{
"description": "Medicatie Gebruik",
"_filename": "StructureDefinition-MedicationStatement.json",
"package_name": "hl7.fhir.nl.zorgviewer",
"date": "2025-04-01T10:39:46+00:00",
"derivation": "constraint",
"publisher": "RIVO-NN HL7NL",
"fhirVersion": "3.0.2",
"jurisdiction": [ {
"coding": [ {
"code": "NL",
"system": "urn:iso:std:iso:3166"
} ]
} ],
"name": "MedicationUse",
"mapping": [ {
"uri": "https://zibs.nl/wiki/MedicationUse2-v1.0.1(2017EN)",
"name": "HCIM MedicationUse2-v1.0.1(2017EN)",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"uri": "https://zibs.nl/wiki/TimeInterval-v1.0(2017EN)",
"name": "HCIM TimeInterval-v1.0(2017EN)",
"identity": "hcim-timeinterval-v1.0-2017EN"
}, {
"uri": "https://zibs.nl/wiki/InstructionsForUse-v1.1(2017EN)",
"name": "HCIM InstructionsForUse-v1.1(2017EN)",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"uri": "https://zibs.nl/wiki/BasicElements-v1.0(2017EN)",
"name": "HCIM BasicElements-v1.0(2017EN)",
"identity": "hcim-basicelements-v1.0-2017EN"
}, {
"uri": "https://decor.nictiz.nl/medicatieproces/mp-html-20181220T121121/ds-2.16.840.1.113883.2.4.3.11.60.20.77.1.3-2016-06-01T000000.html",
"name": "Medication Process v09",
"comment": "Language of Medication Process is Dutch.",
"identity": "Medication-Process-v09"
}, {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Mapping",
"identity": "workflow"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/w5",
"name": "W5 Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
} ],
"abstract": false,
"type": "MedicationStatement",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "MedicationUse",
"package_version": "1.13.0",
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-1",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"xpath": "not(parent::f:contained and f:text)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.text.empty()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-3",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
"xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()"
}, {
"key": "mst-1",
"human": "Reason not taken is only permitted if Taken is No",
"xpath": "not(exists(f:reasonNotTaken)) or f:taken/@value='n'",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "reasonNotTaken.exists().not() or (taken = 'n')"
} ],
"path": "MedicationStatement",
"min": 0,
"definition": "MedicationUse is a statement on the historic, current or intended use of a certain medicine.",
"short": "MedicationUse",
"mapping": [ {
"map": "NL-CM:9.11.21338",
"comment": "MedicationUse",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "..Event",
"identity": "workflow"
}, {
"map": "SubstanceAdministration",
"identity": "rim"
}, {
"map": "clinical.medication",
"identity": "w5"
} ],
"alias": [ "Medicatiegebruik" ],
"max": "*",
"id": "MedicationStatement",
"comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement"
}
}, {
"path": "MedicationStatement.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"short": "Logical id of this artifact",
"type": [ {
"code": "id"
} ],
"max": "1",
"id": "MedicationStatement.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"path": "MedicationStatement.meta",
"min": 0,
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "MedicationStatement.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"path": "MedicationStatement.implicitRules",
"min": 0,
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.implicitRules",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isSummary": true
}, {
"path": "MedicationStatement.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "extensible",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages"
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
} ],
"description": "A human language.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/languages"
}
},
"max": "1",
"id": "MedicationStatement.language",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
}
}, {
"path": "MedicationStatement.text",
"min": 0,
"definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "MedicationStatement.text",
"condition": [ "dom-1" ],
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
}
}, {
"path": "MedicationStatement.contained",
"min": 0,
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "MedicationStatement.contained",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
}
}, {
"path": "MedicationStatement.extension",
"min": 0,
"definition": "An Extension",
"short": "Extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationStatement.extension",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() | (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationStatement.extension",
"min": 0,
"definition": "Is the medicine used as outlined in the medication agreement?",
"short": "AsAgreedIndicator",
"mapping": [ {
"map": "NL-CM:9.11.22492",
"comment": "AsAgreedIndicator",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
} ],
"sliceName": "asAgreedIndicator",
"alias": [ "VolgensAfspraakIndicator" ],
"max": "1",
"id": "MedicationStatement.extension:asAgreedIndicator",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"path": "MedicationStatement.extension.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.extension:asAgreedIndicator.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.extension.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.extension:asAgreedIndicator.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"short": "identifies the meaning of the extension",
"fixedUri": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.extension:asAgreedIndicator.url",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
}
}, {
"path": "MedicationStatement.extension.value[x]",
"min": 0,
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"short": "Value of extension",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationStatement.extension:asAgreedIndicator.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
}
}, {
"path": "MedicationStatement.extension.value[x]",
"min": 0,
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"short": "Value of extension",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
} ],
"sliceName": "valueBoolean",
"max": "1",
"id": "MedicationStatement.extension:asAgreedIndicator.value[x]:valueBoolean",
"example": [ {
"label": "Example of asAgreed",
"valueBoolean": true
} ],
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() | (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationStatement.extension",
"min": 0,
"definition": "The health professional that entered the medication agreement with the patient.",
"short": "Prescriber",
"mapping": [ {
"map": "NL-CM:9.11.23290",
"comment": "Prescriber",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber"
} ],
"sliceName": "prescriber",
"alias": [ "Voorschrijver" ],
"max": "1",
"id": "MedicationStatement.extension:prescriber",
"condition": [ "ele-1" ],
"comment": "The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() | (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationStatement.extension",
"min": 0,
"definition": "The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.",
"short": "Author",
"mapping": [ {
"map": "NL-CM:0.0.7",
"comment": "Author",
"identity": "hcim-basicelements-v1.0-2017EN"
}, {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author"
} ],
"sliceName": "author",
"alias": [ "Auteur" ],
"max": "1",
"id": "MedicationStatement.extension:author",
"condition": [ "ele-1" ],
"comment": "The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() | (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationStatement.extension",
"min": 0,
"definition": "This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.",
"short": "Medical Treatment",
"mapping": [ {
"map": "mp-dataelement900-22092",
"comment": "Medicamenteuze behandeling",
"identity": "Medication-Process-v09"
}, {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment"
} ],
"sliceName": "medicationTreatment",
"alias": [ "Medicamenteuze Behandeling" ],
"max": "1",
"id": "MedicationStatement.extension:medicationTreatment",
"condition": [ "ele-1" ],
"comment": "No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() | (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationStatement.extension",
"min": 0,
"definition": "Reason for changing or discontinuing use of medication.",
"short": "ReasonForChangeOrDiscontinuationOfUse",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
} ],
"sliceName": "reasonForChangeOrDiscontinuationOfUse",
"alias": [ "RedenWijzigenOfStoppenGebruik", "Reden wijzigen of stoppen gebruik" ],
"max": "*",
"id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"path": "MedicationStatement.extension.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.extension.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"short": "identifies the meaning of the extension",
"fixedUri": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.url",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
}
}, {
"path": "MedicationStatement.extension.value[x]",
"min": 0,
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"short": "Value of extension",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"max": "1",
"id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
}
}, {
"path": "MedicationStatement.extension.value[x]",
"min": 0,
"definition": "Reason for changing or discontinuing use of medication.",
"short": "ReasonForChangeOrDiscontinuationOfUse",
"mapping": [ {
"map": "NL-CM:9.11.22493",
"comment": "Reden wijzigen of stoppen gebruik",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "valueCodeableConcept",
"binding": {
"strength": "extensible",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.11.2--20171231000000"
}
},
"alias": [ "Reden wijzigen of stoppen gebruik" ],
"max": "1",
"id": "MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]:valueCodeableConcept",
"example": [ {
"label": "Example of ReasonForChangeOrDiscontinuationOfUse",
"valueCodeableConcept": {
"coding": [ {
"code": "79899007",
"system": "http://snomed.info/sct",
"display": "Drug interaction (finding)"
} ]
}
} ],
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
}
}, {
"path": "MedicationStatement.modifierExtension",
"min": 0,
"definition": "An Extension",
"isModifier": true,
"short": "Extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationStatement.modifierExtension",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() | (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationStatement.modifierExtension",
"min": 0,
"definition": "The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.\r\n\r\nExamples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days.\r\nRepeatPeriodCyclicalSchedule",
"isModifier": true,
"short": "RepeatPeriodCyclicalSchedule",
"mapping": [ {
"map": "NL-CM:9.12.22505",
"comment": "RepeatPeriodCyclicalSchedule",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-Medication-RepeatPeriodCyclicalSchedule"
} ],
"sliceName": "repeatPeriodCyclicalSchedule",
"max": "1",
"label": "HerhaalperiodeCyclischSchema",
"id": "MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
}
}, {
"path": "MedicationStatement.identifier",
"min": 0,
"definition": "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 updated.",
"short": "External identifier",
"mapping": [ {
"map": "NL-CM:0.0.6",
"comment": "IdentificationNumber",
"identity": "hcim-basicelements-v1.0-2017EN"
}, {
"map": "…identifer",
"identity": "workflow"
}, {
"map": ".id",
"identity": "rim"
}, {
"map": "id",
"identity": "w5"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "MedicationStatement.identifier",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.identifier"
},
"isSummary": true
}, {
"path": "MedicationStatement.basedOn",
"requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
"min": 0,
"definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
"short": "Fulfils plan, proposal or order",
"mapping": [ {
"map": "…basedOn",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
} ],
"max": "*",
"id": "MedicationStatement.basedOn",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.basedOn"
},
"isSummary": true
}, {
"path": "MedicationStatement.partOf",
"requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.",
"min": 0,
"definition": "A larger event of which this particular event is a component or step.",
"short": "Part of referenced event",
"mapping": [ {
"map": "…part of",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationDispense"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
} ],
"max": "*",
"id": "MedicationStatement.partOf",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.partOf"
},
"isSummary": true
}, {
"path": "MedicationStatement.context",
"min": 0,
"definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
"short": "Encounter / Episode associated with MedicationStatement",
"mapping": [ {
"map": "…context",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
} ],
"max": "1",
"id": "MedicationStatement.context",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.context"
},
"isSummary": true
}, {
"path": "MedicationStatement.status",
"min": 1,
"definition": "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.",
"isModifier": true,
"short": "MedicationUseStopType",
"mapping": [ {
"map": "NL-CM:9.11.23132",
"comment": "MedicationUseStopType. A ConceptMap (http://nictiz.nl/fhir/ConceptMap/MedicationUseStopTypeCodeLijst-to-MedicationStatementStatus) is available that maps MedicationUseStopTypeCodeLijst to the MedicationStatementStatus value set.",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "…status",
"identity": "workflow"
}, {
"map": ".statusCode",
"identity": "rim"
}, {
"map": "status",
"identity": "w5"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"description": "Allergy Intolerance critically Code list",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/medication-statement-status"
}
},
"alias": [ "MedicatieGebruikStopType" ],
"max": "1",
"id": "MedicationStatement.status",
"comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.\r\n\r\nThis element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive).",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.status"
},
"isSummary": true
}, {
"path": "MedicationStatement.category",
"min": 1,
"definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
"short": "Type of medication usage",
"mapping": [ {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value",
"identity": "rim"
}, {
"map": "class",
"identity": "w5"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementCategory"
} ],
"description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
}
},
"max": "1",
"id": "MedicationStatement.category",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.category"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.category.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.category.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.category.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.category.coding",
"requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "code",
"type": "value"
} ]
},
"type": [ {
"code": "Coding"
} ],
"max": "*",
"id": "MedicationStatement.category.coding",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.coding",
"requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.",
"min": 0,
"definition": "Category code used for indexing/retrieval of the HCIM MedicationUse. The system and code are stated in the Medication Process v09.",
"short": "MedicationUseCode",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"sliceName": "medicationUseCode",
"max": "*",
"id": "MedicationStatement.category.coding:medicationUseCode",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.coding.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.category.coding:medicationUseCode.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.category.coding.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.category.coding:medicationUseCode.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.category.coding.system",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"short": "Identity of the terminology system",
"fixedUri": "urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3",
"mapping": [ {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.category.coding:medicationUseCode.system",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.coding.version",
"min": 0,
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "C*E.7",
"identity": "v2"
}, {
"map": "./codeSystemVersion",
"identity": "rim"
}, {
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationStatement.category.coding:medicationUseCode.version",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.version"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.coding.code",
"fixedCode": "6",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"max": "1",
"id": "MedicationStatement.category.coding:medicationUseCode.code",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.coding.display",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"short": "Representation defined by the system",
"mapping": [ {
"map": "C*E.2 - but note this is not well followed",
"identity": "v2"
}, {
"map": "CV.displayName",
"identity": "rim"
}, {
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.category.coding:medicationUseCode.display",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.coding.userSelected",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "Sometimes implied by being first",
"identity": "v2"
}, {
"map": "CD.codingRationale",
"identity": "rim"
}, {
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]",
"identity": "orim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationStatement.category.coding:medicationUseCode.userSelected",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"base": {
"max": "1",
"min": 0,
"path": "Coding.userSelected"
},
"isSummary": true
}, {
"path": "MedicationStatement.category.text",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.category.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x]",
"min": 1,
"definition": "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 medications.",
"short": "What medication was taken",
"mapping": [ {
"map": "…code",
"identity": "workflow"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
}, {
"map": "what",
"identity": "w5"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "Reference"
} ],
"max": "1",
"id": "MedicationStatement.medication[x]",
"comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example if you require form or lot number, then you must reference the Medication resource. .",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.medication[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x]",
"min": 1,
"definition": "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 medications.",
"short": "ProductUsed",
"mapping": [ {
"map": "NL-CM:9.11.21339",
"comment": "ProductUsed",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "…code",
"identity": "workflow"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
}, {
"map": "what",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://nictiz.nl/fhir/StructureDefinition/zib-Product"
} ],
"sliceName": "medicationReference",
"alias": [ "Gebruiksproduct" ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.medication[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x].id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.medication[x].extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.medication[x]:medicationReference.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.medication[x].reference",
"min": 0,
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference.reference",
"condition": [ "ref-1" ],
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x].identifier",
"min": 0,
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference.identifier",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x].display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference.display",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"path": "MedicationStatement.effective[x]",
"min": 0,
"definition": "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).",
"short": "The date/time or interval when the medication was taken",
"mapping": [ {
"map": "…occurrence[x]",
"identity": "workflow"
}, {
"map": ".effectiveTime",
"identity": "rim"
}, {
"map": "when.done",
"identity": "w5"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "MedicationStatement.effective[x]",
"comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.effective[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.effective[x]",
"min": 0,
"definition": "Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.\r\n\r\nStart date: This is the time at which the agreement was to take effect (or took effect or will take effect). \r\n\r\nDuration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. \r\n\r\nEnd date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.",
"short": "PeriodOfUse",
"mapping": [ {
"map": "NL-CM:9.11.22663",
"comment": "PeriodOfUse",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "NL-CM:0.0.14",
"comment": "DateTime",
"identity": "hcim-basicelements-v1.0-2017EN"
}, {
"map": "…occurrence[x]",
"identity": "workflow"
}, {
"map": ".effectiveTime",
"identity": "rim"
}, {
"map": "when.done",
"identity": "w5"
} ],
"type": [ {
"code": "Period"
} ],
"sliceName": "effectivePeriod",
"alias": [ "Gebruiksperiode" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod",
"comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.effective[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.effective[x].id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.effective[x].extension",
"min": 0,
"definition": "An Extension",
"short": "Extension",
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.effective[x].extension",
"min": 0,
"definition": "The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.",
"short": "Duration",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
} ],
"sliceName": "Duration",
"alias": [ "tijdsDuur" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.effective[x].extension.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.effective[x].extension.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.effective[x].extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"short": "identifies the meaning of the extension",
"fixedUri": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.url",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
}
}, {
"path": "MedicationStatement.effective[x].extension.value[x]",
"min": 0,
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"short": "Value of extension",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "Duration"
} ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
}
}, {
"path": "MedicationStatement.effective[x].extension.value[x]",
"min": 0,
"definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
"short": "UsageDuration",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
} ],
"sliceName": "valueDuration",
"alias": [ "Gebruiksduur" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension:Duration.value[x]:valueDuration",
"example": [ {
"label": "Example of Duration",
"valueDuration": {
"code": "d",
"unit": "day",
"value": 3,
"system": "http://unitsofmeasure.org"
}
} ],
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
}
}, {
"path": "MedicationStatement.effective[x].start",
"min": 0,
"definition": "This is the time at which the agreement was to take effect (or took effect or will take effect).",
"short": "StartDate",
"mapping": [ {
"map": "NL-CM:20.3.2",
"comment": "startDateTime",
"identity": "hcim-timeinterval-v1.0-2017EN"
}, {
"map": "DR.1",
"identity": "v2"
}, {
"map": "./low",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"alias": [ "Ingangsdatum" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.start",
"condition": [ "per-1" ],
"comment": "If the low element is missing, the meaning is that the low boundary is not known.",
"base": {
"max": "1",
"min": 0,
"path": "Period.start"
},
"isSummary": true
}, {
"path": "MedicationStatement.effective[x].end",
"min": 0,
"definition": "The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.",
"short": "EndDate",
"mapping": [ {
"map": "NL-CM:20.3.3",
"comment": "endDateTime",
"identity": "hcim-timeinterval-v1.0-2017EN"
}, {
"map": "DR.2",
"identity": "v2"
}, {
"map": "./high",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
"alias": [ "Einddatum" ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.end",
"condition": [ "per-1" ],
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
"base": {
"max": "1",
"min": 0,
"path": "Period.end"
},
"isSummary": true
}, {
"path": "MedicationStatement.dateAsserted",
"min": 1,
"definition": "Date on which this use is entered.",
"short": "MedicationUseDateTime",
"mapping": [ {
"map": "NL-CM:9.11.22398",
"comment": "MedicationUseDateTime",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": ".participation[typeCode=AUT].time",
"identity": "rim"
}, {
"map": "when.recorded",
"identity": "w5"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"alias": [ "Registratiedatum" ],
"max": "1",
"id": "MedicationStatement.dateAsserted",
"example": [ {
"label": "Example of MedicationUseDateTime",
"valueDateTime": "2017-06-14"
} ],
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.dateAsserted"
},
"isSummary": true
}, {
"path": "MedicationStatement.informationSource",
"min": 0,
"definition": "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 MedicationRequest.",
"short": "Person or organization that provided the information about the taking of this medication",
"mapping": [ {
"map": "NL-CM:0.0.2",
"comment": "InformationSource",
"identity": "hcim-basicelements-v1.0-2017EN"
}, {
"map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)",
"identity": "rim"
}, {
"map": "who.source",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient"
}, {
"code": "Reference",
"targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner"
}, {
"code": "Reference",
"targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson"
}, {
"code": "Reference",
"targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-organization"
} ],
"max": "1",
"id": "MedicationStatement.informationSource",
"comment": "If a health professional is the informationSource the PractitionerRole reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.informationSource"
}
}, {
"path": "MedicationStatement.informationSource.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.informationSource.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.informationSource.extension",
"min": 0,
"definition": "An Extension",
"short": "Extension",
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationStatement.informationSource.extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.informationSource.extension",
"min": 0,
"definition": "Optional Extension Element - found in all resources.",
"short": "Optional Extensions Element",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": "http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference"
} ],
"sliceName": "practitionerRole",
"max": "1",
"id": "MedicationStatement.informationSource.extension:practitionerRole",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.informationSource.reference",
"min": 0,
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationStatement.informationSource.reference",
"condition": [ "ref-1" ],
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"path": "MedicationStatement.informationSource.identifier",
"min": 0,
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "MedicationStatement.informationSource.identifier",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"path": "MedicationStatement.informationSource.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.informationSource.display",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"path": "MedicationStatement.subject",
"min": 1,
"definition": "The person, animal or group who is/was taking the medication.",
"short": "Who is/was taking the medication",
"mapping": [ {
"map": "NL-CM:0.0.11",
"comment": "Subject",
"identity": "hcim-basicelements-v1.0-2017EN"
}, {
"map": "…subject",
"identity": "workflow"
}, {
"map": "PID-3-Patient ID List",
"identity": "v2"
}, {
"map": ".participation[typeCode=SBJ].role[classCode=PAT]",
"identity": "rim"
}, {
"map": "who",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient"
} ],
"max": "1",
"id": "MedicationStatement.subject",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.subject"
},
"isSummary": true
}, {
"path": "MedicationStatement.derivedFrom",
"min": 0,
"definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
"short": "Additional supporting information",
"mapping": [ {
"map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
} ],
"max": "*",
"id": "MedicationStatement.derivedFrom",
"comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.derivedFrom"
}
}, {
"path": "MedicationStatement.taken",
"min": 1,
"definition": "Is this medicine used or not?",
"isModifier": true,
"short": "UseIndicator",
"mapping": [ {
"map": "NL-CM:9.11.22399",
"comment": "UseIndicator",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "…notDone",
"identity": "workflow"
}, {
"map": ".actionNegationInd",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementTaken"
} ],
"description": "A coded concept identifying level of certainty if patient has taken or has not taken the medication",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/medication-statement-taken"
}
},
"alias": [ "GebruikIndicator" ],
"max": "1",
"id": "MedicationStatement.taken",
"comment": "This element is labeled as a modifier because it indicates that the medication was not taken.",
"example": [ {
"label": "Example of taken",
"valueCode": "y"
} ],
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.taken"
},
"isSummary": true
}, {
"path": "MedicationStatement.reasonNotTaken",
"min": 0,
"definition": "A code indicating why the medication was not taken.",
"short": "True if asserting medication was not given",
"mapping": [ {
"map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason not taken\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementNotTakenReason"
} ],
"description": "A coded concept indicating the reason why the medication was not taken",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/reason-medication-not-taken-codes"
}
},
"max": "*",
"id": "MedicationStatement.reasonNotTaken",
"condition": [ "mst-1" ],
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.reasonNotTaken"
}
}, {
"path": "MedicationStatement.reasonCode",
"min": 0,
"definition": "A reason for why the medication is being/was taken.",
"short": "Reason for why the medication is being/was taken",
"mapping": [ {
"map": "…reasoneCodeableConcept",
"identity": "workflow"
}, {
"map": ".reasonCode",
"identity": "rim"
}, {
"map": "why",
"identity": "w5"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationReason"
} ],
"description": "A coded concept identifying why the medication is being taken.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/condition-code"
}
},
"max": "*",
"id": "MedicationStatement.reasonCode",
"comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.reasonCode"
}
}, {
"path": "MedicationStatement.reasonCode.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.reasonCode.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.reasonCode.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.reasonCode.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.reasonCode.coding",
"requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"max": "*",
"id": "MedicationStatement.reasonCode.coding",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationStatement.reasonCode.text",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"definition": "The reason for using the medication, particularly in self-care medicine purchased by the patient themselves.",
"short": "ReasonForUse",
"mapping": [ {
"map": "NL-CM:9.11.22491",
"comment": "ReasonForUse",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"alias": [ "RedenGebruik" ],
"max": "1",
"id": "MedicationStatement.reasonCode.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"path": "MedicationStatement.reasonReference",
"min": 0,
"definition": "Condition or observation that supports why the medication is being/was taken.",
"short": "Condition or observation that supports why the medication is being/was taken",
"mapping": [ {
"map": "…reasonReference",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value",
"identity": "rim"
}, {
"map": "why",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
}, {
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
} ],
"max": "*",
"id": "MedicationStatement.reasonReference",
"comment": "This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.reasonReference"
}
}, {
"path": "MedicationStatement.note",
"min": 0,
"definition": "Comments on the medication use.",
"short": "Comment",
"mapping": [ {
"map": "NL-CM:9.11.21624",
"comment": "Comment",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "…note",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"alias": [ "Toelichting" ],
"max": "*",
"id": "MedicationStatement.note",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.note"
}
}, {
"path": "MedicationStatement.dosage",
"min": 0,
"definition": "Indicates how the medication is/was or should be taken by the patient.",
"short": "Details of how medication is/was taken or should be taken",
"mapping": [ {
"map": "NL-CM:9.11.22504",
"comment": "InstructionsForUse",
"identity": "hcim-medicationuse2-v1.0.1-2017EN"
}, {
"map": "refer dosageInstruction mapping",
"identity": "rim"
} ],
"type": [ {
"code": "Dosage",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse"
} ],
"max": "*",
"id": "MedicationStatement.dosage",
"comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\" It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.dosage"
}
}, {
"path": "MedicationStatement.dosage.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.dosage.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.dosage.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.dosage.sequence",
"requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.",
"min": 0,
"definition": "This indicates the sequence of the dosing instructions within the medication agreement.",
"short": "SequenceNumber",
"mapping": [ {
"map": "NL-CM:9.12.22503",
"comment": "SequenceNumber",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "integer"
} ],
"alias": [ "Volgnummer" ],
"max": "1",
"id": "MedicationStatement.dosage.sequence",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.sequence"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.text",
"requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.",
"min": 0,
"definition": "Textual description of the complete instructions for use including the period of use.",
"short": "Description",
"mapping": [ {
"map": "NL-CM:9.12.9581",
"comment": "Description",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"alias": [ "Omschrijving" ],
"max": "1",
"id": "MedicationStatement.dosage.text",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.text"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.additionalInstruction",
"requirements": "Additional instruction such as \"Swallow with plenty of water\" which may or may not be coded.",
"min": 0,
"definition": "The additional instructions contain extra information on the use of or considerations for the current prescription. This can also include all instructions for use. The text can come from the original 'paper' medication prescription, but can also be generated from the coded information. This concept may contain more information than what is structurally coded in the information below, but may not conflict with it. The instructions may not conflict with other components of the request for administration. The instructions can also refer to an existing protocol. The G standard contains many texts that can support this attribute, in for example G standard table 362, which contains texts from the general practitioners’ standard WCIA table 25. If desired, these texts can be used to structure this concept.",
"short": "AdditionalInstructions",
"mapping": [ {
"map": "NL-CM:9.12.19944",
"comment": "AdditionalInstructions",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdditionalInstruction"
} ],
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.9--20160407000000"
}
},
"alias": [ "AanvullendeInstructie" ],
"max": "*",
"id": "MedicationStatement.dosage.additionalInstruction",
"base": {
"max": "*",
"min": 0,
"path": "Dosage.additionalInstruction"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.patientInstruction",
"min": 0,
"definition": "Instructions in terms that are understood by the patient or consumer.",
"short": "Patient or consumer oriented instructions",
"mapping": [ {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationStatement.dosage.patientInstruction",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.patientInstruction"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.timing",
"requirements": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"definition": "Specifications of the times at which the medication is to be administered. This is indicated as follows: Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. A specific number of times the medication is to be taken each day (“3x a day“), indicated with the frequency A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: The end date and time has been reached The total administration duration has been reached (14 days) A specific amount of administrations has been reached (“20 doses”, “one-time only”), to be entered in the NumberOfDoses concept.",
"short": "When medication should be administered",
"mapping": [ {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "Timing",
"profile": "http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationSchedule"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing",
"comment": "This attribute may not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.timing"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.asNeeded[x]",
"min": 0,
"definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
"short": "Take \"as needed\" (for x)",
"mapping": [ {
"map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAsNeededReason"
} ],
"description": "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.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
}
},
"max": "1",
"id": "MedicationStatement.dosage.asNeeded[x]",
"comment": "Can express \"as needed\" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express \"as needed\" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.asNeeded[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.asNeeded[x]",
"min": 0,
"definition": "As needed means that the dose is only to be administered under certain conditions.",
"short": "AsNeeded",
"mapping": [ {
"map": "NL-CM:9.12.22512",
"comment": "AsNeeded",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": "NL-CM:9.12.19945",
"comment": "Condition",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "asNeededCodeableConcept",
"binding": {
"strength": "extensible",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAsNeededReason"
} ],
"description": "ZonodigCriteriumCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.4--20171231000000"
}
},
"alias": [ "Zo nodig", "Criterium" ],
"max": "1",
"id": "MedicationStatement.dosage.asNeeded[x]:asNeededCodeableConcept",
"comment": "Using the term 'as needed' or a specific reason (eg 'in case of pain') to use medication leads to ambiguity. It is not always clear whether the whole dose is 'as needed' or only part of the dose. For example: 1x daily 1-2 tablets as needed. This can mean: 1 tablet fixed per day and 1 tablet as needed or, as needed, a maximum of 2 tablets.As needed medication is not included in GDS. In the first situation, 1 tablet comes in the GDS (drug dispensing systems) and 1 tablet is delivered separately. In the second situation there is only separate delivery.The system must make sufficiently clear whether the entire instruction or part of the dose is necessary. The HCIM supports both options described above.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.asNeeded[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.site",
"requirements": "A coded specification of the anatomic site where the medication first enters the body.",
"min": 0,
"definition": "Body site to administer to.",
"short": "Body site to administer to",
"mapping": [ {
"map": ".approachSiteCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAdministrationSite"
} ],
"description": "A coded concept describing the site location the medicine enters into or onto the body.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/approach-site-codes"
}
},
"max": "1",
"id": "MedicationStatement.dosage.site",
"comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](http://hl7.org/fhir/STU3/extension-body-site-instance.html). May be a summary code, or a reference to a very precise definition of the location, or both.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.site"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.route",
"requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
"min": 0,
"definition": "The route through which the medication is administered (oral, nasal, intravenous, etc.)",
"short": "RouteOfAdministration",
"mapping": [ {
"map": "NL-CM:9.12.19941",
"comment": "RouteOfAdministration",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".routeCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"description": "ToedieningswegCodelijst",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.1--20171231000000"
}
},
"alias": [ "Toedieningsweg" ],
"max": "1",
"id": "MedicationStatement.dosage.route",
"example": [ {
"label": "Example of RouteOfAdministration",
"valueCodeableConcept": {
"coding": [ {
"code": "oraal",
"system": "urn:oid:2.16.840.1.113883.2.4.4.9",
"display": "Oraal"
} ]
}
} ],
"base": {
"max": "1",
"min": 0,
"path": "Dosage.route"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.route.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.route.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.dosage.route.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.dosage.route.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.dosage.route.coding",
"requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"short": "Code defined by a terminology system",
"mapping": [ {
"map": "C*E.1-8, C*E.10-22",
"identity": "v2"
}, {
"map": "union(., ./translation)",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding"
} ],
"max": "*",
"id": "MedicationStatement.dosage.route.coding",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.route.text",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.dosage.route.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.method",
"requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.",
"min": 0,
"definition": "Technique for administering medication.",
"short": "Technique for administering medication",
"mapping": [ {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAdministrationMethod"
} ],
"description": "A coded concept describing the technique by which the medicine is administered.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/administration-method-codes"
}
},
"max": "1",
"id": "MedicationStatement.dosage.method",
"comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.method"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "The dose indicates the dose amount per administration. \n \nThe dosage is described in the unit accompanying the product; usually, this is just a number of units or doses. Liquids and other divisible products will usually include a unit of volume (preferably \"ml\"). \n \nIn many cases, the prescriber will want to indicate the dose in units of weight of the active ingredient. \n \nIf only the ingredient is included and not the product, then the amount of that ingredient will be given. Paracetamol 1000mg is equivalent to 2 Paracetamol 500mg tablets or units. \n \nThe dosage is sometimes given as a calculation, in which the patient’s body weight or body surface area is used as a parameter. The calculation is however no more than an aid in reaching a decision. \n \nIn the event of constant administration, sometimes the dose is given in addition to the administration speed (infusion rate) (e.g. 20ml in a syringe or 500ml in a bag), but it is often also omitted. \n \nA general dosage recommendation such as ‘Use according to protocol’ or ‘See instructions’ can be sufficient. In that case, no dose is given.",
"short": "Dose",
"mapping": [ {
"map": "NL-CM:9.12.19940",
"comment": "Dose",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "Range"
}, {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"alias": [ "Keerdosis" ],
"max": "1",
"id": "MedicationStatement.dosage.dose[x]",
"comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.dose[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "Amount of medication per dose.",
"short": "Amount of medication per dose",
"mapping": [ {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"sliceName": "doseQuantity",
"binding": {
"strength": "required",
"description": "GstdTabel902",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453"
}
},
"max": "1",
"id": "MedicationStatement.dosage.dose[x]:doseQuantity",
"comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.dose[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "Amount of medication per dose.",
"short": "Amount of medication per dose",
"mapping": [ {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Range"
} ],
"sliceName": "doseRange",
"max": "1",
"id": "MedicationStatement.dosage.dose[x]:doseRange",
"comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.dose[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.dose[x].id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.dose[x]:doseRange.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.dosage.dose[x].extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.dosage.dose[x]:doseRange.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.dosage.dose[x].low",
"min": 0,
"definition": "The low limit. The boundary is inclusive.",
"short": "Low limit",
"mapping": [ {
"map": "NR.1",
"identity": "v2"
}, {
"map": "./low",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"binding": {
"strength": "required",
"description": "GstdTabel902",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453"
}
},
"max": "1",
"id": "MedicationStatement.dosage.dose[x]:doseRange.low",
"condition": [ "rng-2" ],
"comment": "If the low element is missing, the low boundary is not known.",
"base": {
"max": "1",
"min": 0,
"path": "Range.low"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.dose[x].high",
"min": 0,
"definition": "The high limit. The boundary is inclusive.",
"short": "High limit",
"mapping": [ {
"map": "NR.2",
"identity": "v2"
}, {
"map": "./high",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"binding": {
"strength": "required",
"description": "GstdTabel902",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453"
}
},
"max": "1",
"id": "MedicationStatement.dosage.dose[x]:doseRange.high",
"condition": [ "rng-2" ],
"comment": "If the high element is missing, the high boundary is not known.",
"base": {
"max": "1",
"min": 0,
"path": "Range.high"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.maxDosePerPeriod",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.",
"min": 0,
"definition": "A maximum dose indicates the maximum duration a product can be used with an ‘as needed’ prescription.\r\n\r\nFor example:\r\n- Max 6 units per day\r\n- Max 200ml per week",
"short": "MaximumDose",
"mapping": [ {
"map": "NL-CM:9.12.19946",
"comment": "MaximumDose",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".maxDoseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
} ],
"alias": [ "Maximale dosering", "Maximale dosis (per dag enz.)" ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerPeriod",
"comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example \"2 tablets every 4 hours to a maximum of 8/day\".",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerPeriod"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.maxDosePerPeriod.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "xml:id (or equivalent in JSON)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerPeriod.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"path": "MedicationStatement.dosage.maxDosePerPeriod.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional Content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.dosage.maxDosePerPeriod.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.dosage.maxDosePerPeriod.numerator",
"min": 0,
"definition": "The value of the numerator.",
"short": "Numerator value",
"mapping": [ {
"map": ".numerator",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity"
} ],
"binding": {
"strength": "required",
"description": "GstdTabel902",
"valueSetReference": {
"reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453"
}
},
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerPeriod.numerator",
"base": {
"max": "1",
"min": 0,
"path": "Ratio.numerator"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.maxDosePerPeriod.denominator",
"min": 0,
"definition": "The value of the denominator.",
"short": "Denominator value",
"mapping": [ {
"map": ".denominator",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity"
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerPeriod.denominator",
"base": {
"max": "1",
"min": 0,
"path": "Ratio.denominator"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.maxDosePerAdministration",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
"min": 0,
"definition": "Upper limit on medication per administration.",
"short": "Upper limit on medication per administration",
"mapping": [ {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerAdministration",
"comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerAdministration"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.maxDosePerLifetime",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
"min": 0,
"definition": "Upper limit on medication per lifetime of the patient.",
"short": "Upper limit on medication per lifetime of the patient",
"mapping": [ {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerLifetime",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerLifetime"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.rate[x]",
"requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"definition": "The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: amount = 10, dose unit = ml time unit = hour",
"short": "AdministeringSpeed",
"mapping": [ {
"map": "NL-CM:9.12.19942",
"comment": "AdministeringSpeed",
"identity": "hcim-instructionsforuse-v1.1-2017EN"
}, {
"map": ".rateQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
}, {
"code": "Range"
}, {
"code": "Quantity",
"profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
} ],
"alias": [ "Toedieningssnelheid", "Inloopsnelheid" ],
"max": "1",
"id": "MedicationStatement.dosage.rate[x]",
"comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.rate[x]"
},
"isSummary": true
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "2.2.11"
} ]
},
"status": "active",
"id": "9086945a-ccf4-4161-a0ee-e9a4831e4667",
"kind": "resource",
"url": "http://fhir.hl7.nl/zorgviewer/StructureDefinition/MedicationStatement",
"version": "1.13.0",
"differential": {
"element": [ {
"id": "MedicationStatement.category.text",
"path": "MedicationStatement.category.text",
"mustSupport": true
}, {
"id": "MedicationStatement.medicationReference.display",
"path": "MedicationStatement.medicationReference.display",
"mustSupport": true
}, {
"id": "MedicationStatement.dateAsserted",
"path": "MedicationStatement.dateAsserted",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.text",
"path": "MedicationStatement.dosage.text",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.text",
"path": "MedicationStatement.dosage.route.text",
"mustSupport": true
} ]
},
"contact": [ {
"name": "RIVO-NN",
"telecom": [ {
"value": "https://rivo-noord.nl",
"system": "url"
} ]
}, {
"name": "HL7NL",
"telecom": [ {
"value": "https://hl7.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse"
}