FHIR Release 3 (STU)

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11.4 Ресурс MedicationStatement - Назначение

Pharmacy Work GroupMaturity Level: 3 Trial UseCompartments: Patient, Practitioner, RelatedPerson

Запись о том, что лекарственное средство было употреблено пациентом. MedicationStatement может указывать на то, что пациент может принимать медикамент в текущее время, или принял медикамент в прошлом, или примет медикамент в будущем. Источником этой информации может выступать пациент, кто-то значимый для него (член семьи или супруг) или клиницист. Распространённым сценарием, когда вводится такая информация, является процесс сбора анамнеза пациента во время его визита или пребывания. Информация о медикаменте может сообщаться пациентом по памяти, быть взята из предписания на бутылочке с лекарством или из списка медикаментов, поддерживаемого пациентом, клиницистом или другой стороной Основное различие между заявлением о медикаменте и введением медикамента в том, что введение медикамента содержит полную информацию о введении и основывается на реальной информации о введении от человека, который ввёл этот медикамент. Заявление о медикаменте часто, если не всегда, будет менее точным. В нём нет обязательного указания даты/времени, когда медикамент был введён, на деле мы знаем только, что источник сообщил о том, что пациент принимает этот медикамент, и такие детали, как время, количество, скорость или даже название медицинского препарата могут быть неполными, неточными или отсутствовать. Как указано выше, информация для заявления о медикаменте может идти из памяти пациента, из предписания на бутылочке или из списка медикаментов, поддерживаемого пациентом, клиницистом или другой стороной. Введение медикамента является более официальным, и в нём нет отсутствующих деталей информации.

Стандартное использование включает в себя:

  • запись лекарственных средств, продающихся без рецепта, и/или рекреационных (развлекательных) наркотиков
  • запись списка принимаемых медикаментов при госпитализации
  • резюмирование активных медикаментов пациента в профиле пациента

A MedicationStatement may be used to record substance abuse or the use of other agents such as tobacco or alcohol. This would typically be done if these substances are intended to be inluded in clinical decision support checking (for example, interaction checking) and as part of an active medication list. If the intent is to populate social history and/or to include additional information (for example, desire to quit, amount per day, negative health effects), then it is better to record as an Observation that could then be used to populate Social History.

This resource does not produce a medication list, but it does produce individual medication statements that may be used in the List resource to construct various types of medication lists. Note that other medication lists can also be constructed from the other Pharmacy resources (e.g., MedicationRequest, MedicationAdministration).

A medication statement is not a part of the prescribe -> dispense -> administer sequence, but is a report by a patient, significant other or a clinician that one or more of the prescribe, dispense or administer actions has occurred, resulting is a belief that the patient is, has, or will be using a particular medication.

MedicationStatement is an event resource from a FHIR workflow perspective - see Workflow Event

С точки зрения рабочего процесса FHIR, MedicationStatement - ресурс-событие. См. Событие в рабочем процессе.

The MedicationStatement resource is used to record a medications or substances that the patient reports as being taken, not taking, have taken in the past or may take in the future. It can also be used to record medication use that is derived from other records such as a MedicationRequest. The statement is not used to request or order a medication, supply or device. When requesting medicaation, supplies or devices when there is a patient focus or instructions regarding their use, a MedicationRequest, SupplyRequest or DeviceRequestDeviceRequest should be used instead

Домен Medication включает в себя ряд взаимосвязанных ресурсов:

MedicationRequest Заказ как на поставку лекарственного средства, так и распоряжения по вводу лекарственного средства пациенту.
MedicationDispense Обеспечение поставки лекарственного средства с тем, чтобы впоследствии его выдали пациенту (как правило, в ответ на предписание (prescription))
MedicationAdministration Когда пациент непосредственно употребляет лекарственное средство, или оно вводится пациенту иным способом
MedicationStatement Запись о том, что лекарственное средство было принято пациентом, или что лекарственное средство было выдано пациенту, где данная запись является результатом сообщения от пациента или другого клинициста, или вытекает из вспомогательной информации (например Claim, Observation или MedicationRequest). Medication statement не является частью последовательности выписать->отпустить препарат по рецепту->ввести (в организм) (prescribe->dispense->administer), это протокол о том, что такая последовательность (или, по крайней мере, её часть) действительно имела место и привела к убеждению о том, что пациент получил конкретный медикамент.

Данный ресурс отличается от MedicationRequest, MedicationDispense и MedicationAdministration. Каждый из этих трех ресурсов относится к конкретным событиям - отдельный заказ, предоставление отдельного медикамента, отдельная доза. MedicationStatement - это более широкое утверждение, охватывающее больший промежуток времени и не зависящее от конкретных событий. Наличие экземпляров ресурсов любого из предыдущих трех типов может использоваться, чтобы заключить Medication statement. Однако Medication statement может также записываться на основе другой информации, включая утверждение пациентом или лицом, осуществляющим уход, результатов лабораторных тестов и т. п.

На этот ресурс ссылаются AdverseEvent и Goal

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. MedicationStatement IDomainResourceЗапись о том, что лекарственное средство было принято пациентом
+ Reason not taken is only permitted if Taken is No
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierВнешний идентификатор
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold
MedicationStatementStatus (Required)
... category Σ0..1CodeableConceptType of medication usage
MedicationStatementCategory (Preferred)
... medication[x] Σ1..1Какое именно лекарственное средство было принято?
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... effective[x] Σ0..1The date/time or interval when the medication was taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeКогда было сделано это заявление?
... informationSource 0..1Reference(Patient | Practitioner | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... subject Σ1..1Reference(Patient | Group)Кто принимал/принимает этот медикамент
... derivedFrom 0..*Reference(Any)Дополнительная вспомогательная информация
... taken ?!Σ1..1codey | n | unk | na
MedicationStatementTaken (Required)
... reasonNotTaken I0..*CodeableConceptИстинно, если описываемый медикамент не был выдан
SNOMED CT Drugs not taken/completed Codes (Example)
... reasonCode 0..*CodeableConceptПричина, почему это лекарственное средство принимается/было принято
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationДополнительная информация о заявлении
... dosage 0..*DosageDetails of how medication is/was taken or should be taken

doco Документация по этому формату

UML-диаграмма (Legend)

MedicationStatement (DomainResource) - FHIR ( URLs), . , FHIR - ; , , . , identifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] MedicationRequest|CarePlan| ProcedureRequest|ReferralRequest A larger event of which this particular event is a component or steppartOf : Reference [0..*] MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] Encounter|EpisodeOfCare , , . , active completed (this element modifies the meaning of other elements)status : code [1..1] A coded concept indicating the current status of a MedicationStatement. (Strength=Required)MedicationStatementStatus! Indicates where type of medication statement and where the medication is expected to be consumed or administeredcategory : CodeableConcept [0..1] A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered (Strength=Preferred)MedicationStatementCategory? , . , , medication[x] : Type [1..1] CodeableConcept|Reference(Medication); A coded concept identifying the substance or product being taken. (Strength=Example) SNOMED CT Medication ?? , , ( , 'wasNotGiven' true)effective[x] : Type [0..1] dateTime|Period , dateAsserted : dateTime [0..1]The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequestinformationSource : Reference [0..1] Patient|Practitioner| RelatedPerson|Organization The person, animal or group who is/was taking the medicationsubject : Reference [1..1] Patient|Group MedicationStatement MedicationOrder , MedicationStatementderivedFrom : Reference [0..*] Any Indicator of the certainty of whether the medication was taken by the patient (this element modifies the meaning of other elements)taken : code [1..1] A coded concept identifying level of certainty if patient has taken or has not taken the medication (Strength=Required)MedicationStatementTaken! , , reasonNotTaken : CodeableConcept [0..*] A coded concept indicating the reason why the medication was not taken (Strength=Example)SNOMED CT Drugs not taken/com...?? , / reasonCode : CodeableConcept [0..*] A coded concept identifying why the medication is being taken. (Strength=Example)Condition/Problem/Diagnosis ?? Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] Condition|Observation , note : Annotation [0..*]Indicates how the medication is/was or should be taken by the patientdosage : Dosage [0..*]

XML-шаблон

<MedicationStatement xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Внешний идентификатор --></identifier>
 <basedOn><!-- 0..* Reference(MedicationRequest|CarePlan|ProcedureRequest|
   ReferralRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold -->
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Какое именно лекарственное средство было принято? --></medication[x]>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication was taken --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 Когда было сделано это заявление? -->
 <informationSource><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson|
   Organization) Person or organization that provided the information about the taking of this medication --></informationSource>
 <subject><!-- 1..1 Reference(Patient|Group) Кто принимал/принимает этот медикамент --></subject>
 <derivedFrom><!-- 0..* Reference(Any) Дополнительная вспомогательная информация --></derivedFrom>
 <taken value="[code]"/><!-- 1..1 y | n | unk | na -->
 <reasonNotTaken><!-- ?? 0..* CodeableConcept Истинно, если описываемый медикамент не был выдан --></reasonNotTaken>
 <reasonCode><!-- 0..* CodeableConcept Причина, почему это лекарственное средство принимается/было принято --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) Condition or observation that supports why the medication is being/was taken --></reasonReference>
 <note><!-- 0..* Annotation Дополнительная информация о заявлении --></note>
 <dosage><!-- 0..* Dosage Details of how medication is/was taken or should be taken --></dosage>
</MedicationStatement>

JSON-шаблон

{doco
  "resourceType" : "MedicationStatement",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Внешний идентификатор
  "basedOn" : [{ Reference(MedicationRequest|CarePlan|ProcedureRequest|
   ReferralRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: Какое именно лекарственное средство было принято?. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  // effective[x]: The date/time or interval when the medication was taken. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // Когда было сделано это заявление?
  "informationSource" : { Reference(Patient|Practitioner|RelatedPerson|
   Organization) }, // Person or organization that provided the information about the taking of this medication
  "subject" : { Reference(Patient|Group) }, // R!  Кто принимал/принимает этот медикамент
  "derivedFrom" : [{ Reference(Any) }], // Дополнительная вспомогательная информация
  "taken" : "<code>", // R!  y | n | unk | na
  "reasonNotTaken" : [{ CodeableConcept }], // C? Истинно, если описываемый медикамент не был выдан
  "reasonCode" : [{ CodeableConcept }], // Причина, почему это лекарственное средство принимается/было принято
  "reasonReference" : [{ Reference(Condition|Observation) }], // Condition or observation that supports why the medication is being/was taken
  "note" : [{ Annotation }], // Дополнительная информация о заявлении
  "dosage" : [{ Dosage }] // Details of how medication is/was taken or should be taken
}

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationStatement;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationStatement.identifier [ Identifier ], ... ; # 0..* Внешний идентификатор
  fhir:MedicationStatement.basedOn [ Reference(MedicationRequest|CarePlan|ProcedureRequest|ReferralRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold
  fhir:MedicationStatement.category [ CodeableConcept ]; # 0..1 Type of medication usage
  # MedicationStatement.medication[x] : 1..1 Какое именно лекарственное средство было принято?. One of these 2
    fhir:MedicationStatement.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationStatement.medicationReference [ Reference(Medication) ]
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication was taken. One of these 2
    fhir:MedicationStatement.effectiveDateTime [ dateTime ]
    fhir:MedicationStatement.effectivePeriod [ Period ]
  fhir:MedicationStatement.dateAsserted [ dateTime ]; # 0..1 Когда было сделано это заявление?
  fhir:MedicationStatement.informationSource [ Reference(Patient|Practitioner|RelatedPerson|Organization) ]; # 0..1 Person or organization that provided the information about the taking of this medication
  fhir:MedicationStatement.subject [ Reference(Patient|Group) ]; # 1..1 Кто принимал/принимает этот медикамент
  fhir:MedicationStatement.derivedFrom [ Reference(Any) ], ... ; # 0..* Дополнительная вспомогательная информация
  fhir:MedicationStatement.taken [ code ]; # 1..1 y | n | unk | na
  fhir:MedicationStatement.reasonNotTaken [ CodeableConcept ], ... ; # 0..* Истинно, если описываемый медикамент не был выдан
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Причина, почему это лекарственное средство принимается/было принято
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation) ], ... ; # 0..* Condition or observation that supports why the medication is being/was taken
  fhir:MedicationStatement.note [ Annotation ], ... ; # 0..* Дополнительная информация о заявлении
  fhir:MedicationStatement.dosage [ Dosage ], ... ; # 0..* Details of how medication is/was taken or should be taken
]

Changes since DSTU2

MedicationStatement
MedicationStatement.basedOn added Element
MedicationStatement.partOf added Element
MedicationStatement.context added Element
MedicationStatement.category added Element
MedicationStatement.informationSource Add Reference(Organization)
MedicationStatement.subject Renamed from patient to subject
Add Reference(Group)
MedicationStatement.derivedFrom Renamed from supportingInformation to derivedFrom
MedicationStatement.taken added Element
MedicationStatement.reasonCode added Element
MedicationStatement.reasonReference added Element
MedicationStatement.note Max Cardinality changed from 1 to *
Type changed from string to Annotation
MedicationStatement.dosage Type changed from BackboneElement to Dosage
MedicationStatement.wasNotTaken deleted
MedicationStatement.reasonForUse[x] deleted
MedicationStatement.dosage.text deleted
MedicationStatement.dosage.timing deleted
MedicationStatement.dosage.asNeeded[x] deleted
MedicationStatement.dosage.site[x] deleted
MedicationStatement.dosage.route deleted
MedicationStatement.dosage.method deleted
MedicationStatement.dosage.quantity[x] deleted
MedicationStatement.dosage.rate[x] deleted
MedicationStatement.dosage.maxDosePerPeriod deleted

See the Full Difference for further information

See R2 <--> R3 Conversion Maps (status = 7 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (1 errors).).

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. MedicationStatement IDomainResourceЗапись о том, что лекарственное средство было принято пациентом
+ Reason not taken is only permitted if Taken is No
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierВнешний идентификатор
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold
MedicationStatementStatus (Required)
... category Σ0..1CodeableConceptType of medication usage
MedicationStatementCategory (Preferred)
... medication[x] Σ1..1Какое именно лекарственное средство было принято?
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... effective[x] Σ0..1The date/time or interval when the medication was taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeКогда было сделано это заявление?
... informationSource 0..1Reference(Patient | Practitioner | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... subject Σ1..1Reference(Patient | Group)Кто принимал/принимает этот медикамент
... derivedFrom 0..*Reference(Any)Дополнительная вспомогательная информация
... taken ?!Σ1..1codey | n | unk | na
MedicationStatementTaken (Required)
... reasonNotTaken I0..*CodeableConceptИстинно, если описываемый медикамент не был выдан
SNOMED CT Drugs not taken/completed Codes (Example)
... reasonCode 0..*CodeableConceptПричина, почему это лекарственное средство принимается/было принято
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationДополнительная информация о заявлении
... dosage 0..*DosageDetails of how medication is/was taken or should be taken

doco Документация по этому формату

UML-диаграмма (Legend)

MedicationStatement (DomainResource) - FHIR ( URLs), . , FHIR - ; , , . , identifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] MedicationRequest|CarePlan| ProcedureRequest|ReferralRequest A larger event of which this particular event is a component or steppartOf : Reference [0..*] MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] Encounter|EpisodeOfCare , , . , active completed (this element modifies the meaning of other elements)status : code [1..1] A coded concept indicating the current status of a MedicationStatement. (Strength=Required)MedicationStatementStatus! Indicates where type of medication statement and where the medication is expected to be consumed or administeredcategory : CodeableConcept [0..1] A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered (Strength=Preferred)MedicationStatementCategory? , . , , medication[x] : Type [1..1] CodeableConcept|Reference(Medication); A coded concept identifying the substance or product being taken. (Strength=Example) SNOMED CT Medication ?? , , ( , 'wasNotGiven' true)effective[x] : Type [0..1] dateTime|Period , dateAsserted : dateTime [0..1]The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequestinformationSource : Reference [0..1] Patient|Practitioner| RelatedPerson|Organization The person, animal or group who is/was taking the medicationsubject : Reference [1..1] Patient|Group MedicationStatement MedicationOrder , MedicationStatementderivedFrom : Reference [0..*] Any Indicator of the certainty of whether the medication was taken by the patient (this element modifies the meaning of other elements)taken : code [1..1] A coded concept identifying level of certainty if patient has taken or has not taken the medication (Strength=Required)MedicationStatementTaken! , , reasonNotTaken : CodeableConcept [0..*] A coded concept indicating the reason why the medication was not taken (Strength=Example)SNOMED CT Drugs not taken/com...?? , / reasonCode : CodeableConcept [0..*] A coded concept identifying why the medication is being taken. (Strength=Example)Condition/Problem/Diagnosis ?? Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] Condition|Observation , note : Annotation [0..*]Indicates how the medication is/was or should be taken by the patientdosage : Dosage [0..*]

XML-шаблон

<MedicationStatement xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Внешний идентификатор --></identifier>
 <basedOn><!-- 0..* Reference(MedicationRequest|CarePlan|ProcedureRequest|
   ReferralRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold -->
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Какое именно лекарственное средство было принято? --></medication[x]>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication was taken --></effective[x]>
 <dateAsserted value="[dateTime]"/><!-- 0..1 Когда было сделано это заявление? -->
 <informationSource><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson|
   Organization) Person or organization that provided the information about the taking of this medication --></informationSource>
 <subject><!-- 1..1 Reference(Patient|Group) Кто принимал/принимает этот медикамент --></subject>
 <derivedFrom><!-- 0..* Reference(Any) Дополнительная вспомогательная информация --></derivedFrom>
 <taken value="[code]"/><!-- 1..1 y | n | unk | na -->
 <reasonNotTaken><!-- ?? 0..* CodeableConcept Истинно, если описываемый медикамент не был выдан --></reasonNotTaken>
 <reasonCode><!-- 0..* CodeableConcept Причина, почему это лекарственное средство принимается/было принято --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) Condition or observation that supports why the medication is being/was taken --></reasonReference>
 <note><!-- 0..* Annotation Дополнительная информация о заявлении --></note>
 <dosage><!-- 0..* Dosage Details of how medication is/was taken or should be taken --></dosage>
</MedicationStatement>

JSON-шаблон

{doco
  "resourceType" : "MedicationStatement",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Внешний идентификатор
  "basedOn" : [{ Reference(MedicationRequest|CarePlan|ProcedureRequest|
   ReferralRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: Какое именно лекарственное средство было принято?. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  // effective[x]: The date/time or interval when the medication was taken. One of these 2:
  "effectiveDateTime" : "<dateTime>",
  "effectivePeriod" : { Period },
  "dateAsserted" : "<dateTime>", // Когда было сделано это заявление?
  "informationSource" : { Reference(Patient|Practitioner|RelatedPerson|
   Organization) }, // Person or organization that provided the information about the taking of this medication
  "subject" : { Reference(Patient|Group) }, // R!  Кто принимал/принимает этот медикамент
  "derivedFrom" : [{ Reference(Any) }], // Дополнительная вспомогательная информация
  "taken" : "<code>", // R!  y | n | unk | na
  "reasonNotTaken" : [{ CodeableConcept }], // C? Истинно, если описываемый медикамент не был выдан
  "reasonCode" : [{ CodeableConcept }], // Причина, почему это лекарственное средство принимается/было принято
  "reasonReference" : [{ Reference(Condition|Observation) }], // Condition or observation that supports why the medication is being/was taken
  "note" : [{ Annotation }], // Дополнительная информация о заявлении
  "dosage" : [{ Dosage }] // Details of how medication is/was taken or should be taken
}

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationStatement;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationStatement.identifier [ Identifier ], ... ; # 0..* Внешний идентификатор
  fhir:MedicationStatement.basedOn [ Reference(MedicationRequest|CarePlan|ProcedureRequest|ReferralRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold
  fhir:MedicationStatement.category [ CodeableConcept ]; # 0..1 Type of medication usage
  # MedicationStatement.medication[x] : 1..1 Какое именно лекарственное средство было принято?. One of these 2
    fhir:MedicationStatement.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationStatement.medicationReference [ Reference(Medication) ]
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication was taken. One of these 2
    fhir:MedicationStatement.effectiveDateTime [ dateTime ]
    fhir:MedicationStatement.effectivePeriod [ Period ]
  fhir:MedicationStatement.dateAsserted [ dateTime ]; # 0..1 Когда было сделано это заявление?
  fhir:MedicationStatement.informationSource [ Reference(Patient|Practitioner|RelatedPerson|Organization) ]; # 0..1 Person or organization that provided the information about the taking of this medication
  fhir:MedicationStatement.subject [ Reference(Patient|Group) ]; # 1..1 Кто принимал/принимает этот медикамент
  fhir:MedicationStatement.derivedFrom [ Reference(Any) ], ... ; # 0..* Дополнительная вспомогательная информация
  fhir:MedicationStatement.taken [ code ]; # 1..1 y | n | unk | na
  fhir:MedicationStatement.reasonNotTaken [ CodeableConcept ], ... ; # 0..* Истинно, если описываемый медикамент не был выдан
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Причина, почему это лекарственное средство принимается/было принято
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation) ], ... ; # 0..* Condition or observation that supports why the medication is being/was taken
  fhir:MedicationStatement.note [ Annotation ], ... ; # 0..* Дополнительная информация о заявлении
  fhir:MedicationStatement.dosage [ Dosage ], ... ; # 0..* Details of how medication is/was taken or should be taken
]

Changes since DSTU2

MedicationStatement
MedicationStatement.basedOn added Element
MedicationStatement.partOf added Element
MedicationStatement.context added Element
MedicationStatement.category added Element
MedicationStatement.informationSource Add Reference(Organization)
MedicationStatement.subject Renamed from patient to subject
Add Reference(Group)
MedicationStatement.derivedFrom Renamed from supportingInformation to derivedFrom
MedicationStatement.taken added Element
MedicationStatement.reasonCode added Element
MedicationStatement.reasonReference added Element
MedicationStatement.note Max Cardinality changed from 1 to *
Type changed from string to Annotation
MedicationStatement.dosage Type changed from BackboneElement to Dosage
MedicationStatement.wasNotTaken deleted
MedicationStatement.reasonForUse[x] deleted
MedicationStatement.dosage.text deleted
MedicationStatement.dosage.timing deleted
MedicationStatement.dosage.asNeeded[x] deleted
MedicationStatement.dosage.site[x] deleted
MedicationStatement.dosage.route deleted
MedicationStatement.dosage.method deleted
MedicationStatement.dosage.quantity[x] deleted
MedicationStatement.dosage.rate[x] deleted
MedicationStatement.dosage.maxDosePerPeriod deleted

See the Full Difference for further information

See R2 <--> R3 Conversion Maps (status = 7 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (1 errors).).

 

Альтернативные определения: Основное определение (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

ПутьОписаниеТипСсылка
MedicationStatement.status A coded concept indicating the current status of a MedicationStatement.RequiredMedicationStatementStatus
MedicationStatement.category A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administeredPreferredMedicationStatementCategory
MedicationStatement.medication[x] A coded concept identifying the substance or product being taken.ExampleSNOMED CT Medication Codes
MedicationStatement.taken A coded concept identifying level of certainty if patient has taken or has not taken the medicationRequiredMedicationStatementTaken
MedicationStatement.reasonNotTaken A coded concept indicating the reason why the medication was not takenExampleSNOMED CT Drugs not taken/completed Codes
MedicationStatement.reasonCode A coded concept identifying why the medication is being taken.ExampleCondition/Problem/Diagnosis Codes

  • mst-1: Reason not taken is only permitted if Taken is No (expression : reasonNotTaken.exists().not() or (taken = 'n'))

The MedicationStatement resource includes both a status and a taken code. The taken code conveys whether the medication was taken by the patient from the perspective of the information source. The status code reflects the current state of the practitioner’s instructions to the patient whether the consumption of the medication should continue or not.

Note: Medication statements can be made about prescribed medications as well as non-prescribed (i.e. over the counter) medications.

If you desire to perform a query for all medication statements that “imply” that a medication has been taken, you will need to use both MedicationStatement.status and MedicationStatement.taken in your query. The following table is intended to provide guidance on the interpretation of these two attributes with respect to the MedicationStatement.

In the table below the “X” represents a valid status that can be present in combination with the Taken value.

Taken Information Source Active Completed Stopped On Hold Entered in Error Intended Interpretation or Meaning
N Exists (e.g. Patient or RelatedPerson) X X X Patient or related person states the medication is not currently being taken. Taken must = N.
When status = Active, it means that although a statement was made that the patient isn’t taking the medication, the practitioner still expects and instructs the patient to take the medication.
When status = On Hold, it means that although a statement was made that the patient isn’t taking the medication, the practitioner has suspended the medication, but intends for the patient to take the medication in the future.
When status = Intended, it means that although a statement was made that the patient isn’t taking the medication, the practitioner intends for the patient to take the medication in the future.
Y Exists (e.g. Patient or RelatedPerson) X X X Patient or related person states the medication is or will be taken. Taken must = Y. The status values can be any of the following: active, on hold, or intended.
UNK No information source exists X X X No assertion by patient or related person of whether the medication is being consumed.
The MedicationStatement still exists because it can be derived from a MedicationRequest, but it is unknown whether the Patient is taking the medication as prescribed in the MedicationRequest.
NA No information source exists X X X X X X Patient reporting does not apply.
For example, this can occur when MedicationStatements are derived from MedicationRequests that are administered by a practitioner. In this example, there is no need to ask for input from the patient or related person since the practitioner was responsible for the administration.
Another example might be a MedicationStatement derived from an end-stated (stopped, completed, entered in error) MedicationRequest. In this example, there is no need to ask for input from the patient or related person since the MedicationRequest is no longer applicable.

Параметры поиска для этого ресурса. Также к нему применяются общие параметры. Более подробную информацию о поиске в REST, обмене сообщениями и сервисах см. в разделе Поиск.

ИмяТипОписаниеВыражениеIn Common
categorytokenReturns statements of this category of medicationstatementMedicationStatement.category
codetokenReturn statements of this medication codeMedicationStatement.medication.as(CodeableConcept)4 Resources
contextreferenceReturns statements for a specific context (episode or episode of Care).MedicationStatement.context
(EpisodeOfCare, Encounter)
effectivedateДата, когда пациент принял (или не принял) этот медикаментMedicationStatement.effective
identifiertokenВозвращает заявления с указанным внешним идентификаторомMedicationStatement.identifier3 Resources
medicationreferenceReturn statements of this medication referenceMedicationStatement.medication.as(Reference)
(Medication)
3 Resources
part-ofreferenceReturns statements that are part of another event.MedicationStatement.partOf
(MedicationDispense, Observation, MedicationAdministration, Procedure, MedicationStatement)
patientreferenceReturns statements for a specific patient.MedicationStatement.subject
(Patient)
3 Resources
sourcereferenceWho or where the information in the statement came fromMedicationStatement.informationSource
(Practitioner, Organization, Patient, RelatedPerson)
statustokenВозвращает заявления, которые соответствуют указанному статусуMedicationStatement.status3 Resources
subjectreferenceThe identity of a patient, animal or group to list statements forMedicationStatement.subject
(Group, Patient)