Medication
2.0.0 - STU Belgium flag

Medication, published by HL7 Belgium. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/medication and changes regularly. See the Directory of published versions

Resource Profile: BEMedicationLine - Detailed Descriptions

Draft as of 2024-04-07

Definitions for the BEMedicationLine resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MedicationStatement
2. MedicationStatement.extension
Control2..?
SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. MedicationStatement.extension:exposure-category
    Slice Nameexposure-category
    ShortExposure category
    Control0..1
    TypeExtension(ExposureCategory) (Extension Type: CodeableConcept)
    Must Supporttrue
    6. MedicationStatement.extension:dispense-request-needed
    Slice Namedispense-request-needed
    ShortIndication of whether a dispense request is needed for delivering the medication
    Control0..1
    TypeExtension(DispenseRequestNeededCategory) (Extension Type: boolean)
    Must Supporttrue
    8. MedicationStatement.extension:visibility-flag
    Slice Namevisibility-flag
    ShortCoded preference or assertion about the visibility of the medication line
    Control0..1
    TypeExtension(VisibilityFlag) (Extension Type: boolean)
    Must Supporttrue
    10. MedicationStatement.extension:artifact-version
    Slice Nameartifact-version
    ShortThe business version of the medication line - this version changes when the content update is considered clinically relevant
    Control1..1
    TypeExtension(ArtifactVersion) (Extension Type: string)
    Must Supporttrue
    12. MedicationStatement.extension:artifact-date
    Slice Nameartifact-date
    ShortThe business-relevant recorded date - the date the medication line was created or changed
    Control0..1
    TypeExtension(Artifact Date) (Extension Type: dateTime)
    Must Supporttrue
    14. MedicationStatement.extension:adherence
    Slice Nameadherence
    ShortIndicates whether the medication is or is not being consumed or administered
    Comments

    This is a FHIR R5 element, preadopted as an extension in this FHIR R4 specification. For the full definition see here: http://hl7.org/fhir/R5/medicationstatement-definitions.html#MedicationStatement.adherence

    Control1..1
    TypeExtension(Extension Definition for MedicationStatement.adherence for Version 5.0) (Complex Extension)
    Must Supporttrue
    16. MedicationStatement.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..?
    Must Supporttrue
    SlicingThis element introduces a set of slices on MedicationStatement.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • pattern @ system
    • 18. MedicationStatement.identifier:vidis
      Slice Namevidis
      Definition

      The national identifier for medication lines.

      ShortVIDIS identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      Must Supporttrue
      20. MedicationStatement.identifier:vidis.system
      Control1..?
      Pattern Valuehttp://ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-medicationline
      22. MedicationStatement.identifier:vidis.value
      Must Supporttrue
      24. MedicationStatement.status
      Must Supporttrue
      26. MedicationStatement.statusReason
      Must Supporttrue
      28. MedicationStatement.category
      Must Supporttrue
      30. MedicationStatement.medication[x]
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Must Supporttrue
      32. MedicationStatement.subject
      TypeReference(BePatient)
      Must Supporttrue
      34. MedicationStatement.effective[x]
      Control1..?
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Must Supporttrue
      36. MedicationStatement.dateAsserted
      Must Supporttrue
      38. MedicationStatement.informationSource
      Control1..?
      TypeReference(BePatient, BePractitioner, BePractitionerRole, RelatedPerson, BeOrganization)
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      40. MedicationStatement.reasonCode
      Must Supporttrue
      42. MedicationStatement.reasonReference
      Must Supporttrue
      44. MedicationStatement.note
      Must Supporttrue
      46. MedicationStatement.dosage
      Must Supporttrue
      48. MedicationStatement.dosage.extension:dosage-override
      Slice Namedosage-override
      ShortIndicates that the recommended dosage was overridden
      Control0..1
      TypeExtension(DosageOverride) (Extension Type: boolean)
      Must Supporttrue
      50. MedicationStatement.dosage.extension:dosage-override-reason
      Slice Namedosage-override-reason
      ShortThe reason why the recommended dosage was overridden
      Control0..1
      TypeExtension(DosageOverrideReason) (Extension Type: CodeableConcept)
      Must Supporttrue

      Guidance on how to interpret the contents of this table can be found here

      0. MedicationStatement
      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.

      The 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.

      ShortRecord of medication being taken by a patient
      Comments

      When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationStatement.implicitRules
      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.

      ShortA set of rules under which this content was created
      Comments

      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.

      Control0..1
      Typeuri
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. MedicationStatement.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional content defined by implementations
      Comments

      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.

      Control20..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. MedicationStatement.extension:exposure-category
        Slice Nameexposure-category
        Definition

        Exposure - category.

        ShortExposure category
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ExposureCategory) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. MedicationStatement.extension:dispense-request-needed
        Slice Namedispense-request-needed
        Definition

        Dispense Request Needed - category.

        ShortIndication of whether a dispense request is needed for delivering the medication
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(DispenseRequestNeededCategory) (Extension Type: boolean)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. MedicationStatement.extension:visibility-flag
        Slice Namevisibility-flag
        Definition

        Visibility Flag.

        ShortCoded preference or assertion about the visibility of the medication line
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(VisibilityFlag) (Extension Type: boolean)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. MedicationStatement.extension:artifact-version
        Slice Nameartifact-version
        Definition

        The identifier that is used to identify this version of the {{title}} when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the {{title}} author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

        ShortThe business version of the medication line - this version changes when the content update is considered clinically relevant
        Control1..1
        TypeExtension(ArtifactVersion) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. MedicationStatement.extension:artifact-date
        Slice Nameartifact-date
        Definition

        The date (and optionally time) when the {{title}} was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the {{title}} changes.

        ShortThe business-relevant recorded date - the date the medication line was created or changed
        Comments

        The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the {{title}}. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

        Control0..1
        TypeExtension(Artifact Date) (Extension Type: dateTime)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. MedicationStatement.extension:adherence
        Slice Nameadherence
        Definition

        Optional Extension Element - found in all resources.

        ShortIndicates whether the medication is or is not being consumed or administered
        Comments

        This is a FHIR R5 element, preadopted as an extension in this FHIR R4 specification. For the full definition see here: http://hl7.org/fhir/R5/medicationstatement-definitions.html#MedicationStatement.adherence

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension Definition for MedicationStatement.adherence for Version 5.0) (Complex Extension)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. MedicationStatement.modifierExtension
        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.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        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.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. MedicationStatement.identifier
        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.

        ShortExternal identifier
        Comments

        This is a business identifier, not a resource identifier.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on MedicationStatement.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • pattern @ system
        • 22. MedicationStatement.identifier:vidis
          Slice Namevidis
          Definition

          The national identifier for medication lines.


          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.

          ShortVIDIS identifierExternal identifier
          Comments

          This is a business identifier, not a resource identifier.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. MedicationStatement.identifier:vidis.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. MedicationStatement.identifier:vidis.system
          Definition

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

          Control10..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

          Pattern Valuehttp://ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-medicationline
          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. MedicationStatement.identifier:vidis.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe value that is unique
          Comments

          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. MedicationStatement.status
          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.

          Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
          Comments

          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).

          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

          Control1..1
          BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
          (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

          A coded concept indicating the current status of a MedicationStatement.

          Typecode
          Is Modifiertrue because 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
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. MedicationStatement.statusReason
          Definition

          Captures the reason for the current state of the MedicationStatement.

          ShortReason for current status
          Comments

          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.

          Control0..*
          BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodeshttp://hl7.org/fhir/ValueSet/reason-medication-status-codes
          (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes)

          A coded concept indicating the reason for the status of the statement.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. MedicationStatement.category
          Definition

          Indicates where the medication is expected to be consumed or administered.

          ShortType of medication usage
          Control0..1
          BindingThe codes SHOULD be taken from Medication usage category codeshttp://hl7.org/fhir/ValueSet/medication-statement-category
          (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category)

          A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. MedicationStatement.medication[x]
          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.

          ShortWhat medication was taken
          Comments

          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.

          Control1..1
          BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
          (example to http://hl7.org/fhir/ValueSet/medication-codes)

          A coded concept identifying the substance or product being taken.

          TypeChoice of: CodeableConcept, Reference(Medication)
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. MedicationStatement.subject
          Definition

          The person, animal or group who is/was taking the medication.

          ShortWho is/was taking the medication
          Control1..1
          TypeReference(BePatient, Patient, Group)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. MedicationStatement.effective[x]
          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).

          ShortThe date/time or interval when the medication is/was/will be taken
          Comments

          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.

          Control10..1
          TypeChoice of: dateTime, Period
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. MedicationStatement.dateAsserted
          Definition

          The date when the medication statement was asserted by the information source.

          ShortWhen the statement was asserted?
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. MedicationStatement.informationSource
          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.

          ShortPerson or organization that provided the information about the taking of this medication
          Control10..1
          TypeReference(BePatient, BePractitioner, BePractitionerRole, RelatedPerson, BeOrganization, Patient, Practitioner, PractitionerRole, Organization)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. MedicationStatement.reasonCode
          Definition

          A reason for why the medication is being/was taken.

          ShortReason for why the medication is being/was taken
          Comments

          This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

          Control0..*
          BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
          (example to http://hl7.org/fhir/ValueSet/condition-code)

          A coded concept identifying why the medication is being taken.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. MedicationStatement.reasonReference
          Definition

          Condition or observation that supports why the medication is being/was taken.

          ShortCondition or observation that supports why the medication is being/was taken
          Comments

          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.

          Control0..*
          TypeReference(Condition, Observation, DiagnosticReport)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. MedicationStatement.note
          Definition

          Provides extra information about the medication statement that is not conveyed by the other attributes.

          ShortFurther information about the statement
          Control0..*
          TypeAnnotation
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationStatement.dosage
          Definition

          Indicates how the medication is/was or should be taken by the patient.

          ShortDetails of how medication is/was taken or should be taken
          Comments

          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.

          Control0..*
          TypeDosage
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. MedicationStatement.dosage.extension:dosage-override
          Slice Namedosage-override
          Definition

          Dispense override.

          ShortIndicates that the recommended dosage was overridden
          Control0..1
          TypeExtension(DosageOverride) (Extension Type: boolean)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          56. MedicationStatement.dosage.extension:dosage-override-reason
          Slice Namedosage-override-reason
          Definition

          Dispense Request Needed - category.

          ShortThe reason why the recommended dosage was overridden
          Control0..1
          TypeExtension(DosageOverrideReason) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          58. MedicationStatement.dosage.modifierExtension
          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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          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.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

          Guidance on how to interpret the contents of this table can be found here

          0. MedicationStatement
          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.

          The 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.

          ShortRecord of medication being taken by a patient
          Comments

          When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

          Control0..*
          Is Modifierfalse
          Summaryfalse
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. MedicationStatement.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. MedicationStatement.meta
          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.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. MedicationStatement.implicitRules
          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.

          ShortA set of rules under which this content was created
          Comments

          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.

          Control0..1
          Typeuri
          Is Modifiertrue because 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
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. MedicationStatement.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          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).

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. MedicationStatement.text
          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.

          ShortText summary of the resource, for human interpretation
          Comments

          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.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. MedicationStatement.contained
          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.

          ShortContained, inline Resources
          Comments

          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.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. MedicationStatement.extension
          Definition

          An Extension

          ShortExtension
          Control2..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. MedicationStatement.extension:exposure-category
            Slice Nameexposure-category
            Definition

            Exposure - category.

            ShortExposure category
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ExposureCategory) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. MedicationStatement.extension:dispense-request-needed
            Slice Namedispense-request-needed
            Definition

            Dispense Request Needed - category.

            ShortIndication of whether a dispense request is needed for delivering the medication
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(DispenseRequestNeededCategory) (Extension Type: boolean)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. MedicationStatement.extension:visibility-flag
            Slice Namevisibility-flag
            Definition

            Visibility Flag.

            ShortCoded preference or assertion about the visibility of the medication line
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(VisibilityFlag) (Extension Type: boolean)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. MedicationStatement.extension:artifact-version
            Slice Nameartifact-version
            Definition

            The identifier that is used to identify this version of the {{title}} when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the {{title}} author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

            ShortThe business version of the medication line - this version changes when the content update is considered clinically relevant
            Control1..1
            TypeExtension(ArtifactVersion) (Extension Type: string)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. MedicationStatement.extension:artifact-date
            Slice Nameartifact-date
            Definition

            The date (and optionally time) when the {{title}} was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the {{title}} changes.

            ShortThe business-relevant recorded date - the date the medication line was created or changed
            Comments

            The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the {{title}}. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

            Control0..1
            TypeExtension(Artifact Date) (Extension Type: dateTime)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            26. MedicationStatement.extension:adherence
            Slice Nameadherence
            Definition

            Optional Extension Element - found in all resources.

            ShortIndicates whether the medication is or is not being consumed or administered
            Comments

            This is a FHIR R5 element, preadopted as an extension in this FHIR R4 specification. For the full definition see here: http://hl7.org/fhir/R5/medicationstatement-definitions.html#MedicationStatement.adherence

            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension Definition for MedicationStatement.adherence for Version 5.0) (Complex Extension)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. MedicationStatement.modifierExtension
            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.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            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.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. MedicationStatement.identifier
            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.

            ShortExternal identifier
            Comments

            This is a business identifier, not a resource identifier.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..*
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationStatement.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • pattern @ system
            • 32. MedicationStatement.identifier:vidis
              Slice Namevidis
              Definition

              The national identifier for medication lines.

              ShortVIDIS identifier
              Comments

              This is a business identifier, not a resource identifier.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. MedicationStatement.identifier:vidis.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              36. MedicationStatement.identifier:vidis.extension
              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.

              ShortAdditional content defined by implementations
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on MedicationStatement.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 38. MedicationStatement.identifier:vidis.use
                Definition

                The purpose of this identifier.

                Shortusual | official | temp | secondary | old (If known)
                Comments

                Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                Control0..1
                BindingThe codes SHALL be taken from IdentifierUse
                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                Identifies the purpose for this identifier, if known .

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. MedicationStatement.identifier:vidis.type
                Definition

                A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                ShortDescription of identifier
                Comments

                This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows users to make use of identifiers when the identifier system is not known.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. MedicationStatement.identifier:vidis.system
                Definition

                Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                ShortThe namespace for the identifier value
                Comments

                Identifier.system is always case sensitive.

                Control1..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                Pattern Valuehttp://ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-medicationline
                Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. MedicationStatement.identifier:vidis.value
                Definition

                The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                ShortThe value that is unique
                Comments

                If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Example<br/><b>General</b>:123456
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. MedicationStatement.identifier:vidis.period
                Definition

                Time period during which identifier is/was valid for use.

                ShortTime period when id is/was valid for use
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                48. MedicationStatement.identifier:vidis.assigner
                Definition

                Organization that issued/manages the identifier.

                ShortOrganization that issued id (may be just text)
                Comments

                The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                Control0..1
                TypeReference(Organization)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. MedicationStatement.basedOn
                Definition

                A plan, proposal or order that is fulfilled in whole or in part by this event.

                ShortFulfils plan, proposal or order
                Control0..*
                TypeReference(MedicationRequest, CarePlan, ServiceRequest)
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. MedicationStatement.partOf
                Definition

                A larger event of which this particular event is a component or step.

                ShortPart of referenced event
                Control0..*
                TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
                Is Modifierfalse
                Summarytrue
                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. MedicationStatement.status
                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.

                Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
                Comments

                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).

                This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                Control1..1
                BindingThe codes SHALL be taken from Medication Status Codes
                (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

                A coded concept indicating the current status of a MedicationStatement.

                Typecode
                Is Modifiertrue because 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
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. MedicationStatement.statusReason
                Definition

                Captures the reason for the current state of the MedicationStatement.

                ShortReason for current status
                Comments

                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.

                Control0..*
                BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodes
                (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes)

                A coded concept indicating the reason for the status of the statement.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. MedicationStatement.category
                Definition

                Indicates where the medication is expected to be consumed or administered.

                ShortType of medication usage
                Control0..1
                BindingThe codes SHOULD be taken from Medication usage category codes
                (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category)

                A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. MedicationStatement.medication[x]
                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.

                ShortWhat medication was taken
                Comments

                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.

                Control1..1
                BindingFor example codes, see SNOMEDCTMedicationCodes
                (example to http://hl7.org/fhir/ValueSet/medication-codes)

                A coded concept identifying the substance or product being taken.

                TypeChoice of: CodeableConcept, Reference(Medication)
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. MedicationStatement.subject
                Definition

                The person, animal or group who is/was taking the medication.

                ShortWho is/was taking the medication
                Control1..1
                TypeReference(BePatient)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. MedicationStatement.context
                Definition

                The encounter or episode of care that establishes the context for this MedicationStatement.

                ShortEncounter / Episode associated with MedicationStatement
                Control0..1
                TypeReference(Encounter, EpisodeOfCare)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. MedicationStatement.effective[x]
                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).

                ShortThe date/time or interval when the medication is/was/will be taken
                Comments

                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.

                Control1..1
                TypeChoice of: dateTime, Period
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. MedicationStatement.dateAsserted
                Definition

                The date when the medication statement was asserted by the information source.

                ShortWhen the statement was asserted?
                Control0..1
                TypedateTime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. MedicationStatement.informationSource
                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.

                ShortPerson or organization that provided the information about the taking of this medication
                Control1..1
                TypeReference(BePatient, BePractitioner, BePractitionerRole, RelatedPerson, BeOrganization)
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. MedicationStatement.derivedFrom
                Definition

                Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

                ShortAdditional supporting information
                Comments

                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.

                Control0..*
                TypeReference(Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. MedicationStatement.reasonCode
                Definition

                A reason for why the medication is being/was taken.

                ShortReason for why the medication is being/was taken
                Comments

                This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

                Control0..*
                BindingFor example codes, see Condition/Problem/DiagnosisCodes
                (example to http://hl7.org/fhir/ValueSet/condition-code)

                A coded concept identifying why the medication is being taken.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. MedicationStatement.reasonReference
                Definition

                Condition or observation that supports why the medication is being/was taken.

                ShortCondition or observation that supports why the medication is being/was taken
                Comments

                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.

                Control0..*
                TypeReference(Condition, Observation, DiagnosticReport)
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. MedicationStatement.note
                Definition

                Provides extra information about the medication statement that is not conveyed by the other attributes.

                ShortFurther information about the statement
                Control0..*
                TypeAnnotation
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                80. MedicationStatement.dosage
                Definition

                Indicates how the medication is/was or should be taken by the patient.

                ShortDetails of how medication is/was taken or should be taken
                Comments

                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.

                Control0..*
                TypeDosage
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. MedicationStatement.dosage.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                84. MedicationStatement.dosage.extension
                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.

                ShortAdditional content defined by implementations
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 86. MedicationStatement.dosage.extension:dosage-override
                  Slice Namedosage-override
                  Definition

                  Dispense override.

                  ShortIndicates that the recommended dosage was overridden
                  Control0..1
                  TypeExtension(DosageOverride) (Extension Type: boolean)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  88. MedicationStatement.dosage.extension:dosage-override-reason
                  Slice Namedosage-override-reason
                  Definition

                  Dispense Request Needed - category.

                  ShortThe reason why the recommended dosage was overridden
                  Control0..1
                  TypeExtension(DosageOverrideReason) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  90. MedicationStatement.dosage.modifierExtension
                  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.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  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.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  92. MedicationStatement.dosage.sequence
                  Definition

                  Indicates the order in which the dosage instructions should be applied or interpreted.

                  ShortThe order of the dosage instructions
                  Control0..1
                  Typeinteger
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. MedicationStatement.dosage.text
                  Definition

                  Free text dosage instructions e.g. SIG.

                  ShortFree text dosage instructions e.g. SIG
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. MedicationStatement.dosage.additionalInstruction
                  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").

                  ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                  Comments

                  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.

                  Control0..*
                  BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                  (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

                  A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. MedicationStatement.dosage.patientInstruction
                  Definition

                  Instructions in terms that are understood by the patient or consumer.

                  ShortPatient or consumer oriented instructions
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. MedicationStatement.dosage.timing
                  Definition

                  When medication should be administered.

                  ShortWhen medication should be administered
                  Comments

                  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.

                  Control0..1
                  TypeTiming
                  Is Modifierfalse
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. MedicationStatement.dosage.asNeeded[x]
                  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).

                  ShortTake "as needed" (for x)
                  Comments

                  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".

                  Control0..1
                  BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                  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.

                  TypeChoice of: boolean, CodeableConcept
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. MedicationStatement.dosage.site
                  Definition

                  Body site to administer to.

                  ShortBody site to administer to
                  Comments

                  If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                  Control0..1
                  BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                  (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

                  A coded concept describing the site location the medicine enters into or onto the body.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  A coded specification of the anatomic site where the medication first enters the body.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. MedicationStatement.dosage.route
                  Definition

                  How drug should enter body.

                  ShortHow drug should enter body
                  Control0..1
                  BindingFor example codes, see SNOMEDCTRouteCodes
                  (example to http://hl7.org/fhir/ValueSet/route-codes)

                  A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. MedicationStatement.dosage.method
                  Definition

                  Technique for administering medication.

                  ShortTechnique for administering medication
                  Comments

                  Terminologies used often pre-coordinate this term with the route and or form of administration.

                  Control0..1
                  BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                  (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

                  A coded concept describing the technique by which the medicine is administered.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. MedicationStatement.dosage.doseAndRate
                  Definition

                  The amount of medication administered.

                  ShortAmount of medication administered
                  Control0..*
                  TypeElement
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. MedicationStatement.dosage.doseAndRate.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  114. MedicationStatement.dosage.doseAndRate.extension
                  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.

                  ShortAdditional content defined by implementations
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 116. MedicationStatement.dosage.doseAndRate.type
                    Definition

                    The kind of dose or rate specified, for example, ordered or calculated.

                    ShortThe kind of dose or rate specified
                    Control0..1
                    BindingFor example codes, see DoseAndRateType
                    (example to http://hl7.org/fhir/ValueSet/dose-rate-type)

                    The kind of dose or rate specified.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    If the type is not populated, assume to be "ordered".

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    118. MedicationStatement.dosage.doseAndRate.dose[x]
                    Definition

                    Amount of medication per dose.

                    ShortAmount of medication per dose
                    Comments

                    Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                    Control0..1
                    TypeChoice of: Range, Quantity(SimpleQuantity)
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    The amount of therapeutic or other substance given at one administration event.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    120. MedicationStatement.dosage.doseAndRate.rate[x]
                    Definition

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

                    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.

                    It 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.

                    Control0..1
                    TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    122. MedicationStatement.dosage.maxDosePerPeriod
                    Definition

                    Upper limit on medication per unit of time.

                    ShortUpper limit on medication per unit of time
                    Comments

                    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".

                    Control0..1
                    TypeRatio
                    Is Modifierfalse
                    Summarytrue
                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    124. MedicationStatement.dosage.maxDosePerAdministration
                    Definition

                    Upper limit on medication per administration.

                    ShortUpper limit on medication per administration
                    Comments

                    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.

                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    126. MedicationStatement.dosage.maxDosePerLifetime
                    Definition

                    Upper limit on medication per lifetime of the patient.

                    ShortUpper limit on medication per lifetime of the patient
                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))