{
"description": "A medication agreement is a prescriber’s proposal for a patient to use medication. An agreement to discontinue the use of medication is also a medication agreement.",
"_filename": "mp-MedicationAgreement.json",
"package_name": "nictiz.fhir.nl.r4.medicationprocess9",
"date": null,
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "4.0.1",
"purpose": "This MedicationRequest resource represents the Dutch zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) MedicationAgreement, in a development version that will be released in pre-publication 2022-1. This profile also contains augmentations to the zib with elements found in the transactions of MP9, to provide a profile better suited for implementation purposes.",
"name": "MpMedicationAgreement",
"mapping": [ {
"uri": "https://zibs.nl/wiki/MedicationAgreement-v1.2(2020EN)",
"name": "zib MedicationAgreement-v1.2(2020EN)",
"identity": "zib-medicationagreement-v1.2-2020EN"
}, {
"uri": "https://zibs.nl/wiki/InstructionsForUse-v1.2.1(2020EN)",
"name": "zib InstructionsForUse-v1.2.1(2020EN)",
"identity": "zib-instructionsforuse-v1.2.1-2020EN"
}, {
"uri": "https://decor.nictiz.nl/pub/medicatieproces/mp-html-20220402T205710/ds-2.16.840.1.113883.2.4.3.11.60.20.77.1.4-2022-01-05T132845.html",
"name": "MP9 v2.0.0",
"identity": "Medication-Process-v9-2-0-0"
} ],
"abstract": true,
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
"type": "MedicationRequest",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "mp MedicationAgreement",
"package_version": "1.0.0",
"status": "active",
"id": "c47f70c3-2634-45fe-8388-bf3d336c2f8f",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/mp-MedicationAgreement",
"version": "1.0.0",
"differential": {
"element": [ {
"id": "MedicationRequest",
"path": "MedicationRequest",
"alias": [ "Medicatieafspraak" ],
"short": "MedicationAgreement",
"mapping": [ {
"map": "NL-CM:9.6.9580",
"comment": "MedicationAgreement",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ]
}, {
"id": "MedicationRequest.extension",
"min": 0,
"path": "MedicationRequest.extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.extension:medicationAgreementAdditionalInformation",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.MedicationAgreementAdditionalInformation" ]
} ],
"sliceName": "medicationAgreementAdditionalInformation"
}, {
"id": "MedicationRequest.extension:medicationAgreementAdditionalInformation.value[x]",
"path": "MedicationRequest.extension.value[x]",
"mapping": [ {
"map": "mp-dataelement920-90",
"comment": "MedicationAgreementAdditionalInformation",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.extension:renderedDosageInstruction",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction" ]
} ],
"sliceName": "renderedDosageInstruction"
}, {
"id": "MedicationRequest.extension:renderedDosageInstruction.value[x]",
"path": "MedicationRequest.extension.value[x]",
"alias": [ "Omschrijving" ],
"short": "Description",
"mapping": [ {
"map": "NL-CM:9.12.9581",
"comment": "Description",
"identity": "zib-instructionsforuse-v1.2.1-2020EN"
} ],
"definition": "Textual description of the complete instructions for use including the period of use."
}, {
"id": "MedicationRequest.extension:periodOfUse",
"max": "1",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-TimeInterval.Period" ]
} ],
"sliceName": "periodOfUse"
}, {
"id": "MedicationRequest.extension:periodOfUse.value[x]",
"path": "MedicationRequest.extension.value[x]",
"type": [ {
"code": "Period",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/nl-core-TimeInterval" ]
} ],
"alias": [ "Gebruiksperiode" ],
"short": "PeriodOfUse",
"mapping": [ {
"map": "NL-CM:9.6.19936",
"comment": "PeriodOfUse",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"definition": "**Start date**: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued.\r\n\r\n**Duration**: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.\r\n\r\n**End date**: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.\r\n\r\nWith medication for an indefinite period only a start date is indicated."
}, {
"id": "MedicationRequest.extension:periodOfUse.value[x].extension",
"min": 0,
"path": "MedicationRequest.extension.value[x].extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.extension:periodOfUse.value[x].extension:condition",
"min": 0,
"path": "MedicationRequest.extension.value[x].extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.PeriodOfUse.Condition" ]
} ],
"sliceName": "condition"
}, {
"id": "MedicationRequest.extension:periodOfUse.value[x].extension:condition.value[x]",
"path": "MedicationRequest.extension.value[x].extension.value[x]",
"mapping": [ {
"map": "mp-dataelement920-1365",
"comment": "Condition",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.extension:pharmaceuticalTreatmentIdentifier",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier" ]
} ],
"sliceName": "pharmaceuticalTreatmentIdentifier"
}, {
"id": "MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x]",
"path": "MedicationRequest.extension.value[x]",
"mapping": [ {
"map": "mp-dataelement920-42",
"comment": "Identification",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.extension:relationEpisodeOfCare",
"max": "1",
"min": 0,
"path": "MedicationRequest.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-Context-EpisodeOfCare" ]
} ],
"sliceName": "relationEpisodeOfCare"
}, {
"id": "MedicationRequest.extension:relationEpisodeOfCare.value[x]",
"path": "MedicationRequest.extension.value[x]",
"alias": [ "RelatieZorgepisode" ],
"short": "RelationEpisodeOfCare",
"mapping": [ {
"map": "mp-dataelement920-843",
"comment": "RelationEpisodeOfCare",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.modifierExtension",
"min": 0,
"path": "MedicationRequest.modifierExtension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.modifierExtension:stopType",
"min": 0,
"path": "MedicationRequest.modifierExtension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-StopType" ]
} ],
"sliceName": "stopType"
}, {
"id": "MedicationRequest.modifierExtension:stopType.value[x]",
"path": "MedicationRequest.modifierExtension.value[x]",
"alias": [ "MedicatieafspraakStopType" ],
"short": "MedicationAgreementStopType",
"mapping": [ {
"map": "NL-CM:9.6.19954",
"comment": "MedicationAgreementStopType",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ]
}, {
"id": "MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule",
"min": 0,
"path": "MedicationRequest.modifierExtension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule" ]
} ],
"sliceName": "repeatPeriodCyclicalSchedule"
}, {
"id": "MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.value[x]",
"path": "MedicationRequest.modifierExtension.value[x]",
"mapping": [ {
"map": "NL-CM:9.12.22505",
"comment": "RepeatPeriodCyclicalSchedule",
"identity": "zib-instructionsforuse-v1.2.1-2020EN"
} ]
}, {
"id": "MedicationRequest.identifier",
"path": "MedicationRequest.identifier",
"alias": [ "Identificatie" ],
"short": "Identification",
"mapping": [ {
"map": "mp-dataelement920-194",
"comment": "Identification",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.status",
"path": "MedicationRequest.status",
"alias": [ "GeannuleerdIndicator" ],
"short": "CanceledIndicator",
"comment": "This element is implictly mapped to the zib concepts NL-CM:9.6.19936 (PeriodOfUse) and NL-CM:9.6.19954 (MedicationAgreementStopType).\r\nUnless the status is explicitly recorded, the following guidance applies:\r\n\r\n* When CanceledIndicator is _true_, `.status` will be set to _entered-in-error_.\r\n* When PeriodOfUse start date is in the future, `.status` will usually be set to _active_.\r\n* When PeriodOfUse start date is in the past and PeriodOfUse end date is present and in the future, `.status` will usually be set to _active_.\r\n* When PeriodOfUse end date is present and in the past and MedicationAgreementStopType has no value, `.status` will usually be set to _completed_.\r\n* When PeriodOfUse end date is present and in the past and MedicationAgreementStopType is _113381000146106_, `.status` will usually be set to _on-hold_.\r\n* When PeriodOfUse end date is present and in the past and MedicationAgreementStopType is _113371000146109_, `.status` will usually be set to _stopped_.\r\n* When PeriodOfUse duration and start date are known, the end date can be deduced and the previous rules apply. \r\n* When a system is unable to infer the status, `.status` will be set to _unknown_. The _unknown_ code is not to be used to convey other statuses. The _unknown_ code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the MedicationAgreement.",
"mapping": [ {
"map": "mp-dataelement920-1373",
"comment": "CanceledIndicator",
"identity": "Medication-Process-v9-2-0-0"
}, {
"map": "NL-CM:9.6.19936",
"comment": "PeriodOfUse (implicit, main mapping is on the extensions ext-TimeInterval.Period and ext-TimeInterval.Duration)",
"identity": "zib-medicationagreement-v1.2-2020EN"
}, {
"map": "NL-CM:9.6.19954",
"comment": "MedicationAgreementStopType (implicit, main mapping is on the modifier extension ext-StopType)",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ]
}, {
"id": "MedicationRequest.intent",
"path": "MedicationRequest.intent",
"definition": "Unless `.intent` is explicitly recorded and a more appropriate code is known, the value can be set to _order_ because a MedicationAgreement should authorize an action for a patient, pharmacist, professional administrator et cetera."
}, {
"id": "MedicationRequest.category",
"min": 1,
"path": "MedicationRequest.category",
"patternCodeableConcept": {
"coding": [ {
"code": "33633005",
"system": "http://snomed.info/sct"
} ]
}
}, {
"id": "MedicationRequest.reported[x]",
"path": "MedicationRequest.reported[x]",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "MedicationRequest.reported[x]:reportedBoolean",
"path": "MedicationRequest.reported[x]",
"type": [ {
"code": "boolean"
} ],
"alias": [ "KopieIndicator" ],
"short": "CopyIndicator",
"mapping": [ {
"map": "mp-dataelement920-273",
"comment": "CopyIndicator",
"identity": "Medication-Process-v9-2-0-0"
} ],
"sliceName": "reportedBoolean",
"definition": "An indication whether the resource is original (false) or a copy from a different source (true)."
}, {
"id": "MedicationRequest.medication[x]",
"path": "MedicationRequest.medication[x]",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "MedicationRequest.medication[x]:medicationReference",
"path": "MedicationRequest.medication[x]",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication", "http://nictiz.nl/fhir/StructureDefinition/nl-core-PharmaceuticalProduct" ]
} ],
"alias": [ "AfgesprokenGeneesmiddel" ],
"short": "AgreedMedicine",
"mapping": [ {
"map": "NL-CM:9.6.19925",
"comment": "AgreedMedicine",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"sliceName": "medicationReference",
"definition": "The medicine agreed upon to be used."
}, {
"id": "MedicationRequest.subject",
"path": "MedicationRequest.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Group", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" ]
} ]
}, {
"id": "MedicationRequest.encounter",
"path": "MedicationRequest.encounter",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Encounter" ]
} ],
"alias": [ "RelatieContact" ],
"short": "RelationContact",
"mapping": [ {
"map": "mp-dataelement920-199",
"comment": "RelationContact",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.authoredOn",
"path": "MedicationRequest.authoredOn",
"alias": [ "MedicatieafspraakDatumTijd" ],
"short": "MedicationAgreementDateTime",
"mapping": [ {
"map": "NL-CM:9.6.19757",
"comment": "MedicationAgreementDateTime",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"definition": "The time at which the agreement was made. Appointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day)"
}, {
"id": "MedicationRequest.requester",
"path": "MedicationRequest.requester",
"type": [ {
"code": "Reference",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference" ],
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Device", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" ]
} ],
"alias": [ "Voorschrijver" ],
"short": "Prescriber",
"mapping": [ {
"map": "NL-CM:9.6.1030",
"comment": "Prescriber",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"definition": "The health professional that entered the medication agreement with the patient."
}, {
"id": "MedicationRequest.reasonCode",
"max": "1",
"path": "MedicationRequest.reasonCode",
"alias": [ "RedenWijzigenOfStaken" ],
"short": "ReasonModificationOrDiscontinuation",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.42--20220222180251"
},
"mapping": [ {
"map": "mp-dataelement920-89",
"comment": "ReasonModificationOrDiscontinuation",
"identity": "Medication-Process-v9-2-0-0"
} ],
"definition": "Reason for modification or discontinuation of the medication agreement."
}, {
"id": "MedicationRequest.reasonReference",
"max": "1",
"path": "MedicationRequest.reasonReference",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition", "http://hl7.org/fhir/StructureDefinition/Observation", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Problem" ]
} ],
"alias": [ "RedenVanVoorschrijven" ],
"short": "PrescriptionReason",
"mapping": [ {
"map": "NL-CM:9.6.23133",
"comment": "PrescriptionReason",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"definition": "The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. \r\nIt can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. Please note: The BST401T file of the G standard contains a “special reference” to indicate that “exchange of the reason for prescription is essential”."
}, {
"id": "MedicationRequest.basedOn.extension",
"min": 0,
"path": "MedicationRequest.basedOn.extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "MedicationRequest.basedOn.extension:relationAdministrationAgreement",
"min": 0,
"path": "MedicationRequest.basedOn.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.RelationAdministrationAgreement" ]
} ],
"sliceName": "relationAdministrationAgreement"
}, {
"id": "MedicationRequest.basedOn.extension:relationAdministrationAgreement.value[x]",
"path": "MedicationRequest.basedOn.extension.value[x]",
"mapping": [ {
"map": "mp-dataelement920-1328",
"comment": "RelationAdministrationAgreement",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.basedOn.extension:relationMedicationUse",
"min": 0,
"path": "MedicationRequest.basedOn.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.RelationMedicationUse" ]
} ],
"sliceName": "relationMedicationUse"
}, {
"id": "MedicationRequest.basedOn.extension:relationMedicationUse.value[x]",
"path": "MedicationRequest.basedOn.extension.value[x]",
"mapping": [ {
"map": "mp-dataelement920-1327",
"comment": "RelationMedicationUse",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.note",
"max": "1",
"path": "MedicationRequest.note"
}, {
"id": "MedicationRequest.note.text",
"path": "MedicationRequest.note.text",
"alias": [ "Toelichting" ],
"short": "Comment",
"mapping": [ {
"map": "NL-CM:9.6.22273",
"comment": "Comment",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"definition": "Comments regarding to the medication agreement. For example: in consultation with the medical specialist."
}, {
"id": "MedicationRequest.dosageInstruction",
"path": "MedicationRequest.dosageInstruction",
"type": [ {
"code": "Dosage",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/mp-InstructionsForUse.DosageInstructions" ]
} ],
"alias": [ "Gebruiksinstructie" ],
"short": "DosingInstructions / InstructionsForUse",
"mapping": [ {
"map": "NL-CM:9.6.23240",
"comment": "InstructionsForUse",
"identity": "zib-medicationagreement-v1.2-2020EN"
} ],
"definition": "Instructions for the use of the medication, e.g. dose and route of administration."
}, {
"id": "MedicationRequest.dosageInstruction.additionalInstruction",
"path": "MedicationRequest.dosageInstruction.additionalInstruction",
"mapping": [ {
"map": "mp-dataelement920-51",
"comment": "AdditionalInstructions",
"identity": "Medication-Process-v9-2-0-0"
} ]
}, {
"id": "MedicationRequest.priorPrescription",
"path": "MedicationRequest.priorPrescription",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/MedicationRequest", "http://nictiz.nl/fhir/StructureDefinition/mp-MedicationAgreement" ]
} ],
"alias": [ "RelatieMedicatieafspraak" ],
"short": "RelationMedicationAgreement",
"mapping": [ {
"map": "mp-dataelement920-195",
"comment": "RelationMedicationAgreement",
"identity": "Medication-Process-v9-2-0-0"
} ],
"definition": "A link to a medication agreement that is altered or canceled."
} ]
},
"contact": [ {
"name": "Nictiz",
"telecom": [ {
"use": "work",
"value": "https://www.nictiz.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
}