{
"description": "**CHR:** Current medications are managed in the **Medications** section of the patient chart (tabs: All / Current / Past / External). New medications are added via the New Medication action and can be linked to a prescription.",
"_filename": "StructureDefinition-profile-DwMedicationStatement.json",
"package_name": "telus.dw.emr.extract-1-1-21",
"date": "2026-05-29",
"derivation": "constraint",
"publisher": "TELUS Health",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "CA",
"system": "urn:iso:std:iso:3166",
"display": "Canada"
} ]
} ],
"name": "DwMedicationStatement",
"mapping": [ {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern",
"identity": "workflow"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
} ],
"abstract": false,
"copyright": "Copyright © 2026 TELUS Health. All rights reserved.",
"type": "MedicationStatement",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "1.1.21",
"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-3",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"
}, {
"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-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
} ],
"expression": "text.`div`.exists()"
} ],
"path": "MedicationStatement",
"min": 0,
"definition": "A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. \n\nThe primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.",
"isModifier": false,
"short": "Record of medication being taken by a patient",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Event",
"identity": "workflow"
}, {
"map": "SubstanceAdministration",
"identity": "rim"
} ],
"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"
},
"isSummary": false
}, {
"path": "MedicationStatement.id",
"min": 1,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
} ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.id",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta",
"min": 0,
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"isModifier": false,
"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.meta.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.meta.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.meta.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.meta.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta.versionId",
"min": 0,
"definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
"isModifier": false,
"short": "Version specific identifier",
"type": [ {
"code": "id"
} ],
"max": "1",
"id": "MedicationStatement.meta.versionId",
"comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
"base": {
"max": "1",
"min": 0,
"path": "Meta.versionId"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta.lastUpdated",
"min": 1,
"definition": "When the resource last changed - e.g. when the version changed.",
"isModifier": false,
"short": "When the resource version last changed",
"type": [ {
"code": "instant"
} ],
"max": "1",
"id": "MedicationStatement.meta.lastUpdated",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Meta.lastUpdated"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta.source",
"min": 1,
"definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
"isModifier": false,
"short": "Identifies where the resource comes from",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.meta.source",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Meta.source"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta.profile",
"min": 0,
"definition": "A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).",
"isModifier": false,
"short": "Profiles this resource claims to conform to",
"type": [ {
"code": "canonical",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition|4.0.1" ]
} ],
"max": "*",
"id": "MedicationStatement.meta.profile",
"comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.",
"base": {
"max": "*",
"min": 0,
"path": "Meta.profile"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta.security",
"min": 0,
"definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
"isModifier": false,
"short": "Security Labels applied to this resource",
"type": [ {
"code": "Coding"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/security-labels|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SecurityLabels"
} ],
"description": "Security Labels from the Healthcare Privacy and Security Classification System."
},
"max": "*",
"id": "MedicationStatement.meta.security",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: Populated when the patient record is restricted.",
"base": {
"max": "*",
"min": 0,
"path": "Meta.security"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.meta.tag",
"min": 0,
"definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
"isModifier": false,
"short": "Tags applied to this resource",
"type": [ {
"code": "Coding"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/common-tags|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Tags"
} ],
"description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"."
},
"max": "*",
"id": "MedicationStatement.meta.tag",
"comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
"base": {
"max": "*",
"min": 0,
"path": "Meta.tag"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
} ],
"description": "A human language."
},
"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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.text",
"min": 1,
"definition": "A human-readable narrative that contains a summary of the resource and can 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.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"mustSupport": true,
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "MedicationStatement.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"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.",
"isModifier": false,
"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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"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() or (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": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "MedicationStatement.extension",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"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() or (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": "An Extension",
"isModifier": false,
"short": "Extension",
"type": [ {
"code": "Extension",
"profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction" ]
} ],
"mustSupport": true,
"sliceName": "RenderedDosageInstruction",
"max": "1",
"id": "MedicationStatement.extension:RenderedDosageInstruction",
"condition": [ "ele-1" ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"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() or (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",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.modifierExtension",
"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": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier",
"min": 1,
"definition": "Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.",
"isModifier": false,
"short": "External identifier",
"mapping": [ {
"map": "Event.identifier",
"identity": "workflow"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": ".id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.identifier",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.identifier"
},
"isSummary": true
}, {
"path": "MedicationStatement.identifier.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.identifier.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.identifier.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.identifier.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier.use",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"definition": "The purpose of this identifier.",
"isModifier": true,
"short": "usual | official | temp | secondary | old (If known)",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
} ],
"description": "Identifies the purpose for this identifier, if known ."
},
"max": "1",
"id": "MedicationStatement.identifier.use",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.use"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier.type",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"isModifier": false,
"short": "Description of identifier",
"mapping": [ {
"map": "CX.5",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
} ],
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
},
"max": "1",
"id": "MedicationStatement.identifier.type",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.type"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier.system",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"isModifier": false,
"short": "The namespace for the identifier value",
"mapping": [ {
"map": "CX.4 / EI-2-4",
"identity": "v2"
}, {
"map": "II.root or Role.id.root",
"identity": "rim"
}, {
"map": "./IdentifierType",
"identity": "servd"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.identifier.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nurn:telus:emr:*:*:medicationstatement\r\nIdentifier.system is always case sensitive.",
"example": [ {
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.system"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier.value",
"min": 1,
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"isModifier": false,
"short": "The value that is unique",
"mapping": [ {
"map": "CX.1 / EI.1",
"identity": "v2"
}, {
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)",
"identity": "rim"
}, {
"map": "./Value",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationStatement.identifier.value",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"example": [ {
"label": "General",
"valueString": "123456"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.value"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier.period",
"min": 0,
"definition": "Time period during which identifier is/was valid for use.",
"isModifier": false,
"short": "Time period when id is/was valid for use",
"mapping": [ {
"map": "CX.7 + CX.8",
"identity": "v2"
}, {
"map": "Role.effectiveTime or implied by context",
"identity": "rim"
}, {
"map": "./StartDate and ./EndDate",
"identity": "servd"
} ],
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "MedicationStatement.identifier.period",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.period"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.identifier.assigner",
"min": 0,
"definition": "Organization that issued/manages the identifier.",
"isModifier": false,
"short": "Organization that issued id (may be just text)",
"mapping": [ {
"map": "CX.4 / (CX.4,CX.9,CX.10)",
"identity": "v2"
}, {
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper",
"identity": "rim"
}, {
"map": "./IdentifierIssuingAuthority",
"identity": "servd"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "1",
"id": "MedicationStatement.identifier.assigner",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.assigner"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "Fulfills plan, proposal or order",
"mapping": [ {
"map": "Event.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": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest" ]
} ],
"max": "*",
"id": "MedicationStatement.basedOn",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.basedOn"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "Part of referenced event",
"mapping": [ {
"map": "Event.partOf",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationAdministration", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationStatement", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwProcedure", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults" ]
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationStatement.partOf",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.partOf"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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": "active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken",
"mapping": [ {
"map": "Event.status",
"identity": "workflow"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": ".statusCode",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementStatus"
} ],
"description": "A coded concept indicating the current status of a MedicationStatement."
},
"max": "1",
"id": "MedicationStatement.status",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Status derived from medication state — active for current medications, completed for past medications, stopped when explicitly stopped, entered-in-error for deleted records.\n\nUsage note: Status of the current and past medication on a patient's chart in the EMR \r\n\r\nMedicationStatement 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).\r\rThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.status"
},
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.statusReason",
"min": 0,
"definition": "Captures the reason for the current state of the MedicationStatement.",
"isModifier": false,
"short": "Reason for current status",
"mapping": [ {
"map": "Event.statusReason",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/reason-medication-status-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationStatementStatusReason"
} ],
"description": "A coded concept indicating the reason for the status of the statement."
},
"max": "*",
"id": "MedicationStatement.statusReason",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Populated when a cancellation note is present.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.statusReason"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.category",
"min": 0,
"definition": "Indicates where the medication is expected to be consumed or administered.",
"isModifier": false,
"short": "Type of medication usage",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-category|4.0.1",
"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."
},
"max": "1",
"id": "MedicationStatement.category",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.category"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "What medication was taken",
"mapping": [ {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
} ],
"slicing": {
"rules": "closed",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication|4.0.1" ]
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationCode"
} ],
"description": "A coded concept identifying the substance or product being taken."
},
"max": "1",
"id": "MedicationStatement.medication[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Either medicationReference (when DIN/product record available) or medicationCodeableConcept (when no medication on record).",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.medication[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x]",
"min": 0,
"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.",
"isModifier": false,
"short": "What medication was taken",
"mapping": [ {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedication" ]
} ],
"mustSupport": true,
"sliceName": "medicationReference",
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Used when a product record with DIN exists.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.medication[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x]",
"min": 0,
"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.",
"isModifier": false,
"short": "What medication was taken",
"mapping": [ {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"sliceName": "medicationCodeableConcept",
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-medications-uv-ips"
},
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: no-medication-info or no-known-medications when no specific medication is on record.",
"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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.medication[x].extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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]:medicationCodeableConcept.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"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.medication[x]:medicationCodeableConcept.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.medication[x].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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.medication[x].coding.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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]:medicationCodeableConcept.coding.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].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.",
"isModifier": false,
"short": "Identity of the terminology system",
"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"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].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.",
"isModifier": false,
"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.medication[x]:medicationCodeableConcept.coding.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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].coding.code",
"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).",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.code",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].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.",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].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 - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"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.medication[x]:medicationCodeableConcept.coding.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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.medication[x].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.",
"isModifier": false,
"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.medication[x]:medicationCodeableConcept.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.subject",
"min": 1,
"definition": "The person, animal or group who is/was taking the medication.",
"isModifier": false,
"short": "Who is/was taking the medication",
"mapping": [ {
"map": "Event.subject",
"identity": "workflow"
}, {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "PID-3-Patient ID List",
"identity": "v2"
}, {
"map": ".participation[typeCode=SBJ].role[classCode=PAT]",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient" ]
} ],
"max": "1",
"id": "MedicationStatement.subject",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.subject"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.context",
"min": 0,
"definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
"isModifier": false,
"short": "Encounter / Episode associated with MedicationStatement",
"mapping": [ {
"map": "Event.context",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwEncounter" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.context",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.context"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.effective[x]",
"min": 1,
"definition": "The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).",
"isModifier": false,
"short": "The date/time or interval when the medication is/was/will be taken",
"mapping": [ {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "FiveWs.done[x]",
"identity": "w5"
}, {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
}, {
"code": "Period"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.effective[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note:\r\nProvide effective.period with start and end date\r\nIf the medication is current and does not have an end date in the EMR then provide the effective.period with just the start date. \r\n\r\n\r\nThis 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. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.effective[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dateAsserted",
"min": 0,
"definition": "The date when the medication statement was asserted by the information source.",
"isModifier": false,
"short": "When the statement was asserted?",
"mapping": [ {
"map": "FiveWs.recorded",
"identity": "w5"
}, {
"map": ".participation[typeCode=AUT].time",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dateAsserted",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.dateAsserted"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "Person or organization that provided the information about the taking of this medication",
"mapping": [ {
"map": "FiveWs.source",
"identity": "w5"
}, {
"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"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1", "http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1", "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"max": "1",
"id": "MedicationStatement.informationSource",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.informationSource"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"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|4.0.1" ]
} ],
"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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.reasonCode",
"min": 0,
"definition": "A reason for why the medication is being/was taken.",
"isModifier": false,
"short": "Reason for why the medication is being/was taken",
"mapping": [ {
"map": "Event.reasonCode",
"identity": "workflow"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": ".reasonCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/condition-code|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationReason"
} ],
"description": "A coded concept identifying why the medication is being taken."
},
"max": "*",
"id": "MedicationStatement.reasonCode",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: Diagnosis codes and free-text condition notes linked to the medication.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.reasonCode"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.reasonReference",
"min": 0,
"definition": "Condition or observation that supports why the medication is being/was taken.",
"isModifier": false,
"short": "Condition or observation that supports why the medication is being/was taken",
"mapping": [ {
"map": "Event.reasonReference",
"identity": "workflow"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwCondition", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwDiagnosticReport" ]
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationStatement.reasonReference",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: MA and PSS - indication identified in the prescription\r\n\r\nThis 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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.note",
"min": 0,
"definition": "Provides extra information about the medication statement that is not conveyed by the other attributes.",
"isModifier": false,
"short": "Further information about the statement",
"mapping": [ {
"map": "Event.note",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationStatement.note",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.note"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage",
"min": 0,
"definition": "Indicates how the medication is/was or should be taken by the patient.",
"isModifier": false,
"short": "Details of how medication is/was taken or should be taken",
"mapping": [ {
"map": "refer dosageInstruction mapping",
"identity": "rim"
} ],
"type": [ {
"code": "Dosage"
} ],
"mustSupport": true,
"max": "*",
"id": "MedicationStatement.dosage",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Structured dosage including route, additionalInstruction, and timing. A rendered dosage string is also available via extension[RenderedDosageInstruction].",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.dosage"
},
"isSummary": false
}, {
"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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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"
},
"isSummary": false
}, {
"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() or (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.dosage.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationStatement.dosage.modifierExtension",
"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": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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": "Indicates the order in which the dosage instructions should be applied or interpreted.",
"isModifier": false,
"short": "The order of the dosage instructions",
"mapping": [ {
"map": "TQ1-1",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "integer"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.sequence",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: 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.\r\n\r\n32 bit number; for values larger than this, use decimal",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.sequence"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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. Additional information about administration or preparation of the medication should be included as text.",
"min": 0,
"definition": "Free text dosage instructions e.g. SIG.",
"isModifier": false,
"short": "Free text dosage instructions e.g. SIG",
"mapping": [ {
"map": "RXO-6; RXE-21",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.text",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.text"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.additionalInstruction",
"requirements": "Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, \"Swallow with plenty of water\" which might or might not be coded.",
"min": 0,
"definition": "Supplemental instructions to the patient on how to take the medication (e.g. \"with meals\" or\"take half to one hour before food\") or warnings for the patient about the medication (e.g. \"may cause drowsiness\" or \"avoid exposure of skin to direct sunlight or sunlamps\").",
"isModifier": false,
"short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"",
"mapping": [ {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdditionalInstruction"
} ],
"description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\"."
},
"max": "*",
"id": "MedicationStatement.dosage.additionalInstruction",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note:: To convey explicit instructions to the Pharmacist/dispenser related to this medication order.\r\n\r\nInformation about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.",
"base": {
"max": "*",
"min": 0,
"path": "Dosage.additionalInstruction"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.patientInstruction",
"min": 0,
"definition": "Instructions in terms that are understood by the patient or consumer.",
"isModifier": false,
"short": "Patient or consumer oriented instructions",
"mapping": [ {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.patientInstruction",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nPSS: Label Instruction. Note: this is also part of text. Note, with meals\", \"may cause drowsiness are included here but FHIR shows under additional instructions.\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.patientInstruction"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing",
"requirements": "The timing schedule for giving the medication to the patient. This 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": "When medication should be administered.",
"isModifier": false,
"short": "When medication should be administered",
"mapping": [ {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "Timing"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.timing",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Includes dosage duration.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.timing"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.timing.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.timing.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.timing.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.timing.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"
},
"isSummary": false
}, {
"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() or (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.dosage.timing.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationStatement.dosage.timing.modifierExtension",
"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": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.event",
"requirements": "In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.",
"min": 0,
"definition": "Identifies specific times when the event occurs.",
"isModifier": false,
"short": "When the event occurs",
"mapping": [ {
"map": "QLIST",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "*",
"id": "MedicationStatement.dosage.timing.event",
"base": {
"max": "*",
"min": 0,
"path": "Timing.event"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
}, {
"key": "tim-1",
"human": "if there's a duration, there needs to be duration units",
"xpath": "not(exists(f:duration)) or exists(f:durationUnit)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "duration.empty() or durationUnit.exists()"
}, {
"key": "tim-2",
"human": "if there's a period, there needs to be period units",
"xpath": "not(exists(f:period)) or exists(f:periodUnit)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "period.empty() or periodUnit.exists()"
}, {
"key": "tim-4",
"human": "duration SHALL be a non-negative value",
"xpath": "f:duration/@value >= 0 or not(f:duration/@value)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "duration.exists() implies duration >= 0"
}, {
"key": "tim-5",
"human": "period SHALL be a non-negative value",
"xpath": "f:period/@value >= 0 or not(f:period/@value)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "period.exists() implies period >= 0"
}, {
"key": "tim-6",
"human": "If there's a periodMax, there must be a period",
"xpath": "not(exists(f:periodMax)) or exists(f:period)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "periodMax.empty() or period.exists()"
}, {
"key": "tim-7",
"human": "If there's a durationMax, there must be a duration",
"xpath": "not(exists(f:durationMax)) or exists(f:duration)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "durationMax.empty() or duration.exists()"
}, {
"key": "tim-8",
"human": "If there's a countMax, there must be a count",
"xpath": "not(exists(f:countMax)) or exists(f:count)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "countMax.empty() or count.exists()"
}, {
"key": "tim-9",
"human": "If there's an offset, there must be a when (and not C, CM, CD, CV)",
"xpath": "not(exists(f:offset)) or exists(f:when)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))"
}, {
"key": "tim-10",
"human": "If there's a timeOfDay, there cannot be a when, or vice versa",
"xpath": "not(exists(f:timeOfDay)) or not(exists(f:when))",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
"severity": "error",
"expression": "timeOfDay.empty() or when.empty()"
} ],
"path": "MedicationStatement.dosage.timing.repeat",
"requirements": "Many timing schedules are determined by regular repetitions.",
"min": 0,
"definition": "A set of rules that describe when the event is scheduled.",
"isModifier": false,
"short": "When the event is to occur",
"mapping": [ {
"map": "Implies PIVL or EIVL",
"identity": "rim"
} ],
"type": [ {
"code": "Element"
} ],
"mustSupport": false,
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.timing.repeat.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.timing.repeat.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.timing.repeat.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.bounds[x]",
"min": 0,
"definition": "Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.",
"isModifier": false,
"short": "Length/Range of lengths, or (Start and/or end) limits",
"mapping": [ {
"map": "IVL(TS) used in a QSI",
"identity": "rim"
} ],
"type": [ {
"code": "Duration"
}, {
"code": "Range"
}, {
"code": "Period"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.bounds[x]",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.bounds[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.count",
"requirements": "Repetitions may be limited by end time or total occurrences.",
"min": 0,
"definition": "A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.",
"isModifier": false,
"short": "Number of times to repeat",
"mapping": [ {
"map": "PIVL.count",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.count",
"comment": "If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.count"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.countMax",
"min": 0,
"definition": "If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.",
"isModifier": false,
"short": "Maximum number of times to repeat",
"mapping": [ {
"map": "PIVL.count",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.countMax",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.countMax"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.duration",
"requirements": "Some activities are not instantaneous and need to be maintained for a period of time.",
"min": 0,
"definition": "How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.",
"isModifier": false,
"short": "How long when it happens",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.duration",
"comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.duration"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.durationMax",
"requirements": "Some activities are not instantaneous and need to be maintained for a period of time.",
"min": 0,
"definition": "If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.",
"isModifier": false,
"short": "How long when it happens (Max)",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.durationMax",
"comment": "For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.durationMax"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.durationUnit",
"min": 0,
"definition": "The units of time for the duration, in UCUM units.",
"isModifier": false,
"short": "s | min | h | d | wk | mo | a - unit of time (UCUM)",
"mapping": [ {
"map": "PIVL.phase.unit",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "UnitsOfTime"
} ],
"description": "A unit of time (units from UCUM)."
},
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.durationUnit",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.durationUnit"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.frequency",
"min": 0,
"definition": "The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.",
"isModifier": false,
"short": "Event occurs frequency times per period",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"meaningWhenMissing": "If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this",
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.frequency",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.frequency"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.frequencyMax",
"min": 0,
"definition": "If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.",
"isModifier": false,
"short": "Event occurs up to frequencyMax times per period",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "positiveInt"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.frequencyMax",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.frequencyMax"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.period",
"min": 0,
"definition": "Indicates the duration of time over which repetitions are to occur; e.g. to express \"3 times per day\", 3 would be the frequency and \"1 day\" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.",
"isModifier": false,
"short": "Event occurs frequency times per period",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.period",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.period"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.periodMax",
"min": 0,
"definition": "If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as \"do this once every 3-5 days.",
"isModifier": false,
"short": "Upper limit of period (3-4 hours)",
"mapping": [ {
"map": "PIVL.phase",
"identity": "rim"
} ],
"type": [ {
"code": "decimal"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.periodMax",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.periodMax"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.periodUnit",
"min": 0,
"definition": "The units of time for the period in UCUM units.",
"isModifier": false,
"short": "s | min | h | d | wk | mo | a - unit of time (UCUM)",
"mapping": [ {
"map": "PIVL.phase.unit",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "UnitsOfTime"
} ],
"description": "A unit of time (units from UCUM)."
},
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.periodUnit",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.periodUnit"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.dayOfWeek",
"min": 0,
"definition": "If one or more days of week is provided, then the action happens only on the specified day(s).",
"isModifier": false,
"short": "mon | tue | wed | thu | fri | sat | sun",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/days-of-week|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DayOfWeek"
} ]
},
"max": "*",
"id": "MedicationStatement.dosage.timing.repeat.dayOfWeek",
"comment": "If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.",
"base": {
"max": "*",
"min": 0,
"path": "Timing.repeat.dayOfWeek"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.timeOfDay",
"min": 0,
"definition": "Specified time of day for action to take place.",
"isModifier": false,
"short": "Time of day for action",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "time"
} ],
"max": "*",
"id": "MedicationStatement.dosage.timing.repeat.timeOfDay",
"comment": "When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.",
"base": {
"max": "*",
"min": 0,
"path": "Timing.repeat.timeOfDay"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.when",
"requirements": "Timings are frequently determined by occurrences such as waking, eating and sleep.",
"min": 0,
"definition": "An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.",
"isModifier": false,
"short": "Code for time period of occurrence",
"mapping": [ {
"map": "EIVL.event",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/event-timing|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "EventTiming"
} ],
"description": "Real world event relating to the schedule."
},
"max": "*",
"id": "MedicationStatement.dosage.timing.repeat.when",
"comment": "When more than one event is listed, the event is tied to the union of the specified events.",
"base": {
"max": "*",
"min": 0,
"path": "Timing.repeat.when"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.repeat.offset",
"min": 0,
"definition": "The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.",
"isModifier": false,
"short": "Minutes from event (before or after)",
"mapping": [ {
"map": "EIVL.offset",
"identity": "rim"
} ],
"type": [ {
"code": "unsignedInt"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing.repeat.offset",
"base": {
"max": "1",
"min": 0,
"path": "Timing.repeat.offset"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.code",
"min": 0,
"definition": "A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).",
"isModifier": false,
"short": "BID | TID | QID | AM | PM | QD | QOD | +",
"mapping": [ {
"map": "QSC.code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "TimingAbbreviation"
} ],
"description": "Code for a known / defined timing pattern."
},
"max": "1",
"id": "MedicationStatement.dosage.timing.code",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Timing.code"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.timing.code.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.timing.code.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.timing.code.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.timing.code.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.code.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"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.timing.code.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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.timing.code.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.",
"isModifier": false,
"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.timing.code.text",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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).",
"isModifier": false,
"short": "Take \"as needed\" (for x)",
"mapping": [ {
"map": "TQ1-9",
"identity": "v2"
}, {
"map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
}, {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1",
"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."
},
"max": "1",
"id": "MedicationStatement.dosage.asNeeded[x]",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.asNeeded[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "Body site to administer to",
"mapping": [ {
"map": "RXR-2",
"identity": "v2"
}, {
"map": ".approachSiteCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1",
"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."
},
"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 [bodySite](http://hl7.org/fhir/R4/extension-bodysite.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
}, {
"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() or (children().count() > id.count())"
} ],
"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": "How drug should enter body.",
"isModifier": false,
"short": "How drug should enter body",
"mapping": [ {
"map": "RXR-1",
"identity": "v2"
}, {
"map": ".routeCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/route-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RouteOfAdministration"
} ],
"description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."
},
"max": "1",
"id": "MedicationStatement.dosage.route",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Route mapped to SNOMED CT CA (routeSCTCA) and EMR-specific codes (routeEMR).",
"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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.route.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.route.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"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": "system",
"type": "value"
} ]
},
"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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"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"
} ],
"sliceName": "routeSCTCA",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
},
"max": "*",
"id": "MedicationStatement.dosage.route.coding:routeSCTCA",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Mapped to the Infoway route-of-administration ValueSet.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.route.coding.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.coding:routeSCTCA.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"short": "Identity of the terminology system",
"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"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"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.dosage.route.coding:routeSCTCA.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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.coding.code",
"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).",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.code",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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 - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"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.dosage.route.coding:routeSCTCA.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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"sliceName": "routeEMR",
"max": "*",
"id": "MedicationStatement.dosage.route.coding:routeEMR",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: this will provide the EMR specific route codes \r\r\nCodes 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.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeEMR.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.route.coding.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.coding:routeEMR.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"short": "Identity of the terminology system",
"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"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeEMR.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.system"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"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.dosage.route.coding:routeEMR.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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.coding.code",
"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).",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeEMR.code",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.code"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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.",
"isModifier": false,
"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"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.dosage.route.coding:routeEMR.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.route.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 - e.g. off a pick list of available items (codes or displays).",
"isModifier": false,
"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.dosage.route.coding:routeEMR.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
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"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": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Free-text route value.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "Technique for administering medication",
"mapping": [ {
"map": "RXR-4",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAdministrationMethod"
} ],
"description": "A coded concept describing the technique by which the medicine is administered."
},
"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
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.doseAndRate",
"min": 0,
"definition": "The amount of medication administered.",
"isModifier": false,
"short": "Amount of medication administered",
"mapping": [ {
"map": "TQ1-2",
"identity": "v2"
} ],
"type": [ {
"code": "Element"
} ],
"max": "*",
"id": "MedicationStatement.dosage.doseAndRate",
"base": {
"max": "*",
"min": 0,
"path": "Dosage.doseAndRate"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.doseAndRate.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.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"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() or (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.dosage.doseAndRate.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"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.doseAndRate.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"
},
"isSummary": false
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.doseAndRate.type",
"requirements": "If the type is not populated, assume to be \"ordered\".",
"min": 0,
"definition": "The kind of dose or rate specified, for example, ordered or calculated.",
"isModifier": false,
"short": "The kind of dose or rate specified",
"mapping": [ {
"map": "RXO-21; RXE-23",
"identity": "v2"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DoseAndRateType"
} ],
"description": "The kind of dose or rate specified."
},
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.type",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.type"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "Amount of medication per dose.",
"isModifier": false,
"short": "Amount of medication per dose",
"mapping": [ {
"map": "RXO-2, RXE-3",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.dose[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"path": "MedicationStatement.dosage.doseAndRate.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": "Amount of medication per unit of time.",
"isModifier": false,
"short": "Amount of medication per unit of time",
"mapping": [ {
"map": "RXE22, RXE23, RXE-24",
"identity": "v2"
}, {
"map": ".rateQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
}, {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.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.\r\rIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.rate[x]"
},
"isSummary": true
}, {
"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() or (children().count() > id.count())"
} ],
"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": "Upper limit on medication per unit of time.",
"isModifier": false,
"short": "Upper limit on medication per unit of time",
"mapping": [ {
"map": "RXO-23, RXE-19",
"identity": "v2"
}, {
"map": ".maxDoseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
} ],
"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
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"short": "Upper limit on medication per administration",
"mapping": [ {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1" ]
} ],
"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
}, {
"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() or (children().count() > id.count())"
} ],
"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.",
"isModifier": false,
"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|4.0.1" ]
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerLifetime",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerLifetime"
},
"isSummary": true
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "4.0.1"
} ]
},
"status": "draft",
"id": "bbdfb940-6866-4190-895f-a9c8599a9f7c",
"kind": "resource",
"url": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationStatement",
"version": "2.0.0",
"differential": {
"element": [ {
"id": "MedicationStatement",
"path": "MedicationStatement"
}, {
"id": "MedicationStatement.id",
"min": 1,
"path": "MedicationStatement.id",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.meta.lastUpdated",
"min": 1,
"path": "MedicationStatement.meta.lastUpdated",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known"
}, {
"id": "MedicationStatement.meta.source",
"min": 1,
"path": "MedicationStatement.meta.source",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known"
}, {
"id": "MedicationStatement.meta.security",
"path": "MedicationStatement.meta.security",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: Populated when the patient record is restricted."
}, {
"id": "MedicationStatement.text",
"min": 1,
"path": "MedicationStatement.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.extension",
"path": "MedicationStatement.extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationStatement.extension:RenderedDosageInstruction",
"max": "1",
"min": 0,
"path": "MedicationStatement.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-rendered-dosage-instruction" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"sliceName": "RenderedDosageInstruction",
"mustSupport": true
}, {
"id": "MedicationStatement.identifier",
"max": "1",
"min": 1,
"path": "MedicationStatement.identifier",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.identifier.system",
"min": 1,
"path": "MedicationStatement.identifier.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nurn:telus:emr:*:*:medicationstatement\r\nIdentifier.system is always case sensitive."
}, {
"id": "MedicationStatement.identifier.value",
"min": 1,
"path": "MedicationStatement.identifier.value",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known"
}, {
"id": "MedicationStatement.basedOn",
"path": "MedicationStatement.basedOn",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationRequest" ]
} ],
"short": "Fulfills plan, proposal or order",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported"
}, {
"id": "MedicationStatement.partOf",
"path": "MedicationStatement.partOf",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationAdministration", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedicationStatement", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwProcedure", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported",
"mustSupport": true
}, {
"id": "MedicationStatement.status",
"path": "MedicationStatement.status",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Status derived from medication state — active for current medications, completed for past medications, stopped when explicitly stopped, entered-in-error for deleted records.\n\nUsage note: Status of the current and past medication on a patient's chart in the EMR \r\n\r\nMedicationStatement 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).\r\rThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"mustSupport": true
}, {
"id": "MedicationStatement.statusReason",
"path": "MedicationStatement.statusReason",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Populated when a cancellation note is present.",
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]",
"path": "MedicationStatement.medication[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Either medicationReference (when DIN/product record available) or medicationCodeableConcept (when no medication on record).",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]:medicationReference",
"max": "1",
"min": 0,
"path": "MedicationStatement.medication[x]",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwMedication" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Used when a product record with DIN exists.",
"sliceName": "medicationReference",
"mustSupport": true
}, {
"path": "MedicationStatement.medication[x]",
"min": 0,
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"sliceName": "medicationCodeableConcept",
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-medications-uv-ips"
},
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: no-medication-info or no-known-medications when no specific medication is on record."
}, {
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system",
"path": "MedicationStatement.medication[x].coding.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.code",
"path": "MedicationStatement.medication[x].coding.code",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display",
"path": "MedicationStatement.medication[x].coding.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.text",
"path": "MedicationStatement.medication[x].text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.subject",
"path": "MedicationStatement.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient" ]
} ]
}, {
"id": "MedicationStatement.context",
"path": "MedicationStatement.context",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwEncounter" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.effective[x]",
"min": 1,
"path": "MedicationStatement.effective[x]",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note:\r\nProvide effective.period with start and end date\r\nIf the medication is current and does not have an end date in the EMR then provide the effective.period with just the start date. \r\n\r\n\r\nThis 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. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.",
"mustSupport": true
}, {
"id": "MedicationStatement.dateAsserted",
"path": "MedicationStatement.dateAsserted",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.reasonCode",
"path": "MedicationStatement.reasonCode",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🔴 Not Supported\n- PSS: 🔴 Not Supported\n\nCHR: Diagnosis codes and free-text condition notes linked to the medication.",
"mustSupport": true
}, {
"id": "MedicationStatement.reasonReference",
"path": "MedicationStatement.reasonReference",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwCondition", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwObservationResults", "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwDiagnosticReport" ]
} ],
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: MA and PSS - indication identified in the prescription\r\n\r\nThis is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.",
"mustSupport": true
}, {
"id": "MedicationStatement.note",
"path": "MedicationStatement.note",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage",
"path": "MedicationStatement.dosage",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Structured dosage including route, additionalInstruction, and timing. A rendered dosage string is also available via extension[RenderedDosageInstruction].",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.sequence",
"path": "MedicationStatement.dosage.sequence",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage note: 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.\r\n\r\n32 bit number; for values larger than this, use decimal",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.text",
"path": "MedicationStatement.dosage.text",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.additionalInstruction",
"path": "MedicationStatement.dosage.additionalInstruction",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note:: To convey explicit instructions to the Pharmacist/dispenser related to this medication order.\r\n\r\nInformation about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.patientInstruction",
"path": "MedicationStatement.dosage.patientInstruction",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nPSS: Label Instruction. Note: this is also part of text. Note, with meals\", \"may cause drowsiness are included here but FHIR shows under additional instructions.\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.timing",
"path": "MedicationStatement.dosage.timing",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Includes dosage duration.",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.timing.repeat",
"path": "MedicationStatement.dosage.timing.repeat",
"mustSupport": false
}, {
"id": "MedicationStatement.dosage.timing.code",
"path": "MedicationStatement.dosage.timing.code",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.timing.code.text",
"path": "MedicationStatement.dosage.timing.code.text",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.asNeeded[x]",
"path": "MedicationStatement.dosage.asNeeded[x]",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route",
"path": "MedicationStatement.dosage.route",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Route mapped to SNOMED CT CA (routeSCTCA) and EMR-specific codes (routeEMR).",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding",
"path": "MedicationStatement.dosage.route.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "system",
"type": "value"
} ]
}
}, {
"id": "MedicationStatement.dosage.route.coding:routeSCTCA",
"max": "*",
"min": 0,
"path": "MedicationStatement.dosage.route.coding",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration"
},
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Mapped to the Infoway route-of-administration ValueSet.",
"sliceName": "routeSCTCA"
}, {
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.system",
"path": "MedicationStatement.dosage.route.coding.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.code",
"path": "MedicationStatement.dosage.route.coding.code",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding:routeSCTCA.display",
"path": "MedicationStatement.dosage.route.coding.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding:routeEMR",
"max": "*",
"min": 0,
"path": "MedicationStatement.dosage.route.coding",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nUsage Note: this will provide the EMR specific route codes \r\r\nCodes 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.",
"sliceName": "routeEMR",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding:routeEMR.system",
"path": "MedicationStatement.dosage.route.coding.system",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding:routeEMR.code",
"path": "MedicationStatement.dosage.route.coding.code",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.coding:routeEMR.display",
"path": "MedicationStatement.dosage.route.coding.display",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.route.text",
"path": "MedicationStatement.dosage.route.text",
"comment": "**EMR Support:**\n- CHR: 🟢 populate-if-known\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known\n\nCHR: Free-text route value.",
"mustSupport": true
}, {
"id": "MedicationStatement.dosage.doseAndRate.dose[x]",
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"comment": "**EMR Support:**\n- CHR: 🔴 Not Supported\n- MA: 🟢 populate-if-known\n- PSS: 🟢 populate-if-known",
"mustSupport": true
} ]
},
"contact": [ {
"name": "TELUS Health",
"telecom": [ {
"value": "https://www.telus.com/health",
"system": "url"
} ]
}, {
"name": "TELUS Health",
"telecom": [ {
"value": "https://www.telus.com/health",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
}