Guide d'implémentation du médicament
0.1.0 - ci-build

Guide d'implémentation du médicament - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: FrMedicationNonproprietaryName - Detailed Descriptions

Draft as of 2021-10-18

Definitions for the FrMedicationNonproprietaryName resource profile.

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

0. Medication
Definition

This ressource is profiled for describing a simple medicament (vs compound medication) in the presription line represented by a MedicationRequest, a MedicationDispense or a MedicationUsage (pka MedicationStatement).

ShortSimple nonproprietary name Medication of MRQ, MDP or MUS
Comments

A simple medication is made of one single component made of one to many substances. Optionality of doseForm, amount and strehgth attributes supports different levels of granularity. The coarser level only defines the substances it's made of. For instance, contaning only paracetamol or containing only glucose. The finest level is the defines the composition and the dose form. For instance, paracetamol 500 mg tablet or 500 mL glucose 5% (50 mg/mL) solution for injection.

2. Medication.extension
SlicingThis element introduces a set of slices on Medication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Medication.extension:drugCharacteristic
    Slice NamedrugCharacteristic
    Shortdescriptive properties of the medicine
    Control0..*
    TypeExtension(Medication descriptive properties) (Complex Extension)
    6. Medication.code
    Definition

    A sctid that specify this medication.

    Control1..?
    BindingUnless not suitable, these codes SHALL be taken from French Medicinal Product only
    (extensible to http://interopsante.org/fhir/ValueSet/fr-medicinal-product-only)
    Requirements

    The developper SHALL support the infusion use case, which requires a multi-compounds Medication ressource.

    8. Medication.code.text
    Comments

    When some code is available, the text is the same as a displayName of one of the codings.

    10. Medication.form
    BindingUnless not suitable, these codes SHALL be taken from French Medicinal product Dose form
    (extensible to http://interopsante.org/fhir/ValueSet/fr-mp-dose-form)
    12. Medication.amount
    Definition

    The quantity of the only substance or the volume (liquid) or mass (ointment) in the Medication of the MedicationRequest, Dispense or Use (pka MedicationStatement).

    ShortAmount of drug in the MRequest, MDispense or MUsage
    Comments

    If the strenght of the ingredients is a concentration, it is the volume (liquid) or mass (ointment) in the Medication of the MedicationRequest, Dispense or Use (pka MedicationStatement). If there is only one ingredient and the strenght is not defined, it is the quantity of the substance.

    TypeRatio(Ratio with UCUM quantity units)
    14. Medication.ingredient
    Definition

    Identifies a particular constituent in the product.

    Comments

    For the active ingedients, the medication contains ALL the ingredients and ONLY the ingredients.

    Control1..?
    16. Medication.ingredient.item[x]
    Definition

    The actual substance (simple ingredient) of the simple medication (ie. made of single component).

    ShortSubstance
    TypeCodeableConcept(French Active Substance of a Medicinal Product), Reference(Substance, Medication)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Requirements

    The composition of the medication for this ingredient has to be defined

    18. Medication.ingredient.strength
    Definition

    Specifies how much of the items there are in this Medication

    Comments

    The quantity of this igredient defining the medication. For instance, 50 mg/mL defining the glucose quantity for the glucose 5% or 500 mg medicine and 30 mg respectively defining the paracetamol and the codeine quantity for the paracetamol+codeine 500 mg+30 mg medicine.

    TypeRatio(Ratio with UCUM quantity units)
    20. Medication.batch
    Control0..0

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

    0. Medication
    Definition

    This ressource is profiled for describing a simple medicament (vs compound medication) in the presription line represented by a MedicationRequest, a MedicationDispense or a MedicationUsage (pka MedicationStatement).


    This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

    ShortSimple nonproprietary name Medication of MRQ, MDP or MUSDefinition of a Medication
    Comments

    A simple medication is made of one single component made of one to many substances. Optionality of doseForm, amount and strehgth attributes supports different levels of granularity. The coarser level only defines the substances it's made of. For instance, contaning only paracetamol or containing only glucose. The finest level is the defines the composition and the dose form. For instance, paracetamol 500 mg tablet or 500 mL glucose 5% (50 mg/mL) solution for injection.

    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsdom-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 or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Medication.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Medication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. Medication.extension:drugCharacteristic
      Slice NamedrugCharacteristic
      Definition

      Specifies descriptive properties of the medicine, such as color, shape, imprints, release characteristic, etc.

      Shortdescriptive properties of the medicine
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(Medication descriptive properties) (Complex Extension)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Medication.code
      Definition

      A sctid that specify this medication.


      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.

      ShortCodes that identify this medication
      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. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see French Medicinal Product onlyhttp://hl7.org/fhir/ValueSet/medication-codes
      (extensible to http://interopsante.org/fhir/ValueSet/fr-medicinal-product-only)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      The developper SHALL support the infusion use case, which requires a multi-compounds Medication ressource.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. 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.

      ShortPlain text representation of the concept
      Comments

      When some code is available, the text is the same as a displayName of one of the codings.


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

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Medication.status
      Definition

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

      Shortactive | inactive | entered-in-error
      Comments

      This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

      Control0..1
      BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/medication-status|4.0.1)

      A coded concept defining if the medication is in active use.

      Typecode
      Is Modifiertrue because This element changes the interpretation of all descriptive attributes.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Medication.form
      Definition

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

      Shortpowder | tablets | capsule +
      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.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see French Medicinal product Dose formhttp://hl7.org/fhir/ValueSet/medication-form-codes
      (extensible to http://interopsante.org/fhir/ValueSet/fr-mp-dose-form)
      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Medication.amount
      Definition

      The quantity of the only substance or the volume (liquid) or mass (ointment) in the Medication of the MedicationRequest, Dispense or Use (pka MedicationStatement).


      Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).

      ShortAmount of drug in the MRequest, MDispense or MUsageAmount of drug in package
      Comments

      If the strenght of the ingredients is a concentration, it is the volume (liquid) or mass (ointment) in the Medication of the MedicationRequest, Dispense or Use (pka MedicationStatement). If there is only one ingredient and the strenght is not defined, it is the quantity of the substance.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeRatio(Ratio with UCUM quantity units)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
      20. Medication.ingredient
      Definition

      Identifies a particular constituent in the product.


      Identifies a particular constituent of interest in the product.

      ShortActive or inactive ingredient
      Comments

      For the active ingedients, the medication contains ALL the ingredients and ONLY the ingredients.


      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.

      Control10..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. Medication.ingredient.item[x]
      Definition

      The actual substance (simple ingredient) of the simple medication (ie. made of single component).


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

      ShortSubstanceThe actual ingredient or content
      Comments

      Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

      Control1..1
      This element is affected by the following invariants: ele-1
      TypeCodeableConcept(French Active Substance of a Medicinal Product), Reference(Substance, Medication)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Requirements

      The composition of the medication for this ingredient has to be defined


      The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

      Example<br/><b>Glucose</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "67079006", "display" : "glucose (substance)" }], "text" : "glucose" } <br/><b>Perindopril erbumine</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "129485000", "display" : "perindopril erbumine (substance)|" }], "text" : "perindopril erbumine (substance)" }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Medication.ingredient.strength
      Definition

      Specifies how much of the items there are in this Medication


      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.

      ShortA ratio of two precise Quantity values - a numerator and a denominatorQuantity of ingredient present
      Comments

      The quantity of this igredient defining the medication. For instance, 50 mg/mL defining the glucose quantity for the glucose 5% or 500 mg medicine and 30 mg respectively defining the paracetamol and the codeine quantity for the paracetamol+codeine 500 mg+30 mg medicine.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeRatio(Ratio with UCUM quantity units)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
      28. Medication.batch
      Definition

      Information that only applies to packages (not products).

      ShortDetails about packaged medications
      Control0..01
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

      0. Medication
      Definition

      This ressource is profiled for describing a simple medicament (vs compound medication) in the presription line represented by a MedicationRequest, a MedicationDispense or a MedicationUsage (pka MedicationStatement).

      ShortSimple nonproprietary name Medication of MRQ, MDP or MUS
      Comments

      A simple medication is made of one single component made of one to many substances. Optionality of doseForm, amount and strehgth attributes supports different levels of granularity. The coarser level only defines the substances it's made of. For instance, contaning only paracetamol or containing only glucose. The finest level is the defines the composition and the dose form. For instance, paracetamol 500 mg tablet or 500 mL glucose 5% (50 mg/mL) solution for injection.

      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-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 or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Medication.id
      Definition

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

      ShortLogical id of this artifact
      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.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Medication.meta
      Definition

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

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Medication.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Medication.text
      Definition

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

      ShortText summary of the resource, for human interpretation
      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 information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. 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.

      ShortContained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Medication.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Medication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Medication.extension:drugCharacteristic
        Slice NamedrugCharacteristic
        Definition

        Specifies descriptive properties of the medicine, such as color, shape, imprints, release characteristic, etc.

        Shortdescriptive properties of the medicine
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Medication descriptive properties) (Complex Extension)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Medication.identifier
        Definition

        Business identifier for this medication.

        ShortBusiness identifier for this medication
        Comments

        The serial number could be included as an identifier.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Medication.code
        Definition

        A sctid that specify this medication.

        ShortCodes that identify this medication
        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. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from French Medicinal Product only
        (extensible to http://interopsante.org/fhir/ValueSet/fr-medicinal-product-only)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        The developper SHALL support the infusion use case, which requires a multi-compounds Medication ressource.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. 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.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        26. Medication.code.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Medication.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 28. Medication.code.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          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.

          Control0..*
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. 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.

          ShortPlain text representation of the concept
          Comments

          When some code is available, the text is the same as a displayName of one of the codings.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Medication.status
          Definition

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

          Shortactive | inactive | entered-in-error
          Comments

          This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

          Control0..1
          BindingThe codes SHALL be taken from Medication Status Codes
          (required to http://hl7.org/fhir/ValueSet/medication-status|4.0.1)

          A coded concept defining if the medication is in active use.

          Typecode
          Is Modifiertrue because This element changes the interpretation of all descriptive attributes.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. 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.

          ShortManufacturer of the item
          Control0..1
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Medication.form
          Definition

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

          Shortpowder | tablets | capsule +
          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.

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from French Medicinal product Dose form
          (extensible to http://interopsante.org/fhir/ValueSet/fr-mp-dose-form)
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Medication.amount
          Definition

          The quantity of the only substance or the volume (liquid) or mass (ointment) in the Medication of the MedicationRequest, Dispense or Use (pka MedicationStatement).

          ShortAmount of drug in the MRequest, MDispense or MUsage
          Comments

          If the strenght of the ingredients is a concentration, it is the volume (liquid) or mass (ointment) in the Medication of the MedicationRequest, Dispense or Use (pka MedicationStatement). If there is only one ingredient and the strenght is not defined, it is the quantity of the substance.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeRatio(Ratio with UCUM quantity units)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
          40. Medication.ingredient
          Definition

          Identifies a particular constituent in the product.

          ShortActive or inactive ingredient
          Comments

          For the active ingedients, the medication contains ALL the ingredients and ONLY the ingredients.

          Control1..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. 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.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          44. Medication.ingredient.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          46. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          48. Medication.ingredient.item[x]
          Definition

          The actual substance (simple ingredient) of the simple medication (ie. made of single component).

          ShortSubstance
          Comments

          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeCodeableConcept(French Active Substance of a Medicinal Product)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Requirements

          The composition of the medication for this ingredient has to be defined

          Example<br/><b>Glucose</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "67079006", "display" : "glucose (substance)" }], "text" : "glucose" } <br/><b>Perindopril erbumine</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "129485000", "display" : "perindopril erbumine (substance)|" }], "text" : "perindopril erbumine (substance)" }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Medication.ingredient.isActive
          Definition

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

          ShortActive ingredient indicator
          Control0..1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          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).

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Medication.ingredient.strength
          Definition

          Specifies how much of the items there are in this Medication

          ShortA ratio of two precise Quantity values - a numerator and a denominator
          Comments

          The quantity of this igredient defining the medication. For instance, 50 mg/mL defining the glucose quantity for the glucose 5% or 500 mg medicine and 30 mg respectively defining the paracetamol and the codeine quantity for the paracetamol+codeine 500 mg+30 mg medicine.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeRatio(Ratio with UCUM quantity units)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
          54. Medication.batch
          Definition

          Information that only applies to packages (not products).

          ShortDetails about packaged medications
          Control0..0
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))