taken and not taken reason codes from SNOMED CT - provided as an exemplar

ExampleSNOMEDCTDrugTherapyStatusCodes

11.4.5 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
adherencetokenReturns statements based on adherence or complianceMedicationUsage.adherence
categorytokenReturns statements of this category of MedicationUsageMedicationUsage.category
codetokenReturn statements of this medication codeMedicationUsage.medication.concept13 Resources
effectivedateDate when patient was taking (or not taking) the medicationMedicationUsage.effective.as(dateTime) | MedicationUsage.effective.as(Period)
encounterreferenceReturns statements for a specific encounterMedicationUsage.encounter
(Encounter)
identifiertokenReturn statements with this external identifierMedicationUsage.identifier30 Resources
medicationreferenceReturn statements of this medication referenceMedicationUsage.medication.reference4 Resources
patientreferenceReturns statements for a specific patient.MedicationUsage.subject.where(resolve() is Patient)
(Patient)		33 Resources
sourcereferenceWho or where the information in the statement came fromMedicationUsage.informationSource
(Practitioner, Organization, Patient, PractitionerRole, RelatedPerson)
statustokenReturn statements that match the given statusMedicationUsage.status4 Resources
subjectreferenceThe identity of a patient, animal or group to list statements forMedicationUsage.subject
(Group, Patient)