Interweave Implementation Guide
0.1.0 - ci-build

Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the R4 profiles here.

Resource Profile: InterweaveMedication - Detailed Descriptions

Active as of 2024-07-17

Definitions for the Interweave-Medication resource profile.

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

1. Medication
2. Medication.id
Must Supporttrue
3. Medication.meta
Control0..?
4. Medication.meta.versionId
Control0..?
Must Supporttrue
5. Medication.meta.lastUpdated
Control0..?
Must Supporttrue
6. Medication.meta.profile
Control0..?
Must Supporttrue
7. Medication.meta.security
Control0..?
8. Medication.meta.tag
Control0..?
SlicingThis element introduces a set of slices on Medication.meta.tag. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
9. Medication.meta.tag:Source
SliceNameSource
Control0..1
Must Supporttrue
10. Medication.meta.tag:Source.system
Control1..?
Fixed Valuehttps://yhcr.nhs.uk/Source
11. Medication.meta.tag:Source.code
Control1..?
Must Supporttrue
12. Medication.meta.tag:Source.display
Control1..?
Must Supporttrue
13. Medication.meta.tag:Provenance
SliceNameProvenance
Control0..1
Must Supporttrue
14. Medication.meta.tag:Provenance.system
Control1..?
Fixed Valuehttps://yhcr.nhs.uk/Provenance
15. Medication.meta.tag:Provenance.code
Control1..?
Must Supporttrue
16. Medication.meta.tag:Provenance.display
Control1..?
Must Supporttrue
17. Medication.implicitRules
18. Medication.language
19. Medication.text
20. Medication.extension
SlicingThis element introduces a set of slices on Medication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
21. Medication.extension:R4Identifier
SliceNameR4Identifier
Control0..*
TypeExtension(ExtensionInterweaveR4Identifier) (Extension Type: Identifier)
22. Medication.code
Control10..1
Must Supporttrue
23. Medication.code.coding
Control0..?
24. Medication.code.coding.system
Control10..1
25. Medication.code.coding.code
Control10..1
26. Medication.code.coding.display
Control10..1
27. Medication.status
Control0..01
28. Medication.isBrand
Control0..01
29. Medication.isOverTheCounter
Control0..01
30. Medication.form
Must Supporttrue
31. Medication.ingredient
Control0..?
32. Medication.ingredient.extension
SlicingThis element introduces a set of slices on Medication.ingredient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
33. Medication.ingredient.extension:strengthR4
SliceNamestrengthR4
Control0..1
TypeExtension(ExtensionInterweaveR4IngredientStrength) (Extension Type: Ratio)
34. Medication.ingredient.item[x]
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
35. Medication.ingredient.amount
Control0..01
36. Medication.package
Control0..01
37. Medication.image
Control0..0*

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

1. Medication
Definition

This resource is primarily used for the identification and definition of a medication. It covers the ingredients and the packaging for a medication.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-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 (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
2. Medication.id
Definition

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

Control0..1
Typeid
Must Supporttrue
Summarytrue
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.

3. Medication.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
Summarytrue
4. Medication.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.

Control0..1
Typeid
Must Supporttrue
Summarytrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

5. Medication.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

Control0..1
Typeinstant
Must Supporttrue
Summarytrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

6. Medication.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Control0..*
Typeuri
Must Supporttrue
Summarytrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

7. Medication.meta.security
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Control0..*
BindingThe codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable

Security Labels from the Healthcare Privacy and Security Classification System.

TypeCoding
Summarytrue
Comments

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

8. Medication.meta.tag
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..*
BindingFor example codes, see Common Tags

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"

TypeCoding
Summarytrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

SlicingThis element introduces a set of slices on Medication.meta.tag. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
9. Medication.meta.tag:Source
SliceNameSource
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..1*
BindingFor example codes, see Common Tags

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"

TypeCoding
Must Supporttrue
Summarytrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

10. Medication.meta.tag:Source.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Valuehttps://yhcr.nhs.uk/Source
11. Medication.meta.tag:Source.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control10..1
Typecode
Must Supporttrue
Summarytrue
Requirements

Need to refer to a particular code in the system.

12. Medication.meta.tag:Source.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control10..1
Typestring
Must Supporttrue
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

13. Medication.meta.tag:Provenance
SliceNameProvenance
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..1*
BindingFor example codes, see Common Tags

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"

TypeCoding
Must Supporttrue
Summarytrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

14. Medication.meta.tag:Provenance.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control10..1
Typeuri
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Valuehttps://yhcr.nhs.uk/Provenance
15. Medication.meta.tag:Provenance.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control10..1
Typecode
Must Supporttrue
Summarytrue
Requirements

Need to refer to a particular code in the system.

16. Medication.meta.tag:Provenance.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control10..1
Typestring
Must Supporttrue
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

17. Medication.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.

Control0..1
Typeuri
Is Modifiertrue
Summarytrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

18. Medication.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
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).

19. Medication.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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 in formation is added later.

20. Medication.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
21. Medication.extension:R4Identifier
SliceNameR4Identifier
Definition

Business identifier for this resource.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ExtensionInterweaveR4Identifier) (Extension Type: Identifier)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
22. Medication.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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

23. Medication.code
Definition

A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.

Control10..1
BindingThe codes SHALL be taken from Care Connect Medication CodeFor example codes, see SNOMED CT Medication Codes

A code from the SNOMED Clinical Terminology UK coding system that describes a medication from the VTM/VMP/VMPP/AMP/AMPP subsets from the dm+d terminology

A coded concept that defines the type of a medication

TypeCodeableConcept
Must Supporttrue
Summarytrue
Comments

Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc.

24. Medication.status
Definition

A code to indicate if the medication is in active use.

Control0..01
BindingThe codes SHALL be taken from MedicationStatus

A coded concept defining if the medication is in active use

Typecode
Summarytrue
Comments

This status is not intended to specify if a medication is part of a formulary.

25. Medication.isBrand
Definition

Set to true if the item is attributable to a specific manufacturer.

Control0..01
Typeboolean
Summarytrue
26. Medication.isOverTheCounter
Definition

Set to true if the medication can be obtained without an order from a prescriber.

Control0..01
Typeboolean
Summarytrue
27. Medication.form
Definition

Describes the form of the item. Powder; tablets; capsule.

Control0..1
BindingThe codes SHALL be taken from Care Connect Medication FormFor example codes, see SNOMED CT Form Codes

A code from the SNOMED Clinical Terminology UK coding system that describes a medication dose form

A coded concept defining the form of a medication

TypeCodeableConcept
Must Supporttrue
Comments

When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

28. Medication.ingredient
Definition

Identifies a particular constituent of interest in the product.

Control0..*
TypeBackboneElement
Comments

The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
29. Medication.ingredient.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.ingredient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
30. Medication.ingredient.extension:strengthR4
SliceNamestrengthR4
Definition

Quantity of ingredient present.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(ExtensionInterweaveR4IngredientStrength) (Extension Type: Ratio)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
31. Medication.ingredient.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Alternate Namesextensions, user content, modifiers
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.

32. Medication.ingredient.item[x]
Definition

The actual ingredient - either a substance (simple ingredient) or another medication.

Control1..1
TypeChoice of: CodeableConcept, Reference(Substance|CareConnect-Medication-1|Medication)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
33. Medication.ingredient.amount
Definition

Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.

Control0..01
TypeRatio
34. Medication.package
Definition

Information that only applies to packages (not products).

Control0..01
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
35. Medication.image
Definition

Photo(s) or graphic representation(s) of the medication.

Control0..0*
TypeAttachment
Requirements

Note that "image" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg).

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

1. Medication
Definition

This resource is primarily used for the identification and definition of a medication. It covers the ingredients and the packaging for a medication.

Control0..*
2. Medication.id
Definition

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

Control0..1
Typeid
Must Supporttrue
Summarytrue
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.

3. Medication.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
Summarytrue
4. Medication.meta.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
5. Medication.meta.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. Medication.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.

Control0..1
Typeid
Must Supporttrue
Summarytrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

7. Medication.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

Control0..1
Typeinstant
Must Supporttrue
Summarytrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

8. Medication.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Control0..*
Typeuri
Must Supporttrue
Summarytrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

9. Medication.meta.security
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Control0..*
BindingThe codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable Security Labels from the Healthcare Privacy and Security Classification System
TypeCoding
Summarytrue
Comments

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

10. Medication.meta.tag
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..*
BindingFor example codes, see Common Tags Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones
TypeCoding
Summarytrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

SlicingThis element introduces a set of slices on Medication.meta.tag. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
11. Medication.meta.tag:Source
SliceNameSource
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..1
BindingFor example codes, see Common Tags Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones
TypeCoding
Must Supporttrue
Summarytrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

12. Medication.meta.tag:Source.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
13. Medication.meta.tag:Source.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.meta.tag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
14. Medication.meta.tag:Source.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Valuehttps://yhcr.nhs.uk/Source
15. Medication.meta.tag:Source.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Summarytrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

16. Medication.meta.tag:Source.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Must Supporttrue
Summarytrue
Requirements

Need to refer to a particular code in the system.

17. Medication.meta.tag:Source.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control1..1
Typestring
Must Supporttrue
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

18. Medication.meta.tag:Source.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

19. Medication.meta.tag:Provenance
SliceNameProvenance
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..1
BindingFor example codes, see Common Tags Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones
TypeCoding
Must Supporttrue
Summarytrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

20. Medication.meta.tag:Provenance.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
21. Medication.meta.tag:Provenance.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.meta.tag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
22. Medication.meta.tag:Provenance.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Valuehttps://yhcr.nhs.uk/Provenance
23. Medication.meta.tag:Provenance.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Summarytrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

24. Medication.meta.tag:Provenance.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Must Supporttrue
Summarytrue
Requirements

Need to refer to a particular code in the system.

25. Medication.meta.tag:Provenance.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control1..1
Typestring
Must Supporttrue
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

26. Medication.meta.tag:Provenance.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

27. Medication.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.

Control0..1
Typeuri
Is Modifiertrue
Summarytrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

28. Medication.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
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).

29. Medication.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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 in formation is added later.

30. Medication.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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

31. Medication.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on Medication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
32. Medication.extension:R4Identifier
SliceNameR4Identifier
Definition

Business identifier for this resource.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ExtensionInterweaveR4Identifier) (Extension Type: Identifier)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
33. Medication.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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

34. Medication.code
Definition

A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.

Control1..1
BindingThe codes SHALL be taken from Care Connect Medication Code A code from the SNOMED Clinical Terminology UK coding system that describes a medication from the VTM/VMP/VMPP/AMP/AMPP subsets from the dm+d terminolog
TypeCodeableConcept
Must Supporttrue
Summarytrue
Comments

Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc.

35. Medication.code.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
36. Medication.code.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.code.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
37. Medication.code.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

38. Medication.code.coding.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
39. Medication.code.coding.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on Medication.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
40. Medication.code.coding.extension:snomedCTDescriptionID
SliceNamesnomedCTDescriptionID
Definition

The SNOMED CT Description ID for the display.

Control0..*
TypeExtension(Extension-coding-sctdescid) (Complex Extension)
41. Medication.code.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

42. Medication.code.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Summarytrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

43. Medication.code.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Summarytrue
Requirements

Need to refer to a particular code in the system.

44. Medication.code.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control1..1
Typestring
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

45. Medication.code.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

46. Medication.code.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

47. Medication.status
Definition

A code to indicate if the medication is in active use.

Control0..0
BindingThe codes SHALL be taken from MedicationStatus A coded concept defining if the medication is in active us
Typecode
Summarytrue
Comments

This status is not intended to specify if a medication is part of a formulary.

48. Medication.isBrand
Definition

Set to true if the item is attributable to a specific manufacturer.

Control0..0
Typeboolean
Summarytrue
49. Medication.isOverTheCounter
Definition

Set to true if the medication can be obtained without an order from a prescriber.

Control0..0
Typeboolean
Summarytrue
50. Medication.manufacturer
Definition

Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.

Control0..1
TypeReference(CareConnect-Organization-1)
Summarytrue
51. Medication.form
Definition

Describes the form of the item. Powder; tablets; capsule.

Control0..1
BindingThe codes SHALL be taken from Care Connect Medication Form A code from the SNOMED Clinical Terminology UK coding system that describes a medication dose for
TypeCodeableConcept
Must Supporttrue
Comments

When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

52. Medication.form.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
53. Medication.form.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Medication.form.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
54. Medication.form.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

55. Medication.form.coding.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
56. Medication.form.coding.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on Medication.form.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
57. Medication.form.coding.extension:snomedCTDescriptionID
SliceNamesnomedCTDescriptionID
Definition

The SNOMED CT Description ID for the display.

Control0..*
TypeExtension(Extension-coding-sctdescid) (Complex Extension)
58. Medication.form.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Summarytrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Valuehttp://snomed.info/sct
59. Medication.form.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Summarytrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

60. Medication.form.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Summarytrue
Requirements

Need to refer to a particular code in the system.

61. Medication.form.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control1..1
Typestring
Summarytrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

62. Medication.form.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

63. Medication.form.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

64. Medication.ingredient
Definition

Identifies a particular constituent of interest in the product.

Control0..*
TypeBackboneElement
Comments

The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.

65. Medication.ingredient.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
66. Medication.ingredient.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on Medication.ingredient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
67. Medication.ingredient.extension:strengthR4
SliceNamestrengthR4
Definition

Quantity of ingredient present.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(ExtensionInterweaveR4IngredientStrength) (Extension Type: Ratio)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
68. Medication.ingredient.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Alternate Namesextensions, user content, modifiers
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.

69. Medication.ingredient.item[x]
Definition

The actual ingredient - either a substance (simple ingredient) or another medication.

Control1..1
TypeChoice of: CodeableConcept, Reference(Substance|CareConnect-Medication-1)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
70. Medication.ingredient.isActive
Definition

Indication of whether this ingredient affects the therapeutic action of the drug.

Control0..1
Typeboolean
Requirements

True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

71. Medication.ingredient.amount
Definition

Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.

Control0..0
TypeRatio
72. Medication.package
Definition

Information that only applies to packages (not products).

Control0..0
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
73. Medication.image
Definition

Photo(s) or graphic representation(s) of the medication.

Control0..0
TypeAttachment
Requirements

Note that "image" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg).