CDA On FHIR England - End of Life Care Document

COFE-MedicationsAdministered-MedicationStatement-1

MedicationStatement Resource to carry the current state of medications, or medical devices, following an episode of care.

NameCard.TypeDescription & Constraints
..MedicationStatementMedicationStatementRecord of medication being taken by a patient

...Administration Unit Code0..1ExtensionAn extension to represent the form of the medicinal substance.
Extension http://fhir.nhs.net/StructureDefinition/extension-cofe-administration-unit-code-1

...Course Status0..1ExtensionExtension to carry the medication course status associated with a medication item.
Extension http://fhir.nhs.net/StructureDefinition/extension-cofe-course-status-1

...identifier1..1IdentifierExternal identifier

....value1..1StringShall contain a DCE UUID
Example Value f4b9593e-1d82-46df-b535-d3f4142da6f1

...patient1..1Reference (cofe-patient-1)Who is/was taking the medication

....reference1..1StringRelative URL reference

....display0..1StringText alternative for the resource

...informationSource0..1Reference (cofe-practitioner-1 | cofe-device-1)The person who provided the information about the taking of this medication.

...dateAsserted0..1DateTimeWhen the statement was asserted?

...status1..1Codeactive | completed | entered-in-error | intended
Binding A set of codes indicating the current status of a MedicationStatement. (http://hl7.org/fhir/ValueSet/medication-statement-status)
Binding Strength Required
Fixed Value completed

...reasonForUse[x] (Indication)0..1CodeableConcept | cofe-diagnosis-condition-1A reason for why the medication is being/was taken.
Binding A code from the SNOMED Clinical Terminology UK coding system that describes a finding that is NOT a blood pressure, body weight ,height measurement, or temperature finding. (http://fhir.nhs.net/ValueSet/finding-snct-1)
Binding Strength Required

...effective[x]0..1PeriodOver what period was medication consumed?

...note (Additional Instructions)0..1StringFurther information about the statement

...supportingInformation (Medication Change Summary)0..1Reference (cofe-medicationorder-1)Additional supporting information

....reference1..1StringRelative URL reference

....display0..1StringText alternative for the resource

...medication[x]1..1CodeableConceptWhat medication was taken
Binding Medication items listed in the Dictionary of Medicines and Devices (dm+d). (http://fhir.nhs.net/ValueSet/medication-item-snct-1)
Binding Strength Required

...dosage0..*BackboneElementDetails of how medication was taken

....text0..1StringReported dosage information

....timing0..1TimingWhen/how often was medication taken

.....repeat (Dose Direction Duration)0..1ElementWhen the event is to occur

......count0..1IntegerNumber of times to repeat

......duration0..1DecimalHow long when it happens

......durationMax0..1DecimalHow long when it happens (Max)

......durationUnits0..1Codes | min | h | d | wk | mo | a - unit of time (UCUM)
Binding A unit of time (units from UCUM). (http://hl7.org/fhir/ValueSet/units-of-time)
Binding Strength Required

......frequency0..1IntegerEvent occurs frequency times per period
Default Value 1

......frequencyMax0..1IntegerEvent occurs up to frequencyMax times per period

......period0..1DecimalEvent occurs frequency times per period

......periodMax0..1DecimalUpper limit of period (3-4 hours)

......periodUnits0..1Codes | min | h | d | wk | mo | a - unit of time (UCUM)
Binding A unit of time (units from UCUM). (http://hl7.org/fhir/ValueSet/units-of-time)
Binding Strength Required

......when0..1CodeRegular life events the event is tied to
Binding Real world event that the relating to the schedule. (http://hl7.org/fhir/ValueSet/event-timing)
Binding Strength Required

.....code (Dose Timing)1..1CodeableConceptA set of codes to identify observation type used in the CDA domains.
Binding A set of codes to identify observation type used in the CDA domains. (http://fhir.nhs.net/ValueSet/cda-observation-type-1)
Binding Strength Required

......coding1..1CodingCode defined by a terminology system
Binding A set of codes to identify observation type used in the CDA domains. (http://fhir.nhs.net/ValueSet/cda-observation-type-1)
Binding Strength Required

.......system1..1UriIdentity of the terminology system
Fixed Value http://fhir.nhs.net/ValueSet/cda-observation-type-1

.......code1..1CodeSymbol in syntax defined by the system
Binding A set of codes to identify observation type used in the CDA domains. (http://fhir.nhs.net/ValueSet/cda-observation-type-1)
Binding Strength Required
Fixed Value DOSTIM

.......display1..1StringRepresentation defined by the system
Fixed Value Dose Timing

......text1..1StringPlain text representation of the concept

....site[x]0..1CodeableConceptWhere (on body) medication is/was administered
Binding A code from the SNOMED Clinical Terminology UK coding system that describes the anatomical site at which the medication is to be administered e.g. 'Left eye'. (http://fhir.nhs.net/ValueSet/site-of-medication-administration-snct-1)
Binding Strength Required

....route (Route of Administration)0..1CodeableConceptHow the medication entered the body
Binding A subset of the Snomed-CT clinical terminology (i.e. coding system) intended for use in the UK, previously named SnomedCTUK, that describes routes of administration for medications. (http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1)
Binding Strength Required

.....coding1..1CodingCode defined by a terminology system
Binding A subset of the Snomed-CT clinical terminology (i.e. coding system) intended for use in the UK, previously named SnomedCTUK, that describes routes of administration for medications. (http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1)
Binding Strength Required

......system1..1UriIdentity of the terminology system
Fixed Value http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1

......code1..1CodeSymbol in syntax defined by the system
Binding A subset of the Snomed-CT clinical terminology (i.e. coding system) intended for use in the UK, previously named SnomedCTUK, that describes routes of administration for medications. (http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1)
Binding Strength Required

......display1..1StringRepresentation defined by the system
Fixed Value Route of administration (attribute)

....method (Administration Method)0..1CodeableConceptTechnique used to administer medication
Binding A coded concept describing the technique by which the medicine is administered. (http://snomed.info/sct)
Binding Strength Required

.....coding1..1CodingCode defined by a terminology system
Binding Code defined by a terminology system (http://snomed.info/sct)
Binding Strength Required

......system1..1UriIdentity of the terminology system
Fixed Value http://snomed.info/sct

......code1..1CodeSymbol in syntax defined by the system
Binding Code defined by a terminology system (http://snomed.info/sct)
Binding Strength Required
Fixed Value 447487007

......display1..1StringRepresentation defined by the system
Fixed Value Method of drug administration (observable entity)

.....text1..1StringTo carry the text of the administration method associated with the medication item.

....quantity[x]0..1SimpleQuantity | RangeAmount administered in one dose

....maxDosePerPeriod (Total Daily Dose)0..1RatioMaximum dose that was consumed per unit of time

.....numerator0..1QuantityNumerator value

......value0..1DecimalNumerical value (with implicit precision)

......comparator0..1Code< | <= | >= | > - how to understand the value
Binding How the Quantity should be understood and represented. (http://hl7.org/fhir/ValueSet/quantity-comparator)
Binding Strength Required

......unit0..1StringUnit representation

......system0..1UriSystem that defines coded unit form

......code0..1CodeCoded form of the unit

.....denominator0..1QuantityDenominator value

......value0..1DecimalNumerical value (with implicit precision)

......comparator0..1Code< | <= | >= | > - how to understand the value
Binding How the Quantity should be understood and represented. (http://hl7.org/fhir/ValueSet/quantity-comparator)
Binding Strength Required

......unit0..1StringUnit representation

......system0..1UriSystem that defines coded unit form

......code0..1CodeCoded form of the unit

Name Type Description & Constraints
. . Extension-COFE-Administration-Unit-Code-1 Extension An extension to represent the form of the medicinal substance.
. . Extension-COFE-Course-Status-1 Extension Extension to carry the medication course status associated with a medication item.
Path Name Binding Strength ValueSet
.MedicationStatement.status status Required http://hl7.org/fhir/ValueSet/medication-statement-status
.MedicationStatement.reasonForUse[x] Indication Required http://fhir.nhs.net/ValueSet/finding-snct-1
.MedicationStatement.medication[x] medication[x] Required http://fhir.nhs.net/ValueSet/medication-item-snct-1
.MedicationStatement.dosage.timing.code Dose Timing Required http://fhir.nhs.net/ValueSet/cda-observation-type-1
.MedicationStatement.dosage.timing.code.coding coding Required http://fhir.nhs.net/ValueSet/cda-observation-type-1
.MedicationStatement.dosage.timing.code.coding.code code Required http://fhir.nhs.net/ValueSet/cda-observation-type-1
.MedicationStatement.dosage.site[x] site[x] Required http://fhir.nhs.net/ValueSet/site-of-medication-administration-snct-1
.MedicationStatement.dosage.route Route of Administration Required http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1
.MedicationStatement.dosage.route.coding coding Required http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1
.MedicationStatement.dosage.route.coding.code code Required http://fhir.nhs.net/ValueSet/nhse-prescribing-route-of-administration-snct-1
.MedicationStatement.dosage.method Administration Method Required http://snomed.info/sct
.MedicationStatement.dosage.method.coding coding Required http://snomed.info/sct
.MedicationStatement.dosage.method.coding.code code Required http://snomed.info/sct

COFE-MedicationsAdministered-MedicationStatement-1

Examples Description XML File JSON File
COFE-MedicationsAdministered-MedicationStatement-1-Example-1 Medication Item - Paroxetine
COFE-MedicationsAdministered-MedicationStatement-1-Example-2 Medication Item - Glycerol
COFE-MedicationsAdministered-MedicationStatement-1-Example-3 Medication Item - Midazolam
COFE-MedicationsAdministered-MedicationStatement-1-Example-4 Medication Item - Diazepam