MyHealth@EU Core
1.0.0 - trial-use 150

MyHealth@EU Core - Downloaded Version 1.0.0 See the Directory of published versions

## Resource Profile: MedicationStatement (Core)

Official URL: http://fhir.ehdsi.eu/core/StructureDefinition/medicationStatement-myhealtheu-core | Version: 1.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: MedicationStatementMyHealthCore

This profile sets minimum expectations for the MedicationStatement resource common to most of the use cases. This profile is adapted from the MPD work.

Usages:

- Examples for this Profile: MedicationStatement/e5f6a7b8-c9d0-1234-efab-345678901234

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the statement Binding: eHDSI Language (required)
Slices for extension |  |  |  | Content/Rules for all slices
extension:adherence |  | 0..1 | (Complex) | R5: Indicates whether the medication is or is not being consumed or administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence. Constraints: ext-1
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | CodeableConcept | Type of adherence Binding: R5MedicationStatementAdherenceForR4 (0.1.0) (example)
extension:reason |  | 0..1 | Extension | R5: Details of the reason for the current use of the medication (new) Constraints: ext-1
url |  | 1..1 | uri | "reason"
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!O Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: eHDSI Medication Status Reason With Exceptions (required)
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (Core)) |
subject | Σ | 1..1 | Reference(Patient (Core) | Group) | Who is/was taking the medication
Slices for effective[x] | Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
informationSource |  | 0..1 | Reference(Patient (Core) | Practitioner (Core) | PractitionerRole (Core) | Organization (Core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: eHDSI Medication Reason With Exceptions (required)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | required | eHDSI Language | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​extension:adherence.​extension:code.value[x] | Base | example | Cross-version ValueSet R5.MedicationStatementAdherenceCodes for use in FHIR R4 | 📍0.1.0 | Extensions for Using Data Elements from FHIR R5 in FHIR R4 v0.1
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | required | eHDSI Medication Status Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​reasonCode | Base | required | eHDSI Medication Reason With Exceptions | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | 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 | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | MedicationStatement.extension:adherence, MedicationStatement.extension:adherence.extension, MedicationStatement.extension:adherence.extension:code, MedicationStatement.extension:adherence.extension:reason, MedicationStatement.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationStatementEuCore

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient
language |  | 0..1 | code | Language of the statement Binding: eHDSI Language (required)
status | O | 1..1 | code | State of the medication
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: eHDSI Medication Status Reason With Exceptions (required)
medication[x] | O | 1..1 |  | What medication was taken
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (Core)) |
subject |  | 1..1 | Reference(Patient (Core) | Group) | Who is/was taking the medication
informationSource |  | 0..1 | Reference(Patient (Core) | Practitioner (Core) | PractitionerRole (Core) | Organization (Core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: eHDSI Medication Reason With Exceptions (required)
dosage |  |  |  |
site |  | 0..1 | CodeableConcept | Body site to administer to Binding: eHDSI Body Site With Exceptions (required)
route |  | 0..1 | CodeableConcept | How drug should enter body Binding: eHDSI Route of Administration (extensible)
doseAndRate |  |  |  |
Slices for dose[x] |  | 0..1 | Range, SimpleQuantity(4.0.1) | Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity |  | 0..1 | SimpleQuantityMyHealth | Amount of medication per dose
Slices for rate[x] |  | 0..1 | Ratio, Range, SimpleQuantity(4.0.1) | Amount of medication per unit of time Slice: Unordered, Open by type:$this
rate[x]:rateRatio |  | 0..1 | RatioMyHealth | Amount of medication per unit of time
rate[x]:rateQuantity |  | 0..1 | SimpleQuantityMyHealth | Amount of medication per unit of time
maxDosePerPeriod |  | 0..1 | RatioMyHealth | Upper limit on medication per unit of time
maxDosePerAdministration |  | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per administration
maxDosePerLifetime |  | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | required | eHDSI Language | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​statusReason | Base | required | eHDSI Medication Status Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​reasonCode | Base | required | eHDSI Medication Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.site | Base | required | eHDSI Body Site With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.route | Base | extensible | eHDSI Route of Administration | 📦9.1.0 | MyHealthEu MVC package v9.1

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the statement Binding: eHDSI Language (required)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:adherence |  | 0..1 | (Complex) | R5: Indicates whether the medication is or is not being consumed or administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence. Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | CodeableConcept | Type of adherence Binding: R5MedicationStatementAdherenceForR4 (0.1.0) (example)
extension:reason |  | 0..1 | Extension | R5: Details of the reason for the current use of the medication (new) Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reason"
value[x] |  | 0..1 | CodeableConcept | Details of the reason for the current use of the medication
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Medication Statement Identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!O Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: eHDSI Medication Status Reason With Exceptions (required)
category | Σ | 0..1 | CodeableConcept | Type of intended use Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
Additional Bindings | Purpose
Medication Intended Use | Preferred
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (Core)) |
subject | Σ | 1..1 | Reference(Patient (Core) | Group) | Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Slices for effective[x] | Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource |  | 0..1 | Reference(Patient (Core) | Practitioner (Core) | PractitionerRole (Core) | Organization (Core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | The reference to the source of the statement
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: eHDSI Medication Reason With Exceptions (required)
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Textual note about the statement
dosage |  | 0..* | Dosage | Details of how medication is/was taken or should be taken.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: eHDSI Body Site With Exceptions (required)
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: eHDSI Route of Administration (extensible)
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x] | Σ | 0..1 |  | Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantityMyHealth | Amount of medication per dose
Slices for rate[x] | Σ | 0..1 |  | Amount of medication per unit of time Slice: Unordered, Open by type:$this
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
rate[x]:rateRatio | Σ | 0..1 | RatioMyHealth | Amount of medication per unit of time
rate[x]:rateQuantity | Σ | 0..1 | SimpleQuantityMyHealth | Amount of medication per unit of time
maxDosePerPeriod | Σ | 0..1 | RatioMyHealth | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | required | eHDSI Language | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​extension:adherence.​extension:code.value[x] | Base | example | Cross-version ValueSet R5.MedicationStatementAdherenceCodes for use in FHIR R4 | 📍0.1.0 | Extensions for Using Data Elements from FHIR R5 in FHIR R4 v0.1
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | required | eHDSI Medication Status Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​category | Base | preferred | Medication usage category codes | 📦4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​reasonCode | Base | required | eHDSI Medication Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.site | Base | required | eHDSI Body Site With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.route | Base | extensible | eHDSI Route of Administration | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | 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 | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationStatementEuCore

Summary

Structures

This structure refers to these other structures:

- Medication (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/medication-myhealtheu-core)
- Patient (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/patient-myhealtheu-core)
- Practitioner (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/practitioner-myhealtheu-core)
- PractitionerRole (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/practitionerRole-myhealtheu-core)
- Organization (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/organization-myhealtheu-core)
- Simple Quantity (MyHealth@EU) (http://fhir.ehdsi.eu/core/StructureDefinition/SimpleQuantity-myhealth)
- Ratio (MyHealth@EU) (http://fhir.ehdsi.eu/core/StructureDefinition/Ratio-myhealth)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationStatement.dosage.doseAndRate.dose[x]
- The element 1 is sliced based on the value of MedicationStatement.dosage.doseAndRate.rate[x]

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the statement Binding: eHDSI Language (required)
Slices for extension |  |  |  | Content/Rules for all slices
extension:adherence |  | 0..1 | (Complex) | R5: Indicates whether the medication is or is not being consumed or administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence. Constraints: ext-1
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | CodeableConcept | Type of adherence Binding: R5MedicationStatementAdherenceForR4 (0.1.0) (example)
extension:reason |  | 0..1 | Extension | R5: Details of the reason for the current use of the medication (new) Constraints: ext-1
url |  | 1..1 | uri | "reason"
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!O Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: eHDSI Medication Status Reason With Exceptions (required)
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (Core)) |
subject | Σ | 1..1 | Reference(Patient (Core) | Group) | Who is/was taking the medication
Slices for effective[x] | Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
informationSource |  | 0..1 | Reference(Patient (Core) | Practitioner (Core) | PractitionerRole (Core) | Organization (Core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: eHDSI Medication Reason With Exceptions (required)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | required | eHDSI Language | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​extension:adherence.​extension:code.value[x] | Base | example | Cross-version ValueSet R5.MedicationStatementAdherenceCodes for use in FHIR R4 | 📍0.1.0 | Extensions for Using Data Elements from FHIR R5 in FHIR R4 v0.1
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | required | eHDSI Medication Status Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​reasonCode | Base | required | eHDSI Medication Reason With Exceptions | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | 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 | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | MedicationStatement.extension:adherence, MedicationStatement.extension:adherence.extension, MedicationStatement.extension:adherence.extension:code, MedicationStatement.extension:adherence.extension:reason, MedicationStatement.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from MedicationStatementEuCore

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient
language |  | 0..1 | code | Language of the statement Binding: eHDSI Language (required)
status | O | 1..1 | code | State of the medication
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: eHDSI Medication Status Reason With Exceptions (required)
medication[x] | O | 1..1 |  | What medication was taken
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (Core)) |
subject |  | 1..1 | Reference(Patient (Core) | Group) | Who is/was taking the medication
informationSource |  | 0..1 | Reference(Patient (Core) | Practitioner (Core) | PractitionerRole (Core) | Organization (Core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: eHDSI Medication Reason With Exceptions (required)
dosage |  |  |  |
site |  | 0..1 | CodeableConcept | Body site to administer to Binding: eHDSI Body Site With Exceptions (required)
route |  | 0..1 | CodeableConcept | How drug should enter body Binding: eHDSI Route of Administration (extensible)
doseAndRate |  |  |  |
Slices for dose[x] |  | 0..1 | Range, SimpleQuantity(4.0.1) | Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity |  | 0..1 | SimpleQuantityMyHealth | Amount of medication per dose
Slices for rate[x] |  | 0..1 | Ratio, Range, SimpleQuantity(4.0.1) | Amount of medication per unit of time Slice: Unordered, Open by type:$this
rate[x]:rateRatio |  | 0..1 | RatioMyHealth | Amount of medication per unit of time
rate[x]:rateQuantity |  | 0..1 | SimpleQuantityMyHealth | Amount of medication per unit of time
maxDosePerPeriod |  | 0..1 | RatioMyHealth | Upper limit on medication per unit of time
maxDosePerAdministration |  | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per administration
maxDosePerLifetime |  | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | required | eHDSI Language | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​statusReason | Base | required | eHDSI Medication Status Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​reasonCode | Base | required | eHDSI Medication Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.site | Base | required | eHDSI Body Site With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.route | Base | extensible | eHDSI Route of Administration | 📦9.1.0 | MyHealthEu MVC package v9.1

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the statement Binding: eHDSI Language (required)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:adherence |  | 0..1 | (Complex) | R5: Indicates whether the medication is or is not being consumed or administered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence. Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "code"
value[x] |  | 1..1 | CodeableConcept | Type of adherence Binding: R5MedicationStatementAdherenceForR4 (0.1.0) (example)
extension:reason |  | 0..1 | Extension | R5: Details of the reason for the current use of the medication (new) Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reason"
value[x] |  | 0..1 | CodeableConcept | Details of the reason for the current use of the medication
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Medication Statement Identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!O Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: eHDSI Medication Status Reason With Exceptions (required)
category | Σ | 0..1 | CodeableConcept | Type of intended use Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
Additional Bindings | Purpose
Medication Intended Use | Preferred
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:handle | MyHealth@EU Handler
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (Core)) |
subject | Σ | 1..1 | Reference(Patient (Core) | Group) | Who is/was taking the medication
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Slices for effective[x] | Σ | 0..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource |  | 0..1 | Reference(Patient (Core) | Practitioner (Core) | PractitionerRole (Core) | Organization (Core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | The reference to the source of the statement
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: eHDSI Medication Reason With Exceptions (required)
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Textual note about the statement
dosage |  | 0..* | Dosage | Details of how medication is/was taken or should be taken.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: eHDSI Body Site With Exceptions (required)
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: eHDSI Route of Administration (extensible)
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x] | Σ | 0..1 |  | Amount of medication per dose Slice: Unordered, Open by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | Σ | 0..1 | SimpleQuantityMyHealth | Amount of medication per dose
Slices for rate[x] | Σ | 0..1 |  | Amount of medication per unit of time Slice: Unordered, Open by type:$this
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
rate[x]:rateRatio | Σ | 0..1 | RatioMyHealth | Amount of medication per unit of time
rate[x]:rateQuantity | Σ | 0..1 | SimpleQuantityMyHealth | Amount of medication per unit of time
maxDosePerPeriod | Σ | 0..1 | RatioMyHealth | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantityMyHealth | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | required | eHDSI Language | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​extension:adherence.​extension:code.value[x] | Base | example | Cross-version ValueSet R5.MedicationStatementAdherenceCodes for use in FHIR R4 | 📍0.1.0 | Extensions for Using Data Elements from FHIR R5 in FHIR R4 v0.1
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | required | eHDSI Medication Status Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​category | Base | preferred | Medication usage category codes | 📦4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​reasonCode | Base | required | eHDSI Medication Reason With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.site | Base | required | eHDSI Body Site With Exceptions | 📦1.0.0 | This IG
MedicationStatement.​dosage.route | Base | extensible | eHDSI Route of Administration | 📦9.1.0 | MyHealthEu MVC package v9.1
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationStatement | 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 | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationStatement | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationStatementEuCore

Summary

Structures

This structure refers to these other structures:

- Medication (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/medication-myhealtheu-core)
- Patient (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/patient-myhealtheu-core)
- Practitioner (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/practitioner-myhealtheu-core)
- PractitionerRole (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/practitionerRole-myhealtheu-core)
- Organization (Core) (http://fhir.ehdsi.eu/core/StructureDefinition/organization-myhealtheu-core)
- Simple Quantity (MyHealth@EU) (http://fhir.ehdsi.eu/core/StructureDefinition/SimpleQuantity-myhealth)
- Ratio (MyHealth@EU) (http://fhir.ehdsi.eu/core/StructureDefinition/Ratio-myhealth)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationStatement.dosage.doseAndRate.dose[x]
- The element 1 is sliced based on the value of MedicationStatement.dosage.doseAndRate.rate[x]

Maturity: 2

Other representations of profile: CSV, Excel, Schematron