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11.4 Ресурс MedicationStatement - Назначение

Pharmacy Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: 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.

Common usage includes:

  • the recording of non-prescription and/or recreational drugs
  • the recording of an intake medication list upon admission to hospital
  • the summarization of a patient's "active medications" in a patient profile

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 included 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

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 medication, supplies or devices when there is a patient focus or instructions regarding their use, a MedicationRequest, SupplyRequest or DeviceRequest should be used instead

The Medication domain includes a number of related resources

MedicationRequest An order for both supply of the medication and the instructions for administration of the medicine to a patient.
MedicationDispense Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription).
MedicationAdministration When a patient actually consumes a medicine, or it is otherwise administered to them
MedicationStatement This is a record of a medication being taken by a patient or that a medication has been given to a patient, where the record is the result of a report from the patient or another clinician, or derived from supporting information (for example, Claim, Observation or MedicationRequest). A medication statement is not a part of the prescribe->dispense->administer sequence, but is a report that such a sequence (or at least a part of it) did take place, resulting in a belief that the patient has received a particular medication.

This resource is distinct from MedicationRequest, MedicationDispense and MedicationAdministration. Each of those resources refers to specific events - an individual order, an individual provisioning of medication or an individual dosing. MedicationStatement is a broader assertion covering a wider timespan and is independent of specific events. The existence of resource instances of any of the preceding three types may be used to infer a medication statement. However, medication statements can also be captured on the basis of other information, including an assertion by the patient or a care-giver, the results of a lab test, etc.

На этот ресурс ссылаются AdverseEvent, Goal, itself и Observation

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. MedicationStatement TUDomainResourceЗапись о том, что лекарственное средство было принято пациентом
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierВнешний идентификатор
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Medication status codes (Required)
... statusReason 0..*CodeableConceptReason for current status
SNOMED CT Drug Therapy Status codes (Example)
... category Σ0..1CodeableConceptType of medication usage
Medication status codes (Preferred)
... medication[x] Σ1..1Какое именно лекарственное средство было принято?
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject Σ1..1Reference(Patient | Group)Кто принимал/принимает этот медикамент
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] Σ0..1The date/time or interval when the medication is/was/will 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
... derivedFrom 0..*Reference(Any)Дополнительная вспомогательная информация
... reasonCode 0..*CodeableConceptПричина, почему это лекарственное средство принимается/было принято
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)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)Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] « MedicationRequest|CarePlan| ServiceRequest »A larger event of which this particular event is a component or steppartOf : Reference [0..*] « MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation »Код, представляющий собой суждение пациента или другого источника о статусе использованного медикамента, о котором сделано заявление. Как правило, это будет статус active или 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)Medication Status ! »Captures the reason for the current state of the MedicationStatementstatusReason : CodeableConcept [0..*] « A coded concept indicating the reason for the status of the statement. (Strength=Example) SNOMEDCTDrugTherapyStatusCodes?? »Indicates 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)Medication Status ? »Идентифицирует лекарственное средство, которое было введено. Это либо ссылка на ресурс, представляющий подробное описание медикамента, либо простой атрибут с кодом медикамента из известного списка лекарственных средствmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication); A coded concept identifying the substance or product being taken. (Strength=Example) SNOMEDCTMedicationCodes?? »The person, animal or group who is/was taking the medicationsubject : Reference [1..1] « Patient|Group »The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] « Encounter|EpisodeOfCare »The interval of time during which it is being asserted that the patient is/was/will be taking the medication ( or was not taking, when the MedicationStatement.taken element is No)effective[x] : Type [0..1] « dateTime|Period »Дата, когда источником информации было сделано это заявление о приеме медикаментаdateAsserted : 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 »Позволяет связывать MedicationStatement с лежащим в его основе MedicationOrder или с другой информацией, вспомогательной или используемой для вывода MedicationStatementderivedFrom : Reference [0..*] « Any »Причина, почему это лекарственное средство принимается/было принятоreasonCode : CodeableConcept [0..*] « A coded concept identifying why the medication is being taken. (Strength=Example) Condition/Problem/DiagnosisCo...?? »Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport »Дополнительная информация о заявлении о принятии медикамента, которая не передается другими атрибутамиnote : 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|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Какое именно лекарственное средство было принято? --></medication[x]>
 <subject><!-- 1..1 Reference(Patient|Group) Кто принимал/принимает этот медикамент --></subject>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication is/was/will 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>
 <derivedFrom><!-- 0..* Reference(Any) Дополнительная вспомогательная информация --></derivedFrom>
 <reasonCode><!-- 0..* CodeableConcept Причина, почему это лекарственное средство принимается/было принято --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport) 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|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: Какое именно лекарственное средство было принято?. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Patient|Group) }, // R!  Кто принимал/принимает этот медикамент
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  // effective[x]: The date/time or interval when the medication is/was/will 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
  "derivedFrom" : [{ Reference(Any) }], // Дополнительная вспомогательная информация
  "reasonCode" : [{ CodeableConcept }], // Причина, почему это лекарственное средство принимается/было принято
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport) }], // 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|ServiceRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  fhir:MedicationStatement.statusReason [ CodeableConcept ], ... ; # 0..* Reason for current status
  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) ]
  fhir:MedicationStatement.subject [ Reference(Patient|Group) ]; # 1..1 Кто принимал/принимает этот медикамент
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication is/was/will 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.derivedFrom [ Reference(Any) ], ... ; # 0..* Дополнительная вспомогательная информация
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Причина, почему это лекарственное средство принимается/было принято
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation|DiagnosticReport) ], ... ; # 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 R3

MedicationStatement
MedicationStatement.basedOn
  • Type Reference: Added Target Type ServiceRequest
  • Type Reference: Removed Target Types ProcedureRequest, ReferralRequest
MedicationStatement.status
  • Remove Codes active, completed, entered-in-error, intended, stopped, on-hold
  • Add Codes active, completed, entered-in-error, intended, stopped, on-hold, unknown, not-taken
MedicationStatement.statusReason
  • Added Element
MedicationStatement.reasonReference
  • Type Reference: Added Target Type DiagnosticReport
MedicationStatement.taken
  • deleted
MedicationStatement.reasonNotTaken
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 7 tests of which 2 fail to execute. 5 fail round-trip testing and 2 r3 resources are invalid (0 errors).)

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. MedicationStatement TUDomainResourceЗапись о том, что лекарственное средство было принято пациентом
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierВнешний идентификатор
... basedOn Σ0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!Σ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Medication status codes (Required)
... statusReason 0..*CodeableConceptReason for current status
SNOMED CT Drug Therapy Status codes (Example)
... category Σ0..1CodeableConceptType of medication usage
Medication status codes (Preferred)
... medication[x] Σ1..1Какое именно лекарственное средство было принято?
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject Σ1..1Reference(Patient | Group)Кто принимал/принимает этот медикамент
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] Σ0..1The date/time or interval when the medication is/was/will 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
... derivedFrom 0..*Reference(Any)Дополнительная вспомогательная информация
... reasonCode 0..*CodeableConceptПричина, почему это лекарственное средство принимается/было принято
Condition/Problem/Diagnosis Codes (Example)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)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)Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to serveridentifier : Identifier [0..*]A plan, proposal or order that is fulfilled in whole or in part by this eventbasedOn : Reference [0..*] « MedicationRequest|CarePlan| ServiceRequest »A larger event of which this particular event is a component or steppartOf : Reference [0..*] « MedicationAdministration| MedicationDispense|MedicationStatement|Procedure|Observation »Код, представляющий собой суждение пациента или другого источника о статусе использованного медикамента, о котором сделано заявление. Как правило, это будет статус active или 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)Medication Status ! »Captures the reason for the current state of the MedicationStatementstatusReason : CodeableConcept [0..*] « A coded concept indicating the reason for the status of the statement. (Strength=Example) SNOMEDCTDrugTherapyStatusCodes?? »Indicates 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)Medication Status ? »Идентифицирует лекарственное средство, которое было введено. Это либо ссылка на ресурс, представляющий подробное описание медикамента, либо простой атрибут с кодом медикамента из известного списка лекарственных средствmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication); A coded concept identifying the substance or product being taken. (Strength=Example) SNOMEDCTMedicationCodes?? »The person, animal or group who is/was taking the medicationsubject : Reference [1..1] « Patient|Group »The encounter or episode of care that establishes the context for this MedicationStatementcontext : Reference [0..1] « Encounter|EpisodeOfCare »The interval of time during which it is being asserted that the patient is/was/will be taking the medication ( or was not taking, when the MedicationStatement.taken element is No)effective[x] : Type [0..1] « dateTime|Period »Дата, когда источником информации было сделано это заявление о приеме медикаментаdateAsserted : 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 »Позволяет связывать MedicationStatement с лежащим в его основе MedicationOrder или с другой информацией, вспомогательной или используемой для вывода MedicationStatementderivedFrom : Reference [0..*] « Any »Причина, почему это лекарственное средство принимается/было принятоreasonCode : CodeableConcept [0..*] « A coded concept identifying why the medication is being taken. (Strength=Example) Condition/Problem/DiagnosisCo...?? »Condition or observation that supports why the medication is being/was takenreasonReference : Reference [0..*] « Condition|Observation| DiagnosticReport »Дополнительная информация о заявлении о принятии медикамента, которая не передается другими атрибутамиnote : 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|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <category><!-- 0..1 CodeableConcept Type of medication usage --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Какое именно лекарственное средство было принято? --></medication[x]>
 <subject><!-- 1..1 Reference(Patient|Group) Кто принимал/принимает этот медикамент --></subject>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with MedicationStatement --></context>
 <effective[x]><!-- 0..1 dateTime|Period The date/time or interval when the medication is/was/will 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>
 <derivedFrom><!-- 0..* Reference(Any) Дополнительная вспомогательная информация --></derivedFrom>
 <reasonCode><!-- 0..* CodeableConcept Причина, почему это лекарственное средство принимается/было принято --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport) 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|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(MedicationAdministration|MedicationDispense|
   MedicationStatement|Procedure|Observation) }], // Part of referenced event
  "status" : "<code>", // R!  active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "category" : { CodeableConcept }, // Type of medication usage
  // medication[x]: Какое именно лекарственное средство было принято?. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Patient|Group) }, // R!  Кто принимал/принимает этот медикамент
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with MedicationStatement
  // effective[x]: The date/time or interval when the medication is/was/will 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
  "derivedFrom" : [{ Reference(Any) }], // Дополнительная вспомогательная информация
  "reasonCode" : [{ CodeableConcept }], // Причина, почему это лекарственное средство принимается/было принято
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport) }], // 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|ServiceRequest) ], ... ; # 0..* Fulfils plan, proposal or order
  fhir:MedicationStatement.partOf [ Reference(MedicationAdministration|MedicationDispense|MedicationStatement|Procedure|
  Observation) ], ... ; # 0..* Part of referenced event
  fhir:MedicationStatement.status [ code ]; # 1..1 active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
  fhir:MedicationStatement.statusReason [ CodeableConcept ], ... ; # 0..* Reason for current status
  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) ]
  fhir:MedicationStatement.subject [ Reference(Patient|Group) ]; # 1..1 Кто принимал/принимает этот медикамент
  fhir:MedicationStatement.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with MedicationStatement
  # MedicationStatement.effective[x] : 0..1 The date/time or interval when the medication is/was/will 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.derivedFrom [ Reference(Any) ], ... ; # 0..* Дополнительная вспомогательная информация
  fhir:MedicationStatement.reasonCode [ CodeableConcept ], ... ; # 0..* Причина, почему это лекарственное средство принимается/было принято
  fhir:MedicationStatement.reasonReference [ Reference(Condition|Observation|DiagnosticReport) ], ... ; # 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 Release 3

MedicationStatement
MedicationStatement.basedOn
  • Type Reference: Added Target Type ServiceRequest
  • Type Reference: Removed Target Types ProcedureRequest, ReferralRequest
MedicationStatement.status
  • Remove Codes active, completed, entered-in-error, intended, stopped, on-hold
  • Add Codes active, completed, entered-in-error, intended, stopped, on-hold, unknown, not-taken
MedicationStatement.statusReason
  • Added Element
MedicationStatement.reasonReference
  • Type Reference: Added Target Type DiagnosticReport
MedicationStatement.taken
  • deleted
MedicationStatement.reasonNotTaken
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 7 tests of which 2 fail to execute. 5 fail round-trip testing and 2 r3 resources are invalid (0 errors).)

 

See the Profiles & Extensions and the Альтернативные определения: Основное определение XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the Анализ зависимостей

PathОписаниеТипСсылка
MedicationStatement.status A coded concept indicating the current status of a MedicationStatement.RequiredMedication Status Codes
MedicationStatement.statusReason A coded concept indicating the reason for the status of the statement.ExampleSNOMEDCTDrugTherapyStatusCodes
MedicationStatement.category A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.PreferredMedication Status Codes
MedicationStatement.medication[x] A coded concept identifying the substance or product being taken.ExampleSNOMEDCTMedicationCodes
MedicationStatement.reasonCode A coded concept identifying why the medication is being taken.ExampleCondition/Problem/DiagnosisCodes

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.

ИмяТипОпределениеВыражениеIn Common
categorytokenReturns statements of this category of medicationstatementMedicationStatement.category
codetokenReturn statements of this medication code(MedicationStatement.medication as CodeableConcept)13 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.identifier30 Resources
medicationreferenceReturn statements of this medication reference(MedicationStatement.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.where(resolve() is Patient)
(Patient)
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)