US Core Implementation Guide
6.0.0-ballot - STU6 Ballot US

This page is part of the US Core (v6.0.0-ballot: STU6 Ballot 1) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

Resource Profile: US Core Medication Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication Version: 6.0.0-ballot
Active as of 2019-05-21 Computable Name: USCoreMedicationProfile

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

When referencing a medication, the MedicationRequest resource can either use a code or refer to a Medication resource. This profile sets minimum expectations for the Medication resource to record, search, and fetch medications associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource when using this profile. It provides the floor for standards development for specific use cases

Example Usage Scenarios:

Queries on Medication resource are expected to be within the context of a MedicationRequest resource query. The following are example usage scenarios for the US Core Medication profile:

  • Read Medication resources referenced in MedicationRequest resources.

Mandatory and Must Support Data Elements

The following data-elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Medication must have:

  1. A medication code

Profile specific implementation guidance:

  • RXNorm concepts are used and are defined as an extensible binding. USCDI V3+ recommends the National Drug Codes (NDC) as an optional terminology. They can be supplied as an additional coding element.
  • Since the binding is extensible, when a code is unavailable just text is allowed.
  • When the medication is compounded and is a list of ingredients, the code is still present and may contain only the text.

Usage:

  • Refer to this Resource Profile:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Medication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..*MedicationDefinition of a Medication
... code S1..1CodeableConceptCodes that identify this medication
Binding: Medication Clinical Drug (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Medication.codeextensibleMedication Clinical Drug
NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..*MedicationDefinition of a Medication
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... code SΣ1..1CodeableConceptCodes that identify this medication
Binding: Medication Clinical Drug (extensible)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Medication.codeextensibleMedication Clinical Drug
Medication.statusrequiredMedication Status Codes
NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..*MedicationDefinition of a Medication
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness identifier for this medication
... code SΣ1..1CodeableConceptCodes that identify this medication
Binding: Medication Clinical Drug (extensible)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

... manufacturer Σ0..1Reference(Organization)Manufacturer of the item
... form 0..1CodeableConceptpowder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.

... amount Σ0..1RatioAmount of drug in package
... ingredient 0..*BackboneElementActive or inactive ingredient
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... item[x] 1..1The actual ingredient or content
..... itemCodeableConceptCodeableConcept
..... itemReferenceReference(Substance | Medication)
.... isActive 0..1booleanActive ingredient indicator
.... strength 0..1RatioQuantity of ingredient present
... batch 0..1BackboneElementDetails about packaged medications
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... lotNumber 0..1stringIdentifier assigned to batch
.... expirationDate 0..1dateTimeWhen batch will expire

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Medication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Medication.codeextensibleMedication Clinical Drug
Medication.statusrequiredMedication Status Codes
Medication.formexampleSNOMEDCTFormCodes

This structure is derived from Medication

Summary

Mandatory: 1 element
Must-Support: 1 element

Differential View

This structure is derived from Medication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..*MedicationDefinition of a Medication
... code S1..1CodeableConceptCodes that identify this medication
Binding: Medication Clinical Drug (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Medication.codeextensibleMedication Clinical Drug

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..*MedicationDefinition of a Medication
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... code SΣ1..1CodeableConceptCodes that identify this medication
Binding: Medication Clinical Drug (extensible)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Medication.codeextensibleMedication Clinical Drug
Medication.statusrequiredMedication Status Codes

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..*MedicationDefinition of a Medication
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness identifier for this medication
... code SΣ1..1CodeableConceptCodes that identify this medication
Binding: Medication Clinical Drug (extensible)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

... manufacturer Σ0..1Reference(Organization)Manufacturer of the item
... form 0..1CodeableConceptpowder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.

... amount Σ0..1RatioAmount of drug in package
... ingredient 0..*BackboneElementActive or inactive ingredient
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... item[x] 1..1The actual ingredient or content
..... itemCodeableConceptCodeableConcept
..... itemReferenceReference(Substance | Medication)
.... isActive 0..1booleanActive ingredient indicator
.... strength 0..1RatioQuantity of ingredient present
... batch 0..1BackboneElementDetails about packaged medications
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... lotNumber 0..1stringIdentifier assigned to batch
.... expirationDate 0..1dateTimeWhen batch will expire

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Medication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Medication.codeextensibleMedication Clinical Drug
Medication.statusrequiredMedication Status Codes
Medication.formexampleSNOMEDCTFormCodes

This structure is derived from Medication

Summary

Mandatory: 1 element
Must-Support: 1 element

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

  • The syntax used to describe the interactions is described here.
  • See the General Requirements section for additional rules and expectations when a server requires status parameters.
  • See the General Guidance section for additional guidance on searching for multiple patients.

No required search criteria for us-core-medication profile.