FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). 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 UseCompartments: 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 inluded 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 medicaation, supplies or devices when there is a patient focus or instructions regarding their use, a MedicationRequest, SupplyRequest or DeviceRequestDeviceRequest 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 refer 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 and Goal

11.4.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement IDomainResourceRecord of medication being taken by a patient
+ Reason not taken is only permitted if Taken is No
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold
MedicationStatementStatus (Required)
... category Σ0..1CodeableConceptType of medication usage
MedicationStatementCategory (Preferred)
... medication[x] Σ1..1What medication was taken
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... effective[x] Σ0..1The date/time or interval when the medication was 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
... subject Σ1..1Reference(Patient | Group)Who is/was taking the medication
... derivedFrom 0..*Reference(Any)Additional supporting information
... taken ?!Σ1..1codey | n | unk | na
MedicationStatementTaken (Required)
... reasonNotTaken I0..*CodeableConceptTrue if asserting medication was not given
SNOMED CT Drugs not taken/completed Codes (Example)
... reasonCode 0..*CodeableConceptReason for why the medication is being/was taken
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation)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| ProcedureRequest|ReferralRequest A larger event of which this particular event is a component or steppartOf : Reference [0..*] MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] Encounter|EpisodeOfCare 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! Indicates where type of medication statement and 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) SNOMED CT Medication ?? The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true)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 The person, animal or group who is/was taking the medicationsubject : Reference [1..1] Patient|Group Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatementderivedFrom : Reference [0..*] Any Indicator of the certainty of whether the medication was taken by the patient (this element modifies the meaning of other elements)taken : code [1..1] A coded concept identifying level of certainty if patient has taken or has not taken the medication (Strength=Required)MedicationStatementTaken! A code indicating why the medication was not takenreasonNotTaken : CodeableConcept [0..*] A coded concept indicating the reason why the medication was not taken (Strength=Example)SNOMED CT Drugs not taken/com...?? 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/Diagnosis ?? Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] Condition|Observation 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|ProcedureRequest|
   ReferralRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold -->
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was taken --></medication[x]>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication was 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>
 <subject><!-- 1..1 Reference(Patient|Group) Who is/was taking  the medication --></subject>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <taken value="[code]"/><!-- 1..1 y | n | unk | na -->
 <reasonNotTaken><!-- ?? 0..* CodeableConcept True if asserting medication was not given --></reasonNotTaken>
 <reasonCode><!-- 0..* CodeableConcept Reason for why the medication is being/was taken --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) 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|ProcedureRequest|
   ReferralRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: What medication was taken. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  // effective[x]: The date/time or interval when the medication was 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
  "subject" : { Reference(Patient|Group) }, // R!  Who is/was taking  the medication
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "taken" : "<code>", // R!  y | n | unk | na
  "reasonNotTaken" : [{ CodeableConcept }], // C? True if asserting medication was not given
  "reasonCode" : [{ CodeableConcept }], // Reason for why the medication is being/was taken
  "reasonReference" : [{ Reference(Condition|Observation) }], // 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|ProcedureRequest|ReferralRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold
  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) ]
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication was 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.subject [ Reference(Patient|Group) ]; # 1..1 Who is/was taking  the medication
  fhir:MedicationStatement.derivedFrom [ Reference(Any) ], ... ; # 0..* Additional supporting information
  fhir:MedicationStatement.taken [ code ]; # 1..1 y | n | unk | na
  fhir:MedicationStatement.reasonNotTaken [ CodeableConcept ], ... ; # 0..* True if asserting medication was not given
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Reason for why the medication is being/was taken
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation) ], ... ; # 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 DSTU2

MedicationStatement
MedicationStatement.basedOn
  • Added Element
MedicationStatement.partOf
  • Added Element
MedicationStatement.context
  • Added Element
MedicationStatement.category
  • Added Element
MedicationStatement.informationSource
  • Add Reference(Organization)
MedicationStatement.subject
  • Renamed from patient to subject
  • Add Reference(Group)
MedicationStatement.derivedFrom
  • Renamed from supportingInformation to derivedFrom
MedicationStatement.taken
  • Added Element
MedicationStatement.reasonCode
  • Added Element
MedicationStatement.reasonReference
  • Added Element
MedicationStatement.note
  • Max Cardinality changed from 1 to *
  • Type changed from string to Annotation
MedicationStatement.dosage
  • Type changed from BackboneElement to Dosage
MedicationStatement.wasNotTaken
  • deleted
MedicationStatement.reasonForUse[x]
  • deleted
MedicationStatement.dosage.text
  • deleted
MedicationStatement.dosage.timing
  • deleted
MedicationStatement.dosage.asNeeded[x]
  • deleted
MedicationStatement.dosage.site[x]
  • deleted
MedicationStatement.dosage.route
  • deleted
MedicationStatement.dosage.method
  • deleted
MedicationStatement.dosage.quantity[x]
  • deleted
MedicationStatement.dosage.rate[x]
  • deleted
MedicationStatement.dosage.maxDosePerPeriod
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 7 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (1 errors).).

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement IDomainResourceRecord of medication being taken by a patient
+ Reason not taken is only permitted if Taken is No
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierExternal identifier
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold
MedicationStatementStatus (Required)
... category Σ0..1CodeableConceptType of medication usage
MedicationStatementCategory (Preferred)
... medication[x] Σ1..1What medication was taken
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... effective[x] Σ0..1The date/time or interval when the medication was 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
... subject Σ1..1Reference(Patient | Group)Who is/was taking the medication
... derivedFrom 0..*Reference(Any)Additional supporting information
... taken ?!Σ1..1codey | n | unk | na
MedicationStatementTaken (Required)
... reasonNotTaken I0..*CodeableConceptTrue if asserting medication was not given
SNOMED CT Drugs not taken/completed Codes (Example)
... reasonCode 0..*CodeableConceptReason for why the medication is being/was taken
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation)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| ProcedureRequest|ReferralRequest A larger event of which this particular event is a component or steppartOf : Reference [0..*] MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] Encounter|EpisodeOfCare 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! Indicates where type of medication statement and 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) SNOMED CT Medication ?? The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true)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 The person, animal or group who is/was taking the medicationsubject : Reference [1..1] Patient|Group Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatementderivedFrom : Reference [0..*] Any Indicator of the certainty of whether the medication was taken by the patient (this element modifies the meaning of other elements)taken : code [1..1] A coded concept identifying level of certainty if patient has taken or has not taken the medication (Strength=Required)MedicationStatementTaken! A code indicating why the medication was not takenreasonNotTaken : CodeableConcept [0..*] A coded concept indicating the reason why the medication was not taken (Strength=Example)SNOMED CT Drugs not taken/com...?? 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/Diagnosis ?? Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] Condition|Observation 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|ProcedureRequest|
   ReferralRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold -->
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was taken --></medication[x]>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication was 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>
 <subject><!-- 1..1 Reference(Patient|Group) Who is/was taking  the medication --></subject>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <taken value="[code]"/><!-- 1..1 y | n | unk | na -->
 <reasonNotTaken><!-- ?? 0..* CodeableConcept True if asserting medication was not given --></reasonNotTaken>
 <reasonCode><!-- 0..* CodeableConcept Reason for why the medication is being/was taken --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) 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|ProcedureRequest|
   ReferralRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: What medication was taken. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  // effective[x]: The date/time or interval when the medication was 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
  "subject" : { Reference(Patient|Group) }, // R!  Who is/was taking  the medication
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "taken" : "<code>", // R!  y | n | unk | na
  "reasonNotTaken" : [{ CodeableConcept }], // C? True if asserting medication was not given
  "reasonCode" : [{ CodeableConcept }], // Reason for why the medication is being/was taken
  "reasonReference" : [{ Reference(Condition|Observation) }], // 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|ProcedureRequest|ReferralRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold
  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) ]
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication was 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.subject [ Reference(Patient|Group) ]; # 1..1 Who is/was taking  the medication
  fhir:MedicationStatement.derivedFrom [ Reference(Any) ], ... ; # 0..* Additional supporting information
  fhir:MedicationStatement.taken [ code ]; # 1..1 y | n | unk | na
  fhir:MedicationStatement.reasonNotTaken [ CodeableConcept ], ... ; # 0..* True if asserting medication was not given
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Reason for why the medication is being/was taken
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation) ], ... ; # 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 DSTU2

MedicationStatement
MedicationStatement.basedOn
  • Added Element
MedicationStatement.partOf
  • Added Element
MedicationStatement.context
  • Added Element
MedicationStatement.category
  • Added Element
MedicationStatement.informationSource
  • Add Reference(Organization)
MedicationStatement.subject
  • Renamed from patient to subject
  • Add Reference(Group)
MedicationStatement.derivedFrom
  • Renamed from supportingInformation to derivedFrom
MedicationStatement.taken
  • Added Element
MedicationStatement.reasonCode
  • Added Element
MedicationStatement.reasonReference
  • Added Element
MedicationStatement.note
  • Max Cardinality changed from 1 to *
  • Type changed from string to Annotation
MedicationStatement.dosage
  • Type changed from BackboneElement to Dosage
MedicationStatement.wasNotTaken
  • deleted
MedicationStatement.reasonForUse[x]
  • deleted
MedicationStatement.dosage.text
  • deleted
MedicationStatement.dosage.timing
  • deleted
MedicationStatement.dosage.asNeeded[x]
  • deleted
MedicationStatement.dosage.site[x]
  • deleted
MedicationStatement.dosage.route
  • deleted
MedicationStatement.dosage.method
  • deleted
MedicationStatement.dosage.quantity[x]
  • deleted
MedicationStatement.dosage.rate[x]
  • deleted
MedicationStatement.dosage.maxDosePerPeriod
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 7 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (1 errors).).

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

11.4.3.1 Terminology Bindings

PathDefinitionTypeReference
MedicationStatement.status A coded concept indicating the current status of a MedicationStatement.RequiredMedicationStatementStatus
MedicationStatement.category A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administeredPreferredMedicationStatementCategory
MedicationStatement.medication[x] A coded concept identifying the substance or product being taken.ExampleSNOMED CT Medication Codes
MedicationStatement.taken A coded concept identifying level of certainty if patient has taken or has not taken the medicationRequiredMedicationStatementTaken
MedicationStatement.reasonNotTaken A coded concept indicating the reason why the medication was not takenExampleSNOMED CT Drugs not taken/completed Codes
MedicationStatement.reasonCode A coded concept identifying why the medication is being taken.ExampleCondition/Problem/Diagnosis Codes

11.4.3.2 Constraints

  • mst-1: Reason not taken is only permitted if Taken is No (expression : reasonNotTaken.exists().not() or (taken = 'n'))

11.4.3.3 How to determine if the patient has taken the medication

The MedicationStatement resource includes both a status and a taken code. The taken code conveys whether the medication was taken by the patient from the perspective of the information source. The status code reflects the current state of the practitioner’s instructions to the patient whether the consumption of the medication should continue or not.

Note: Medication statements can be made about prescribed medications as well as non-prescribed (i.e. over the counter) medications.

If you desire to perform a query for all medication statements that “imply” that a medication has been taken, you will need to use both MedicationStatement.status and MedicationStatement.taken in your query. The following table is intended to provide guidance on the interpretation of these two attributes with respect to the MedicationStatement.

In the table below the “X” represents a valid status that can be present in combination with the Taken value.

Taken Information Source Active Completed Stopped On Hold Entered in Error Intended Interpretation or Meaning
N Exists (e.g. Patient or RelatedPerson) X X X Patient or related person states the medication is not currently being taken. Taken must = N.
When status = Active, it means that although a statement was made that the patient isn’t taking the medication, the practitioner still expects and instructs the patient to take the medication.
When status = On Hold, it means that although a statement was made that the patient isn’t taking the medication, the practitioner has suspended the medication, but intends for the patient to take the medication in the future.
When status = Intended, it means that although a statement was made that the patient isn’t taking the medication, the practitioner intends for the patient to take the medication in the future.
Y Exists (e.g. Patient or RelatedPerson) X X X Patient or related person states the medication is or will be taken. Taken must = Y. The status values can be any of the following: active, on hold, or intended.
UNK No information source exists X X X No assertion by patient or related person of whether the medication is being consumed.
The MedicationStatement still exists because it can be derived from a MedicationRequest, but it is unknown whether the Patient is taking the medication as prescribed in the MedicationRequest.
NA No information source exists X X X X X X Patient reporting does not apply.
For example, this can occur when MedicationStatements are derived from MedicationRequests that are administered by a practitioner. In this example, there is no need to ask for input from the patient or related person since the practitioner was responsible for the administration.
Another example might be a MedicationStatement derived from an end-stated (stopped, completed, entered in error) MedicationRequest. In this example, there is no need to ask for input from the patient or related person since the MedicationRequest is no longer applicable.

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 codeMedicationStatement.medication.as(CodeableConcept)4 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.identifier3 Resources
medicationreferenceReturn statements of this medication referenceMedicationStatement.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
(Patient)		3 Resources
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)