HL7 Europe Patient Summary
1.0.0-alpha - qa-preview 150

HL7 Europe Patient Summary - Downloaded Version 1.0.0-alpha See the Directory of published versions

## Resource Profile: Medication Statement (EPS)

Official URL: http://hl7.eu/fhir/eps/StructureDefinition/MedicationStatement-eu-eps | Version: 1.0.0-alpha
Standards status: Draft | Maturity Level: 1 | Computable Name: MedicationStatementEuEps
Copyright/Legal: Used by permission of HL7 Europe, all rights reserved Creative Commons License

This profile constrains the MedicationStatement resource for the purpose of the European patient summary.

This profile constrains the MedicationStatement resource for the purpose of the European patient summary.

Usages:

- Use this Profile: Bundle (EPS)
- Refer to this Profile: Composition (EPS)

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient This profile also imposes the profile MedicationStatement (IPS)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:adherence |  | 0..1 | (Complex) | Indicates whether the medication is or is not being consumed or administered URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence Constraints: ext-1
url |  | 1..1 | uri | "code"
extension:reason |  | 0..1 | Extension | Details of the reason for the current use of the medication Constraints: ext-1
url |  | 1..1 | uri | "reason"
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | O Σ | 1..1 | Reference(Patient (EPS)) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | O Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Slices for effective[x] | O Σ | 1..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Closed by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | O Σ | 0..1 | dateTime | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
dosage | O | 0..* | Dosage | Details of how medication is/was taken or should be taken.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | O Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | O Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from MedicationStatementEuCore

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient This profile also imposes the profile MedicationStatement (IPS)
Slices for extension |  |  |  | Content/Rules for all slices
extension:adherence |  | 0..1 | R5 MedicationStatement.adherence | Indicates whether the medication is or is not being consumed or administered
Slices for extension |  |  |  | Content/Rules for all slices
extension:code |  | 1..1 | Extension | Type of adherence
medication[x] | O | 1..1 |  | What medication was taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | O | 1..1 | Reference(Patient (EPS)) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | O | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
effective[x] | O | 1..1 | dateTime, Period | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Slices for effective[x] |  |  |  | Content/Rules for all slices
effective[x]:effectiveDateTime | O | 0..1 | dateTime | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
dosage | O | 0..* | Dosage | Details of how medication is/was taken or should be taken.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
text | O | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | O | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route |  | 0..1 | CodeableConcept | Route of administration
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient This profile also imposes the profile MedicationStatement (IPS)
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the statement Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:adherence |  | 0..1 | (Complex) | Indicates whether the medication is or is not being consumed or administered URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "code"
value[x] |  | 0..1 | CodeableConcept | Type of adherence Binding: R5_medication_statement_adherence_for_R4 (0.0.1-snapshot-2) (example)
extension:reason |  | 0..1 | Extension | Details of the reason for the current use of the medication Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reason"
value[x] |  | 0..1 | CodeableConcept | Details of the reason for the current use of the medication Binding: R5_reason_medication_status_codes_for_R4 (0.0.1-snapshot-2) (example)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Medication Statement Identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category | Σ | 0..1 | CodeableConcept | Type of intended use Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
Additional Bindings | Purpose
Medication Intended Use | Preferred
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | O Σ | 1..1 | Reference(Patient (EPS)) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | O Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Slices for effective[x] | O Σ | 1..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Closed by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | O Σ | 0..1 | dateTime | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | The reference to the source of the statement
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Textual note about the statement
dosage | O | 0..* | Dosage | Details of how medication is/was taken or should be taken.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | O Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | O Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationStatement.​extension:adherence.​extension:code.value[x] | Base | example | Cross-version VS for R5.MedicationStatementAdherenceCodes for use in FHIR R4 | 📍0.0.1-snapshot-2 | FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0
MedicationStatement.​extension:adherence.​extension:reason.value[x] | Base | example | Cross-version VS for R5.SNOMEDCTDrugTherapyStatusCodes for use in FHIR R4 | 📍0.0.1-snapshot-2 | FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | example | SNOMED CT Drug Therapy Status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​category | Base | preferred | Medication usage category codes | 📦4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from MedicationStatementEuCore

Summary

Mandatory: 2 elements

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Medication (EU core) (http://hl7.eu/fhir/base/StructureDefinition/medication-eu-core)
- Patient (EPS) (http://hl7.eu/fhir/eps/StructureDefinition/patient-eu-eps)

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient This profile also imposes the profile MedicationStatement (IPS)
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:adherence |  | 0..1 | (Complex) | Indicates whether the medication is or is not being consumed or administered URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence Constraints: ext-1
url |  | 1..1 | uri | "code"
extension:reason |  | 0..1 | Extension | Details of the reason for the current use of the medication Constraints: ext-1
url |  | 1..1 | uri | "reason"
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | O Σ | 1..1 | Reference(Patient (EPS)) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | O Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Slices for effective[x] | O Σ | 1..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Closed by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | O Σ | 0..1 | dateTime | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
dosage | O | 0..* | Dosage | Details of how medication is/was taken or should be taken.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | O Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | O Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

Differential View

This structure is derived from MedicationStatementEuCore

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient This profile also imposes the profile MedicationStatement (IPS)
Slices for extension |  |  |  | Content/Rules for all slices
extension:adherence |  | 0..1 | R5 MedicationStatement.adherence | Indicates whether the medication is or is not being consumed or administered
Slices for extension |  |  |  | Content/Rules for all slices
extension:code |  | 1..1 | Extension | Type of adherence
medication[x] | O | 1..1 |  | What medication was taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | O | 1..1 | Reference(Patient (EPS)) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
reference | O | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
effective[x] | O | 1..1 | dateTime, Period | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Slices for effective[x] |  |  |  | Content/Rules for all slices
effective[x]:effectiveDateTime | O | 0..1 | dateTime | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
dosage | O | 0..* | Dosage | Details of how medication is/was taken or should be taken.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
text | O | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
timing | O | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
route |  | 0..1 | CodeableConcept | Route of administration
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationStatement |  | 0..* | MedicationStatementEuCore | Record of medication being taken by a patient This profile also imposes the profile MedicationStatement (IPS)
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the statement Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:adherence |  | 0..1 | (Complex) | Indicates whether the medication is or is not being consumed or administered URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Closed by value:url Constraints: ext-1
extension:code |  | 1..1 | Extension | Type of adherence Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "code"
value[x] |  | 0..1 | CodeableConcept | Type of adherence Binding: R5_medication_statement_adherence_for_R4 (0.0.1-snapshot-2) (example)
extension:reason |  | 0..1 | Extension | Details of the reason for the current use of the medication Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "reason"
value[x] |  | 0..1 | CodeableConcept | Details of the reason for the current use of the medication Binding: R5_reason_medication_status_codes_for_R4 (0.0.1-snapshot-2) (example)
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.adherence"
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Medication Statement Identifier
basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) | Fulfils plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) | Part of referenced event
status | ?!Σ | 1..1 | code | State of the medication Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.
statusReason |  | 0..* | CodeableConcept | Reason for the 'exception' statuses of the medication Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.
category | Σ | 0..1 | CodeableConcept | Type of intended use Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.
Additional Bindings | Purpose
Medication Intended Use | Preferred
medication[x] | O Σ | 1..1 |  | What medication was taken Binding: Medications - IPS (example)
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
medicationCodeableConcept |  |  | CodeableConcept(CodeableConceptIPS) |
medicationReference |  |  | Reference(Medication (EU core)) |
subject | O Σ | 1..1 | Reference(Patient (EPS)) | Who is/was taking the medication
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | O Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with MedicationStatement
Slices for effective[x] | O Σ | 1..1 |  | The date/time or interval when the medication is/was/will be taken Slice: Unordered, Closed by type:$this
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | O Σ | 0..1 | dateTime | The date/time or interval when the medication is/was/will be taken
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
effective[x]:effectivePeriod | Σ | 0..1 | Period | Period when the medication is/was or should be used.
dateAsserted | Σ | 0..1 | dateTime | When the statement was asserted?
informationSource |  | 0..1 | Reference(Patient (EU core) | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | RelatedPerson) | Person or organization that provided the information about the taking of this medication
derivedFrom |  | 0..* | Reference(Resource) | The reference to the source of the statement
reasonCode |  | 0..* | CodeableConcept | Coded reason for use Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication is being/was taken
note |  | 0..* | Annotation | Further information about the statement
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | Textual note about the statement
dosage | O | 0..* | Dosage | Details of how medication is/was taken or should be taken.
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | O Σ | 0..1 | string | Free text dosage instructions e.g. SIG
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | O Σ | 0..1 | Timing | When medication should be administered
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationStatement.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationStatement.​extension:adherence.​extension:code.value[x] | Base | example | Cross-version VS for R5.MedicationStatementAdherenceCodes for use in FHIR R4 | 📍0.0.1-snapshot-2 | FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0
MedicationStatement.​extension:adherence.​extension:reason.value[x] | Base | example | Cross-version VS for R5.SNOMEDCTDrugTherapyStatusCodes for use in FHIR R4 | 📍0.0.1-snapshot-2 | FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 v0.0
MedicationStatement.​status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​statusReason | Base | example | SNOMED CT Drug Therapy Status codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​category | Base | preferred | Medication usage category codes | 📦4.0.1 | FHIR Std.
MedicationStatement.​medication[x] | Base | example | Medications - IPS | 📦2.0.0 | International Patient Summary Implementation Guide v2.0
MedicationStatement.​subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
MedicationStatement.​reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationStatement.​dosage.doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from MedicationStatementEuCore

Summary

Mandatory: 2 elements

Structures

This structure refers to these other structures:

- Codeable Concept (IPS) (http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips)
- Medication (EU core) (http://hl7.eu/fhir/base/StructureDefinition/medication-eu-core)
- Patient (EPS) (http://hl7.eu/fhir/eps/StructureDefinition/patient-eu-eps)

Maturity: 1

Other representations of profile: CSV, Excel, Schematron