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 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore MedicationStatement

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

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

QI Elements:
  • status: (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  • medication[x]: (QI) What medication was taken
  • subject: (QI) Who is/was taking the medication
  • effective[x]: (QI) The date/time or interval when the medication is/was/will be taken
  • dateAsserted: (QI) When the statement was asserted?
  • informationSource: (QI) Person or organization that provided the information about the taking of this medication
  • derivedFrom: (QI) Additional supporting information
  • dosage.timing: (QI) When medication should be administered
  • dosage.route: (QI) How drug should enter body
  • dosage.doseAndRate: (QI) Amount of medication administered
  • dosage.doseAndRate.dose[x]: (QI) Amount of medication per dose
Primary code path: medication
(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.

Examples

Penicillin MedicationStatement Example

Usage:

Formal Views of Profile Content

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

This structure is derived from MedicationStatement

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement MedicationStatement
... status 1..1 code (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
... medication[x] 1..1 (QI) What medication was taken
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject 1..1 Reference(QICore Patient) (QI) Who is/was taking the medication
... dateAsserted 0..1 dateTime (QI) When the statement was asserted?
... informationSource 0..1 Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) (QI) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
... dosage 0..* Dosage (QI) Details of how medication is/was taken or should be taken
.... modifierExtension ?! 0..* Extension Extension
.... timing 0..1 Timing (QI) When medication should be administered
.... site 0..1 CodeableConcept Body site to administer to
.... route 0..1 CodeableConcept (QI) How drug should enter body
Binding: SNOMEDCTRouteCodes (preferred)
.... doseAndRate 0..* Element (QI) Amount of medication administered
..... dose[x] 0..1 Range, SimpleQuantity (QI) Amount of medication per dose

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationStatement.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationStatement.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who is/was taking the medication
... effective[x] Σ 0..1 (QI) The date/time or interval when the medication is/was/will be taken
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dateAsserted Σ 0..1 dateTime (QI) When the statement was asserted?
... informationSource 0..1 Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) (QI) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.


... dosage 0..* Dosage (QI) Details of how medication is/was taken or should be taken
.... modifierExtension ?!Σ 0..* Extension Extension
.... timing Σ 0..1 Timing (QI) When medication should be administered
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept (QI) How drug should enter body
Binding: SNOMEDCTRouteCodes (preferred)
.... doseAndRate Σ 0..* Element (QI) Amount of medication administered
..... dose[x] Σ 0..1 (QI) Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA 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
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... 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 External identifier
... basedOn Σ 0..* Reference(MedicationRequest | CarePlan | ServiceRequest) Fulfils plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) Part of referenced event
... status ?!Σ 1..1 code (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.

... statusReason 0..* CodeableConcept Reason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.


... category Σ 0..1 CodeableConcept Type of medication usage
Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

... medication[x] Σ 1..1 (QI) What medication was taken
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who is/was taking the medication
... context Σ 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with MedicationStatement
... effective[x] Σ 0..1 (QI) The date/time or interval when the medication is/was/will be taken
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dateAsserted Σ 0..1 dateTime (QI) When the statement was asserted?
... informationSource 0..1 Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) (QI) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.


... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication is being/was taken
... note 0..* Annotation Further information about the statement
... dosage 0..* Dosage (QI) Details of how medication is/was taken or should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extension
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text Σ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing Σ 0..1 Timing (QI) When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept (QI) How drug should enter body
Binding: SNOMEDCTRouteCodes (preferred)
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element (QI) Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ 0..1 (QI) Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
http://hl7.org/fhir/ValueSet/reason-medication-status-codes
from the FHIR Standard
MedicationStatement.categorypreferredMedication usage category codes
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA 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 MedicationStatement

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement MedicationStatement
... status 1..1 code (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
... medication[x] 1..1 (QI) What medication was taken
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject 1..1 Reference(QICore Patient) (QI) Who is/was taking the medication
... dateAsserted 0..1 dateTime (QI) When the statement was asserted?
... informationSource 0..1 Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) (QI) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
... dosage 0..* Dosage (QI) Details of how medication is/was taken or should be taken
.... modifierExtension ?! 0..* Extension Extension
.... timing 0..1 Timing (QI) When medication should be administered
.... site 0..1 CodeableConcept Body site to administer to
.... route 0..1 CodeableConcept (QI) How drug should enter body
Binding: SNOMEDCTRouteCodes (preferred)
.... doseAndRate 0..* Element (QI) Amount of medication administered
..... dose[x] 0..1 Range, SimpleQuantity (QI) Amount of medication per dose

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationStatement.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationStatement.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who is/was taking the medication
... effective[x] Σ 0..1 (QI) The date/time or interval when the medication is/was/will be taken
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dateAsserted Σ 0..1 dateTime (QI) When the statement was asserted?
... informationSource 0..1 Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) (QI) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.


... dosage 0..* Dosage (QI) Details of how medication is/was taken or should be taken
.... modifierExtension ?!Σ 0..* Extension Extension
.... timing Σ 0..1 Timing (QI) When medication should be administered
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept (QI) How drug should enter body
Binding: SNOMEDCTRouteCodes (preferred)
.... doseAndRate Σ 0..* Element (QI) Amount of medication administered
..... dose[x] Σ 0..1 (QI) Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA 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
.. MedicationStatement 0..* MedicationStatement Record of medication being taken by a patient
... 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 External identifier
... basedOn Σ 0..* Reference(MedicationRequest | CarePlan | ServiceRequest) Fulfils plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) Part of referenced event
... status ?!Σ 1..1 code (QI) active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.

... statusReason 0..* CodeableConcept Reason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.


... category Σ 0..1 CodeableConcept Type of medication usage
Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

... medication[x] Σ 1..1 (QI) What medication was taken
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who is/was taking the medication
... context Σ 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with MedicationStatement
... effective[x] Σ 0..1 (QI) The date/time or interval when the medication is/was/will be taken
.... effectiveDateTime dateTime
.... effectivePeriod Period
... dateAsserted Σ 0..1 dateTime (QI) When the statement was asserted?
... informationSource 0..1 Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Person or organization that provided the information about the taking of this medication
... derivedFrom 0..* Reference(Resource) (QI) Additional supporting information
... reasonCode 0..* CodeableConcept Reason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.


... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication is being/was taken
... note 0..* Annotation Further information about the statement
... dosage 0..* Dosage (QI) Details of how medication is/was taken or should be taken
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extension
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text Σ 0..1 string Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing Σ 0..1 Timing (QI) When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ 0..1 CodeableConcept (QI) How drug should enter body
Binding: SNOMEDCTRouteCodes (preferred)
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ 0..* Element (QI) Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ 0..1 (QI) Amount of medication per dose
...... doseRange Range
...... doseQuantity Quantity(SimpleQuantity)
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationStatement.statusrequiredMedication Status Codes
http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
from the FHIR Standard
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
http://hl7.org/fhir/ValueSet/reason-medication-status-codes
from the FHIR Standard
MedicationStatement.categorypreferredMedication usage category codes
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationStatement.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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-5errorMedicationStatementIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationStatementA 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()

 

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