{
"description": "This profile applies constraints to the MedicationStatement resource for CA Core+ to support documentation of medication usage in the pan-Canadian context.",
"_filename": "StructureDefinition-medicationstatement-ca-core.json",
"package_name": "ca.infoway.io.core",
"date": "2025-08-27",
"derivation": "constraint",
"publisher": "Canada Health Infoway",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "CA",
"system": "urn:iso:std:iso:3166"
} ]
} ],
"name": "MedicationStatementCACore",
"mapping": [ {
"name": "Canadian Core Data for Interoperability (CACDI)",
"comment": "Mapping for MedicationStatementCACore to Canadian Core Data for Interoperability (CACDI).",
"identity": "CACDI"
} ],
"abstract": false,
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"type": "MedicationStatement",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Medication Statement (CA-Core)",
"package_version": "1.2.0-dft",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
} ],
"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-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-3",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-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()"
}, {
"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()"
} ],
"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.",
"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"
}
}, {
"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.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"short": "Logical id of this artifact",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "id",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
} ]
} ],
"max": "1",
"id": "MedicationStatement.id",
"condition": [ "ele-1" ],
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"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.",
"short": "Metadata about the resource",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "MedicationStatement.meta",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"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",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.implicitRules",
"condition": [ "ele-1" ],
"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.",
"short": "Language of the resource content",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages",
"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",
"condition": [ "ele-1" ],
"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"
}
}, {
"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": 0,
"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.",
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
}, {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "MedicationStatement.text",
"condition": [ "ele-1" ],
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
}
}, {
"path": "MedicationStatement.contained",
"min": 0,
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"short": "Contained, inline Resources",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"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"
}
}, {
"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": "May be used to represent additional information that is not part of the basic definition of the resource. 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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.extension",
"condition": [ "ele-1" ],
"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.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() 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": "A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.",
"short": "Extension for representing rendered dosage instruction.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage" ]
} ],
"sliceName": "RenderedDosageInstruction",
"alias": [ "extensions", "user content" ],
"max": "1",
"id": "MedicationStatement.extension:RenderedDosageInstruction",
"condition": [ "ele-1" ],
"comment": "Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() 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](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"
}, {
"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.modifierExtension",
"condition": [ "ele-1" ],
"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"
}, {
"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": 0,
"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.",
"short": "External identifier",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
"identity": "v2"
}, {
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]",
"identity": "rim"
}, {
"map": "Identifier",
"identity": "servd"
}, {
"map": "Event.identifier",
"identity": "workflow"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": ".id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "MedicationStatement.identifier",
"condition": [ "ele-1" ],
"comment": "This is a business identifier, not a resource identifier.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.identifier"
},
"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": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.basedOn",
"requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
"min": 0,
"definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
"short": "Fulfils plan, proposal or order",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"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": [ "http://hl7.org/fhir/StructureDefinition/MedicationRequest", "http://hl7.org/fhir/StructureDefinition/CarePlan", "http://hl7.org/fhir/StructureDefinition/ServiceRequest" ]
} ],
"max": "*",
"id": "MedicationStatement.basedOn",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"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())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.partOf",
"requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.",
"min": 0,
"definition": "A larger event of which this particular event is a component or step.",
"short": "Part of referenced event",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"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": [ "http://hl7.org/fhir/StructureDefinition/MedicationAdministration", "http://hl7.org/fhir/StructureDefinition/MedicationDispense", "http://hl7.org/fhir/StructureDefinition/MedicationStatement", "http://hl7.org/fhir/StructureDefinition/Procedure", "http://hl7.org/fhir/StructureDefinition/Observation" ]
} ],
"max": "*",
"id": "MedicationStatement.partOf",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"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": "n/a",
"identity": "rim"
}, {
"map": "Event.status",
"identity": "workflow"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": ".statusCode",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"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",
"condition": [ "ele-1" ],
"comment": "MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\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.",
"short": "Reason for current status",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "Event.statusReason",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/reason-medication-status-codes",
"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",
"condition": [ "ele-1" ],
"comment": "This is generally only used for \"exception\" statuses such as \"not-taken\", \"on-hold\", \"cancelled\" or \"entered-in-error\". The reason for performing the event at all is captured in reasonCode, not here.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.statusReason"
}
}, {
"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.",
"short": "Type of medication usage",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"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",
"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",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"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.",
"short": "What medication was taken",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-codes",
"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]",
"condition": [ "ele-1" ],
"comment": "The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.",
"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.",
"short": "What medication was taken",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core" ]
} ],
"sliceName": "medicationReference",
"max": "1",
"id": "MedicationStatement.medication[x]:medicationReference",
"condition": [ "ele-1" ],
"comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.medication[x]"
},
"isSummary": true
}, {
"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": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"short": "Concept - reference to a terminology or just text",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "Medication",
"identity": "CACDI"
} ],
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ]
} ],
"sliceName": "medicationCodeableConcept",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationCode"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts"
}, {
"url": "documentation",
"valueMarkdown": "ValueSet for licensed natural health products"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
}, {
"url": "documentation",
"valueMarkdown": "per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/DIN"
}, {
"url": "documentation",
"valueMarkdown": "A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada"
} ]
} ],
"description": "A coded concept identifying the substance or product being taken."
},
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept",
"condition": [ "ele-1" ],
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationStatement.medication[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x].id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "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"
}
}, {
"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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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",
"condition": [ "ele-1" ],
"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"
}
}, {
"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.",
"short": "A reference to a code defined by a terminology system",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
"identity": "v2"
}, {
"map": "CV",
"identity": "rim"
}, {
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
"identity": "orim"
}, {
"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",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/coding-ca-core" ]
} ],
"max": "*",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding",
"condition": [ "ele-1" ],
"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.",
"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.",
"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"
}
}, {
"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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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",
"condition": [ "ele-1" ],
"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"
}
}, {
"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.",
"short": "Identity of the terminology system",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "C*E.3",
"identity": "v2"
}, {
"map": "./codeSystem",
"identity": "rim"
}, {
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
"identity": "orim"
}, {
"map": "Drug Code System URI",
"identity": "CACDI"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system",
"condition": [ "ele-1" ],
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"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.",
"short": "Version of the system - if relevant",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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",
"condition": [ "ele-1" ],
"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).",
"short": "Symbol in syntax defined by the system",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "C*E.1",
"identity": "v2"
}, {
"map": "./code",
"identity": "rim"
}, {
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
"identity": "orim"
} ],
"type": [ {
"code": "code"
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.code",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"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.",
"short": "Representation defined by the system",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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"
}, {
"map": "Drug English Description",
"identity": "CACDI"
}, {
"map": "Drug French Description",
"identity": "CACDI"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"base": {
"max": "1",
"min": 0,
"path": "Coding.display"
},
"isSummary": true
}, {
"path": "MedicationStatement.medication[x].coding.display.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "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.display.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"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.display.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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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.display.extension",
"condition": [ "ele-1" ],
"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"
}
}, {
"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.display.extension",
"min": 0,
"definition": "Language translation from base language of resource to another language, used to provide translations for strings, including markdown. Generally, the type of the translation extension SHOULD match that of the element being extended.",
"short": "Language Translation (Localization)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
}, {
"map": "ST.translation",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/translation" ]
} ],
"sliceName": "translation",
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.extension:translation",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"path": "MedicationStatement.medication[x].coding.display.value",
"min": 0,
"definition": "Primitive value for string",
"short": "Primitive value for string",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/regex",
"valueString": "[\\r\\n\\t\\u0020-\\uFFFF]*"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display.value",
"maxLength": 1048576,
"base": {
"max": "1",
"min": 0,
"path": "string.value"
}
}, {
"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).",
"short": "If this coding was chosen directly by the user",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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",
"condition": [ "ele-1" ],
"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.",
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.text",
"condition": [ "ele-1" ],
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"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": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.subject",
"min": 1,
"definition": "The person, animal or group who is/was taking the medication.",
"short": "Who is/was taking the medication",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"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": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core", "http://hl7.org/fhir/StructureDefinition/Group" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"max": "1",
"id": "MedicationStatement.subject",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"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())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.context",
"min": 0,
"definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
"short": "Encounter / Episode associated with MedicationStatement",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"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": [ "http://hl7.org/fhir/StructureDefinition/Encounter", "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" ]
} ],
"max": "1",
"id": "MedicationStatement.context",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"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": 0,
"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).",
"short": "The date/time or interval when the medication is/was/will be taken",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "FiveWs.done[x]",
"identity": "w5"
}, {
"map": ".effectiveTime",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "dateTime"
}, {
"code": "Period"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"max": "1",
"id": "MedicationStatement.effective[x]",
"condition": [ "ele-1" ],
"comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. 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.effective[x]",
"min": 0,
"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).",
"short": "The date/time or interval when the medication is/was/will be taken",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "FiveWs.done[x]",
"identity": "w5"
}, {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "Period"
} ],
"sliceName": "effectivePeriod",
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod",
"condition": [ "ele-1" ],
"comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted. 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
}, {
"path": "MedicationStatement.effective[x].id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "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.effective[x]:effectivePeriod.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"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.effective[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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationStatement.effective[x]:effectivePeriod.extension",
"condition": [ "ele-1" ],
"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"
}
}, {
"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].start",
"min": 0,
"definition": "The start of the period. The boundary is inclusive.",
"short": "Starting time with inclusive boundary",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "DR.1",
"identity": "v2"
}, {
"map": "./low",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.start",
"condition": [ "ele-1", "per-1" ],
"comment": "If the low element is missing, the meaning is that the low boundary is not known.",
"base": {
"max": "1",
"min": 0,
"path": "Period.start"
},
"isSummary": true
}, {
"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].end",
"min": 0,
"definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
"short": "End time with inclusive boundary, if not ongoing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "DR.2",
"identity": "v2"
}, {
"map": "./high",
"identity": "rim"
}, {
"map": "Medication End Date and Time",
"identity": "CACDI"
} ],
"type": [ {
"code": "dateTime"
} ],
"meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
"max": "1",
"id": "MedicationStatement.effective[x]:effectivePeriod.end",
"condition": [ "ele-1", "per-1" ],
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
"base": {
"max": "1",
"min": 0,
"path": "Period.end"
},
"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.",
"short": "When the statement was asserted?",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "FiveWs.recorded",
"identity": "w5"
}, {
"map": ".participation[typeCode=AUT].time",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "MedicationStatement.dateAsserted",
"condition": [ "ele-1" ],
"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())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.informationSource",
"min": 0,
"definition": "The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.",
"short": "Person or organization that provided the information about the taking of this medication",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"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", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ],
"max": "1",
"id": "MedicationStatement.informationSource",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationStatement.informationSource"
}
}, {
"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": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.derivedFrom",
"min": 0,
"definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
"short": "Additional supporting information",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
} ],
"max": "*",
"id": "MedicationStatement.derivedFrom",
"condition": [ "ele-1" ],
"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"
}
}, {
"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 concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"short": "Concept - reference to a terminology or just text",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "Event.reasonCode",
"identity": "workflow"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": ".reasonCode",
"identity": "rim"
}, {
"map": "Medication Reason",
"identity": "CACDI"
} ],
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "MAY:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationReason"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
}, {
"url": "documentation",
"valueMarkdown": "Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode"
}, {
"url": "documentation",
"valueMarkdown": "A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment"
} ]
} ],
"description": "A coded concept identifying why the medication is being taken."
},
"max": "*",
"id": "MedicationStatement.reasonCode",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.reasonCode"
}
}, {
"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": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))"
} ],
"path": "MedicationStatement.reasonReference",
"min": 0,
"definition": "Condition or observation that supports why the medication is being/was taken.",
"short": "Condition or observation that supports why the medication is being/was taken",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"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"
}, {
"map": "Medication Reason",
"identity": "CACDI"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition", "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "MAY:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"max": "*",
"id": "MedicationStatement.reasonReference",
"condition": [ "ele-1" ],
"comment": "This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.reasonReference"
}
}, {
"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.",
"short": "Further information about the statement",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act",
"identity": "rim"
}, {
"map": "Event.note",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"max": "*",
"id": "MedicationStatement.note",
"condition": [ "ele-1" ],
"comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.note"
}
}, {
"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.",
"short": "Details of how medication is/was taken or should be taken",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]",
"identity": "rim"
}, {
"map": "refer dosageInstruction mapping",
"identity": "rim"
} ],
"type": [ {
"code": "Dosage"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"max": "*",
"id": "MedicationStatement.dosage",
"condition": [ "ele-1" ],
"comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\" It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationStatement.dosage"
}
}, {
"path": "MedicationStatement.dosage.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "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"
}
}, {
"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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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",
"condition": [ "ele-1" ],
"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"
}
}, {
"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](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"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationStatement.dosage.modifierExtension",
"condition": [ "ele-1" ],
"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.",
"short": "The order of the dosage instructions",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "TQ1-1",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "integer"
} ],
"max": "1",
"id": "MedicationStatement.dosage.sequence",
"condition": [ "ele-1" ],
"comment": "32 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.",
"short": "Free text dosage instructions e.g. SIG",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-6; RXE-21",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"max": "1",
"id": "MedicationStatement.dosage.text",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"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\").",
"short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes",
"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",
"condition": [ "ele-1" ],
"comment": "Information 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.",
"short": "Patient or consumer oriented instructions",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationStatement.dosage.patientInstruction",
"condition": [ "ele-1" ],
"comment": "Note 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.",
"short": "When medication should be administered",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "v2"
}, {
"map": "QSET (GTS)",
"identity": "rim"
}, {
"map": ".effectiveTime",
"identity": "rim"
}, {
"map": "Medication Timing",
"identity": "CACDI"
} ],
"type": [ {
"code": "Timing"
} ],
"max": "1",
"id": "MedicationStatement.dosage.timing",
"condition": [ "ele-1" ],
"comment": "This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.timing"
},
"isSummary": true
}, {
"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).",
"short": "Take \"as needed\" (for x)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason",
"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]",
"condition": [ "ele-1" ],
"comment": "Can express \"as needed\" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express \"as needed\" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.asNeeded[x]"
},
"isSummary": true
}, {
"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.",
"short": "Body site to administer to",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXR-2",
"identity": "v2"
}, {
"map": ".approachSiteCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/approach-site-codes",
"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",
"condition": [ "ele-1" ],
"comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](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": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"short": "Concept - reference to a terminology or just text",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXR-1",
"identity": "v2"
}, {
"map": ".routeCode",
"identity": "rim"
}, {
"map": "Medication Route of Administration",
"identity": "CACDI"
} ],
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RouteOfAdministration"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration"
}, {
"url": "documentation",
"valueMarkdown": "Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
} ]
} ],
"description": "SCTCA Route of Administration"
},
"max": "1",
"id": "MedicationStatement.dosage.route",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.route"
},
"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.",
"short": "Technique for administering medication",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXR-4",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/administration-method-codes",
"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",
"condition": [ "ele-1" ],
"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.",
"short": "Amount of medication administered",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "TQ1-2",
"identity": "v2"
} ],
"type": [ {
"code": "Element"
} ],
"max": "*",
"id": "MedicationStatement.dosage.doseAndRate",
"condition": [ "ele-1" ],
"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.",
"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"
}
}, {
"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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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",
"condition": [ "ele-1" ],
"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"
}
}, {
"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.",
"short": "The kind of dose or rate specified",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXO-21; RXE-23",
"identity": "v2"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type",
"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",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"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.",
"short": "Amount of medication per dose",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-2, RXE-3",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit",
"description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set"
},
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]",
"condition": [ "ele-1" ],
"comment": "Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range",
"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())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "The comparator is not used on a SimpleQuantity",
"isModifier": false,
"short": "A fixed quantity (no comparator)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-2, RXE-3",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"sliceName": "doseQuantity",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity",
"condition": [ "ele-1" ],
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.dose[x]"
},
"isSummary": true
}, {
"path": "MedicationStatement.dosage.doseAndRate.dose[x].id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "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.dose[x]:doseQuantity.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"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.dose[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.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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.dose[x]:doseQuantity.extension",
"condition": [ "ele-1" ],
"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"
}
}, {
"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].value",
"requirements": "Precision is handled implicitly in almost all cases of measurement.",
"min": 0,
"definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
"short": "Numerical value (with implicit precision)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "SN.2 / CQ - N/A",
"identity": "v2"
}, {
"map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value",
"identity": "rim"
}, {
"map": "Medication Dose Value",
"identity": "CACDI"
} ],
"type": [ {
"code": "decimal"
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value",
"condition": [ "ele-1" ],
"comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.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.dosage.doseAndRate.dose[x].comparator",
"requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
"min": 0,
"definition": "Not allowed to be used in this context",
"isModifier": true,
"short": "< | <= | >= | > - how to understand the value",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "SN.1 / CQ.1",
"identity": "v2"
}, {
"map": "IVL properties",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "QuantityComparator"
} ],
"description": "How the Quantity should be understood and represented."
},
"max": "0",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.comparator"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the 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.dosage.doseAndRate.dose[x].unit",
"requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
"min": 0,
"definition": "A human-readable form of the unit.",
"short": "Unit representation",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.unit",
"identity": "rim"
}, {
"map": "Medication Dose Unit of Measure",
"identity": "CACDI"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.unit"
},
"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].system",
"requirements": "Need to know the system that defines the coded form of the unit.",
"min": 0,
"definition": "The identification of the system that provides the coded form of the unit.",
"short": "System that defines coded unit form",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "CO.codeSystem, PQ.translation.codeSystem",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system",
"condition": [ "ele-1", "qty-3" ],
"comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.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.doseAndRate.dose[x].code",
"requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
"min": 0,
"definition": "A computer processable form of the unit in some unit representation system.",
"short": "Coded form of the unit",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "(see OBX.6 etc.) / CQ.2",
"identity": "v2"
}, {
"map": "PQ.code, MO.currency, PQ.translation.code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code",
"condition": [ "ele-1" ],
"comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.",
"base": {
"max": "1",
"min": 0,
"path": "Quantity.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.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.",
"short": "Amount of medication per unit of time",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"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" ]
} ],
"max": "1",
"id": "MedicationStatement.dosage.doseAndRate.rate[x]",
"condition": [ "ele-1" ],
"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())"
}, {
"key": "rat-1",
"human": "Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present",
"xpath": "(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))",
"source": "http://hl7.org/fhir/StructureDefinition/Ratio",
"severity": "error",
"expression": "(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())"
} ],
"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.",
"short": "Upper limit on medication per unit of time",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "v2"
}, {
"map": "RTO",
"identity": "rim"
}, {
"map": "RXO-23, RXE-19",
"identity": "v2"
}, {
"map": ".maxDoseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerPeriod",
"condition": [ "ele-1" ],
"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())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"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": "n/a",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
}, {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerAdministration",
"condition": [ "ele-1" ],
"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())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"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": "n/a",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
}, {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"max": "1",
"id": "MedicationStatement.dosage.maxDosePerLifetime",
"condition": [ "ele-1" ],
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerLifetime"
},
"isSummary": true
} ]
},
"status": "active",
"id": "cde75a27-4ccb-4c2a-9346-b2a3a0ad8e10",
"kind": "resource",
"url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medicationstatement-ca-core",
"version": "1.1.0",
"differential": {
"element": [ {
"id": "MedicationStatement.extension",
"path": "MedicationStatement.extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"path": "MedicationStatement.extension",
"min": 0,
"definition": "A free form textual specification generated from the input specifications as created by the provider. This is made up of either an 'Ad-hoc instruction' or 'Textual rendition of the structured dosage lines', plus route, dosage unit, and other pertinent administration information specified by the provider.",
"short": "Extension for representing rendered dosage instruction.",
"type": [ {
"code": "Extension",
"profile": [ "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage" ]
} ],
"sliceName": "RenderedDosageInstruction",
"max": "1",
"id": "MedicationStatement.extension:RenderedDosageInstruction",
"comment": "Use of structured fields for dosage instructions is heavily encouraged by this specification to promote interoperability of patient summaries. However, this extension is provided to make implementers aware that legacy medication data may come from some systems in this format. This extension is used by PrescribeIT implementations when the system has difficulty sending very complex dosage instructions in the form of structured data. Implementers are encouraged to read the PrescribeIT Specification (https://specs.prescribeit.ca/R5.0/erx/extension-ext-medication-rendered-dosage.html) to understand the context around its use."
}, {
"id": "MedicationStatement.status",
"path": "MedicationStatement.status",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]",
"path": "MedicationStatement.medication[x]",
"comment": "The decision whether to use medicationCodeableConcept versus medicationReference is highly context dependent. Therefore, Ca Core+ defers that decision to downstream, use case specific implementation guides.",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"mustSupport": true
}, {
"id": "MedicationStatement.medication[x]:medicationReference",
"max": "1",
"min": 0,
"path": "MedicationStatement.medication[x]",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/medication-ca-core" ]
} ],
"sliceName": "medicationReference"
}, {
"path": "MedicationStatement.medication[x]",
"min": 0,
"mapping": [ {
"map": "Medication",
"identity": "CACDI"
} ],
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ]
} ],
"sliceName": "medicationCodeableConcept",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/LicensedNaturalHealthProducts"
}, {
"url": "documentation",
"valueMarkdown": "ValueSet for licensed natural health products"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "per pCHDCF: Can be used for the international use case where a medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets. ATC is the recommended supporting classification for reporting and analysis"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/pharmaceuticalbiologicproductandsubstancecode"
}, {
"url": "documentation",
"valueMarkdown": "per PCHDCF: The alternate value set can be used for the international use case where the medication is not available in Canada and therefore does not appear in the recommended pan-Canadian value sets"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/DIN"
}, {
"url": "documentation",
"valueMarkdown": "A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada"
} ]
} ]
},
"max": "1",
"id": "MedicationStatement.medication[x]:medicationCodeableConcept",
"comment": "The preferred binding on this element may continue to change as pCHDCF undergoes further refinement. The point-in-time materials provided by pCHDCF to create the profiles in this release recommends the use of the PrescriptionMedicinalProduct valueSet which uses a codeSystem canonical url that is heavily implemented in production but is not the preferred codeSystem (HC-CCDD) expressed in THO. This will be addressed through pCHDCF and is expected to resolve any current differences in other pan-Canadian specifications (e.g., PS-CA) that currently utilize the HC-CCDD valueSet."
}, {
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.system",
"path": "MedicationStatement.medication[x].coding.system",
"mapping": [ {
"map": "Drug Code System URI",
"identity": "CACDI"
} ]
}, {
"id": "MedicationStatement.medication[x]:medicationCodeableConcept.coding.display",
"path": "MedicationStatement.medication[x].coding.display",
"mapping": [ {
"map": "Drug English Description",
"identity": "CACDI"
}, {
"map": "Drug French Description",
"identity": "CACDI"
} ]
}, {
"id": "MedicationStatement.subject",
"path": "MedicationStatement.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core", "http://hl7.org/fhir/StructureDefinition/Group" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"mustSupport": true
}, {
"id": "MedicationStatement.effective[x]",
"path": "MedicationStatement.effective[x]",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ],
"mustSupport": true
}, {
"id": "MedicationStatement.effective[x]:effectivePeriod",
"max": "1",
"min": 0,
"path": "MedicationStatement.effective[x]",
"type": [ {
"code": "Period"
} ],
"sliceName": "effectivePeriod"
}, {
"id": "MedicationStatement.effective[x]:effectivePeriod.end",
"path": "MedicationStatement.effective[x].end",
"mapping": [ {
"map": "Medication End Date and Time",
"identity": "CACDI"
} ]
}, {
"id": "MedicationStatement.reasonCode",
"path": "MedicationStatement.reasonCode",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/medicationreasoncode",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionindicationforuse"
}, {
"url": "documentation",
"valueMarkdown": "Commonly used reason for which a medication is being ordered reference set (foundation metadata concept)"
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode"
}, {
"url": "documentation",
"valueMarkdown": "A value set for health-related conditions which can be diagnoses, the results of a clinical observation or assessment of judgment"
} ]
} ]
},
"mapping": [ {
"map": "Medication Reason",
"identity": "CACDI"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "MAY:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ]
}, {
"id": "MedicationStatement.reasonReference",
"path": "MedicationStatement.reasonReference",
"mapping": [ {
"map": "Medication Reason",
"identity": "CACDI"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "MAY:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ]
}, {
"id": "MedicationStatement.dosage",
"path": "MedicationStatement.dosage",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ]
}, {
"id": "MedicationStatement.dosage.text",
"path": "MedicationStatement.dosage.text",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:populate-if-known"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
} ]
}, {
"url": "http://hl7.org/fhir/StructureDefinition/obligation",
"extension": [ {
"url": "code",
"valueCode": "SHALL:no-error"
}, {
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
} ]
} ]
}, {
"id": "MedicationStatement.dosage.timing",
"path": "MedicationStatement.dosage.timing",
"mapping": [ {
"map": "Medication Timing",
"identity": "CACDI"
} ]
}, {
"id": "MedicationStatement.dosage.route",
"path": "MedicationStatement.dosage.route",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionrouteofadministration"
}, {
"url": "documentation",
"valueMarkdown": "Route of administration for the prescription from the PrescribeIT value set. Implementers should anticipate that data collected and or exchanged in the context of ePrescribing may contain concepts from this valueSet. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
} ]
} ],
"description": "SCTCA Route of Administration"
},
"mapping": [ {
"map": "Medication Route of Administration",
"identity": "CACDI"
} ]
}, {
"id": "MedicationStatement.dosage.doseAndRate.dose[x]",
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptiondosequantityunit",
"description": "Units of measure and/or products that convey the amount of drug to be given to a patient in one dose from the PrescribeIT value set"
},
"comment": "Mapping of this concept applies to the Quantity data type, however implementers should note that some systems use the Range data type to convey a similar concept when dosing is done as a range",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity",
"max": "1",
"min": 0,
"path": "MedicationStatement.dosage.doseAndRate.dose[x]",
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"sliceName": "doseQuantity"
}, {
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].value",
"mapping": [ {
"map": "Medication Dose Value",
"identity": "CACDI"
} ]
}, {
"id": "MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit",
"path": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
"mapping": [ {
"map": "Medication Dose Unit of Measure",
"identity": "CACDI"
} ]
} ]
},
"contact": [ {
"name": "National Standards Release Centre",
"telecom": [ {
"value": "http://www.infoway-inforoute.ca",
"system": "url"
}, {
"value": "standards@infoway-inforoute.ca",
"system": "email"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
}