Argonaut Data Query Implementation Guide Version 1.0.0

This page is part of the Argonaut Data Query Implementation Guide (v1.0.0: Release) based on FHIR R2. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

D.4.1 StructureDefinition-argo-medicationstatement

Both the Medicationstatement and MedicationStatement resources can be used to record a patient’s medication. For msre information about the context for their usages, refer to the medication domains’s boundaries section. This profile sets minimum expectations for the MedicationStatement resource to record, search and fetch medications associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the Argonaut MedicationStatement profile:

  • Query for active medications belonging to a Patient
  • Record active medications belonging to a Patient
Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present). These are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each MedicationStatement must have:

  1. a patient
  2. a date
  3. a status
  4. a medication

Profile specific implementation guidance:

  • The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.
    • When referencing a Medication resource, the resource may be contained or an external resource.
    • The server application can support one or both methods, but if the an external reference to Medication is used, the server SHALL support the include parameter for searching this element.
    • The client application must support both methods.
    • Additional guidance is provided below in the Search section and in the conformance resource for this profile

Examples

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is: 

http://fhir.org/guides/argonaut/StructureDefinition/argo-medicationstatement

This profile builds on MedicationStatement.

This profile was published on Tue Oct 18 00:00:00 AEDT 2016 as a draft by Argonaut Project.

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

Complete Summary of the Mandatory Requirements

  1. One patient reference in MedicationStatement.patient
  2. One date MedicationStatement.dateAsserted
  3. One status in MedicationStatement.status which has an required binding to:
  4. One medication via MedicationStatement.medicationCodeableConcept or MedicationStatement.medicationReference

Summary of the Must Support Requirements

  1. One date or period in MedicationStatement.effectiveDateTime or MedicationStatment.effectivePeriod
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement I0..*Argonaut MedicationStatement Profile
mst-2: Reason for use is only permitted if wasNotTaken is false
mst-1: Reason not taken is only permitted if wasNotTaken is true
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: IETF BCP-47 (required)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal identifier
... patient S1..1Reference(Argonaut Patient Profile)Who is/was taking the medication
... informationSource Σ0..1Reference(Patient), Reference(Practitioner), Reference(RelatedPerson)
... dateAsserted S1..1dateTimeWhen the statement was asserted?
... status ?!S1..1codeactive | completed | entered-in-error | intended
Binding: MedicationStatementStatus (required)
... wasNotTaken ?!Σ0..1booleanTrue if medication is/was not being taken
... reasonNotTaken ΣI0..*CodeableConceptTrue if asserting medication was not given
Binding: Reason Medication Not Given Codes (example)
... reasonForUse[x] Σ0..1CodeableConcept, Reference(Condition)Binding: Condition/Problem/Diagnosis Codes (example)
... effective[x] S0..1dateTime, PeriodOver what period was medication consumed?
... note Σ0..1stringFurther information about the statement
... supportingInformation Σ0..*Reference(Resource)Additional supporting information
... medication[x] S1..1CodeableConcept, Reference(Argonaut Medication Profile)What medication was taken
Binding: Medication Clinical Drug (RxNorm) (extensible)
... dosage Σ0..*BackboneElementDetails of how medication was taken
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
.... text Σ0..1stringReported dosage information
.... timing Σ0..1TimingWhen/how often was medication taken
.... asNeeded[x] Σ0..1boolean, CodeableConceptTake "as needed" (for x)
Binding: (unbound) (example)
.... site[x] Σ0..1CodeableConcept, Reference(BodySite)Where (on body) medication is/was administered
Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example)
.... route Σ0..1CodeableConceptHow the medication entered the body
Binding: SNOMED CT Route Codes (example)
.... method Σ0..1CodeableConceptTechnique used to administer medication
Binding: (unbound) (example)
.... quantity[x] Σ0..1SimpleQuantity, RangeAmount administered in one dose
.... rate[x] Σ0..1Ratio, RangeDose quantity per unit of time
.... maxDosePerPeriod Σ0..1RatioMaximum dose that was consumed per unit of time

doco Documentation for this format

Complete Summary of the Mandatory Requirements

  1. One patient reference in MedicationStatement.patient
  2. One date MedicationStatement.dateAsserted
  3. One status in MedicationStatement.status which has an required binding to:
  4. One medication via MedicationStatement.medicationCodeableConcept or MedicationStatement.medicationReference

Summary of the Must Support Requirements

  1. One date or period in MedicationStatement.effectiveDateTime or MedicationStatment.effectivePeriod

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement I0..*Argonaut MedicationStatement Profile
mst-2: Reason for use is only permitted if wasNotTaken is false
mst-1: Reason not taken is only permitted if wasNotTaken is true
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: IETF BCP-47 (required)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal identifier
... patient S1..1Reference(Argonaut Patient Profile)Who is/was taking the medication
... informationSource Σ0..1Reference(Patient), Reference(Practitioner), Reference(RelatedPerson)
... dateAsserted S1..1dateTimeWhen the statement was asserted?
... status ?!S1..1codeactive | completed | entered-in-error | intended
Binding: MedicationStatementStatus (required)
... wasNotTaken ?!Σ0..1booleanTrue if medication is/was not being taken
... reasonNotTaken ΣI0..*CodeableConceptTrue if asserting medication was not given
Binding: Reason Medication Not Given Codes (example)
... reasonForUse[x] Σ0..1CodeableConcept, Reference(Condition)Binding: Condition/Problem/Diagnosis Codes (example)
... effective[x] S0..1dateTime, PeriodOver what period was medication consumed?
... note Σ0..1stringFurther information about the statement
... supportingInformation Σ0..*Reference(Resource)Additional supporting information
... medication[x] S1..1CodeableConcept, Reference(Argonaut Medication Profile)What medication was taken
Binding: Medication Clinical Drug (RxNorm) (extensible)
... dosage Σ0..*BackboneElementDetails of how medication was taken
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
.... text Σ0..1stringReported dosage information
.... timing Σ0..1TimingWhen/how often was medication taken
.... asNeeded[x] Σ0..1boolean, CodeableConceptTake "as needed" (for x)
Binding: (unbound) (example)
.... site[x] Σ0..1CodeableConcept, Reference(BodySite)Where (on body) medication is/was administered
Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example)
.... route Σ0..1CodeableConceptHow the medication entered the body
Binding: SNOMED CT Route Codes (example)
.... method Σ0..1CodeableConceptTechnique used to administer medication
Binding: (unbound) (example)
.... quantity[x] Σ0..1SimpleQuantity, RangeAmount administered in one dose
.... rate[x] Σ0..1Ratio, RangeDose quantity per unit of time
.... maxDosePerPeriod Σ0..1RatioMaximum dose that was consumed per unit of time

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, CSV), Schema: XML Schematron

 

D.4.1.2 Quick Start

Below is an overview of the required search and read operations for this profile. See the Conformance requirements for the Argonaut Data Query implementation guide server for a complete list of supported RESTful operations and search parameters for this IG.

GET /MedicationStatement?patient={id}

Example:

GET http://fhirtest.uhn.ca/baseDstu2/MedicationStatement?patient=14676

Support: Mandatory for client to support search by patient. Optional for server to support.

Implementation Notes: Used when the server application represents the medication using either an inline code or a contained Medication resource. This searches for all MedicationStatement resources for a patient and returns a Bundle of all MedicationStatement resources for the specified patient. (how to search by reference).

Response Class:

  • (Status 200): successful operation
  • (Status 400): invalid parameter
  • (Status 401/4xx): unauthorized request
  • (Status 403): insufficient scope

GET /MedicationStatement?patient={id}&_include=MedicationStatement:medication

Example:

GET http://fhirtest.uhn.ca/baseDstu2/MedicationStatement?patient=14676&_include=MedicationStatement:medication

Support: Mandatory for client to support search by patient using the include parameter. Optional for server to support.

Implementation Notes: Used when the server application represents the medication with an external reference to a Medication resource. This searches for all MedicationStatement resources for a patient and returns a Bundle of all MedicationStatement and Medication resources for the specified patient. (how to search by reference).

Response Class:

  • (Status 200): successful operation
  • (Status 400): invalid parameter
  • (Status 401/4xx): unauthorized request
  • (Status 403): insufficient scope