QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 7.0.1. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Medication

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication Version: 7.0.0-ballot
Active as of 2018-08-22 Computable Name: QICoreMedication

Profile of Medication for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Must Have:
  • code: Codes that identify this medication
Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Usage

See the patterns page for implementation and usage patterns. 

define function "GetMedicationCode"(request MedicationRequest):
  if request.medication is CodeableConcept then
    request.medication as CodeableConcept
  else
    (singleton from ([Medication] M where M.id = GetId((request.medication as Reference).reference))).code

Examples

Example of an IV medication - Alemtuzumab

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreMedicationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* USCoreMedicationProfile Definition of a Medication
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... manufacturer Σ 0..1 Reference(QICore Organization) Manufacturer of the item

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* USCoreMedicationProfile Definition of a Medication
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for this medication
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

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

... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 0..* BackboneElement Active or inactive ingredient
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(QICore Substance | QICore Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient present
... batch 0..1 BackboneElement Details about packaged medications
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... lotNumber 0..1 string Identifier assigned to batch
.... expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard
Medication.formexampleSNOMEDCTFormCodes
http://hl7.org/fhir/ValueSet/medication-form-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from USCoreMedicationProfile

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* USCoreMedicationProfile Definition of a Medication
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... manufacturer Σ 0..1 Reference(QICore Organization) Manufacturer of the item

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication 0..* USCoreMedicationProfile Definition of a Medication
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for this medication
... code SΣ 1..1 CodeableConcept Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.

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

... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 0..* BackboneElement Active or inactive ingredient
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(QICore Substance | QICore Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient present
... batch 0..1 BackboneElement Details about packaged medications
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... lotNumber 0..1 string Identifier assigned to batch
.... expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Medication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Medication.codeextensibleMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
Medication.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-status|4.0.1
from the FHIR Standard
Medication.formexampleSNOMEDCTFormCodes
http://hl7.org/fhir/ValueSet/medication-form-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron