RIVO-Noord Zorgviewer Implementation Guide
1.10.0 - sprint48 Netherlands flag

This page is part of the RIVO-Noord Zorgviewer Implementation Guide (v1.10.0: Release) based on FHIR (HL7® FHIR® Standard) R3. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: MedicationUse

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/MedicationStatement Version: 1.10.0
Active as of 2025-01-20 Computable Name: MedicationUse

Medicatie Gebruik

Dit Profiel is het resultaat van de vergelijking tussen de zib2017 FHIR Profiel en de implementaties in Epic, Chipsoft, Topicus en Nexus. De elementen die in ieder geval in alle output beschikbaar zullen zijn. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

Zorginformatiebouwsteen

ZIB Medicatie Gebruik

View Definition

Request

  1. Opvragen (search) definities

    GET <ontsluiten-bronsysteem-base>/MedicationStatement?category=urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3|6&_include=MedicationStatement:medication&patient=<fhir_patient_id>

Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

"meta": {
    "extension": [ {
        "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
        "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
    } ]
}

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (<resource>.subject|patient). Elke patient heeft een Patient.managingOrganization en in de gerefereerde Organization.identifier staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement C 0..* Zib MedicationUse MedicationUse
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
mst-1: Reason not taken is only permitted if Taken is No
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... asAgreedIndicator 0..1 (Complex) AsAgreedIndicator
URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator"
..... Slices for value[x] 0..1 boolean Value of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueBoolean 0..1 boolean Value of extension
Example Example of asAgreed: true
.... prescriber 0..1 Reference(nl-core-practitionerrole | nl-core-practitioner) Prescriber
URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Prescriber
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... author 0..1 Reference(nl-core-practitionerrole | nl-core-practitioner | nl-core-organization | nl-core-patient) Author
URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Author
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... medicationTreatment 0..1 Identifier Medical Treatment
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... reasonForChangeOrDiscontinuationOfUse 0..* (Complex) ReasonForChangeOrDiscontinuationOfUse
URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse"
..... Slices for value[x] 0..1 CodeableConcept Value of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 0..1 CodeableConcept ReasonForChangeOrDiscontinuationOfUse
Binding: RedenWijzigenOfStoppenGebruikCodelijst (extensible)
Example Example of ReasonForChangeOrDiscontinuationOfUse: {"coding":[{"system":"http://snomed.info/sct","code":"79899007","display":"Drug interaction (finding)"}]}
... Slices for modifierExtension ?! 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modifierExtension:repeatPeriodCyclicalSchedule ?! 0..1 Zib Medication RepeatPeriodCyclicalSchedule RepeatPeriodCyclicalSchedule
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... category Σ 1..1 CodeableConcept Type of medication usage
Binding: MedicationStatementCategory (preferred): A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered

.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:code
..... coding:medicationUseCode Σ 0..* Coding MedicationUseCode
...... system Σ 0..1 uri Identity of the terminology system
Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
...... code Σ 0..1 code Symbol in syntax defined by the system
Fixed Value: 6
.... text SΣ 0..1 string Plain text representation of the concept
... Slices for medication[x] Σ 1..1 Reference() What medication was taken
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationReference Σ 1..1 Reference(HCIM PharmaceuticalProduct) ProductUsed
..... display SΣ 0..1 string Text alternative for the resource
... Slices for effective[x] Σ 0..1 Period The date/time or interval when the medication was taken
Slice: Unordered, Closed by type:$this
.... effective[x]:effectivePeriod Σ 0..1 Period PeriodOfUse
..... Slices for extension Content/Rules for all slices
...... Duration 0..1 (Complex) Duration
URL: http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration
....... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration"
....... Slices for value[x] 0..1 Duration Value of extension
Slice: Unordered, Closed by type:$this
........ value[x]:valueDuration 0..1 Duration UsageDuration
Example Example of Duration: {"value":3,"unit":"day","system":"http://unitsofmeasure.org","code":"d"}
... dateAsserted SΣ 1..1 dateTime MedicationUseDateTime
Example Example of MedicationUseDateTime: 2017-06-14
... subject Σ 1..1 Reference(nl-core-patient) Who is/was taking the medication
... taken ?!Σ 1..1 code UseIndicator
Binding: MedicationStatementTaken (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication


Example Example of taken: y
... dosage 0..* Zib InstructionsForUse Details of how medication is/was taken or should be taken
.... text SΣ 0..1 string Description
.... Slices for asNeeded[x] Σ 0..1 CodeableConcept Take "as needed" (for x)
Slice: Unordered, Closed by type:$this
Binding: SNOMED CT Medication As Needed Reason Codes (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.

..... asNeeded[x]:asNeededCodeableConcept Σ 0..1 CodeableConcept AsNeeded
Binding: ZonodigCriteriumCodelijst (extensible): ZonodigCriteriumCodelijst

.... route Σ 0..1 CodeableConcept RouteOfAdministration
Binding: MedicatieToedieningswegCodelijst (extensible): ToedieningswegCodelijst


Example Example of RouteOfAdministration: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.4.9","code":"oraal","display":"Oraal"}]}
..... text SΣ 0..1 string Plain text representation of the concept
.... Slices for dose[x] Σ 0..1 Dose
Slice: Unordered, Closed by type:$this
..... doseRange Range
..... doseQuantity Quantity(SimpleQuantity)
..... dose[x]:doseQuantity Σ 0..1 SimpleQuantity Amount of medication per dose
Binding: G-Standaard Eenhedentabel (required): GstdTabel902

..... dose[x]:doseRange Σ 0..1 Range Amount of medication per dose

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]:valueCodeableConceptextensibleRedenWijzigenOfStoppenGebruikCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.11.2--20171231000000
MedicationStatement.statusrequiredMedicationStatementStatus
http://hl7.org/fhir/ValueSet/medication-statement-status
from the FHIR Standard
MedicationStatement.categorypreferredMedicationStatementCategory
http://hl7.org/fhir/ValueSet/medication-statement-category
from the FHIR Standard
MedicationStatement.takenrequiredMedicationStatementTaken
http://hl7.org/fhir/ValueSet/medication-statement-taken
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]exampleSNOMED CT Medication As Needed Reason Codes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationStatement.dosage.asNeeded[x]:asNeededCodeableConceptextensibleZonodigCriteriumCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.4--20171231000000
MedicationStatement.dosage.routeextensibleMedicatieToedieningswegCodelijst (a valid code from urn:oid:2.16.840.1.113883.2.4.4.9)
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.1--20171231000000
MedicationStatement.dosage.dose[x]:doseQuantityrequiredGstdTabel902 (a valid code from urn:oid:2.16.840.1.113883.2.4.4.1.900.2)
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorMedicationStatementIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationStatementIf 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-4errorMedicationStatementIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mst-1errorMedicationStatementReason not taken is only permitted if Taken is No
: reasonNotTaken.exists().not() or (taken = 'n')

 

Other representations of profile: CSV, Excel, Schematron