The FHIR profiles used for the Medication and medical devices Bundle
Heading Description
The details of and instructions for medications and medical devices the woman is using or has been using but discontinued.
The following FHIR profiles are used to form the https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Medication-1 details list structure:
- CareConnect-List-1
- CareConnect-Practitioner-1
- CareConnect-PractitionerRole-1
- CareConnect-Organization-1
- CareConnect-Medication-1
- CareConnect-MedicationStatement-1
- CareConnect-MedicationAdministration-1
The following profiles are referenced from the https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Medication-1 details list structure:
Medications and Medical Devices Details Structure
Mapping Headings
Medication Item Cluster
| Date/Time | MedicationStatement | effective.effectivePeriod.start |
| Medication Name | medicationReference[Medication.code.coding] | |
| Form | medicationReference[Medication.form] | |
| Route | dosage.route | |
| Site | dosage.site | |
| Method | dosage.method | |
| Dose directions description | dosage.patientInstruction | |
| Dose amount description | dosage.text - TBC | |
| Dose timing description | dosage.text - TBC | |
| Structured dose direction cluster | dosage.timing | |
| Dose direction duration | dosage.timing.duration | |
| Additional instruction | dosage.additionlInstructions |
Medication Change Item Cluster
| Status | MedicationStatement | Extension-CareConnect-MedicationChangeSummary-1.status |
| Indication | Extension-CareConnect-MedicationChangeSummary-1.indicationForChange | |
| Date of latest change | Extension-CareConnect-MedicationChangeSummary-1.dateChanged | |
| Description of amendment | Extension-CareConnect-MedicationChangeSummary-1.detailsOfAmendment | |
| Medical devices entry | TBC |
Discontinued Medication Item Cluster
| Name of discontinued medication | MedicationStatement | |
| Status | status | |
| Indication | Extension-CareConnect-MedicationChangeSummary-1.indicationForChange | |
| Date of latest change | Extension-CareConnect-MedicationChangeSummary-1.dateChanged | |
| Description of amendment | Extension-CareConnect-MedicationChangeSummary-1.detailsOfAmendment | |
| Comment | note - TBC |
Mapping for Medication Statement List
| > | Level 1 | List Resource | > | Level 2 | CareConnect-List-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Digital Maternity Implementation |
|---|---|---|---|---|
| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-List-1' |
| - identifier | 0..* | Required | Identifier | Business identifier An identifier for this Medication Statement details list |
| - - system | 1..1 | Required | Uri | The namespace for the identifier value The system from which the identifier came from |
| - - value | 1..1 | Mandatory | String | The value that is unique An identifier for this Medication Statement details list |
| - status | 1..1 | Mandatory | Code | current : retired : entered-in-error Binding (required): The current state of the list ListStatus The status of the list MUST contain the value 'current' |
| - mode | 1..1 | Mandatory | Code | working : snapshot : changes Binding (required): The processing mode that applies to this list ListMode The mode of the list MUST contain the value 'snapshot' |
| - title | 0..1 | Mandatory | String | Descriptive name for the list This MUST contain the value 'Observation' Mapping to Maternity data item = 'PSRB Heading Medications and Medical Devices' |
| - code | 0..1 | Mandatory | CodeableConcept | What the purpose of this list is Binding (preferred): What the purpose of a list is CareConnect-ListCode-1 The PRSB heading for this list. Note: for Maternity the value stated below is used which is not from the preferred value set |
| - - coding | 0..* | Mandatory | Coding | Code defined by a terminology system The SNOMED CT concept for the PRSB heading type |
| - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system This MUST contain the value 'http://snomed.info/sct' |
| - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system This MUST contain the value '933361000000108'' |
| - - - display | 0..1 | Mandatory | String | Representation defined by the system Mapping to Maternity data item = 'PSRB Heading Medications and medical devices' |
| - subject | 0..1 | Mandatory | Reference | If all resources have the same subject Constraint (ref-1): SHALL have a contained resource if a local reference is provided This is a reference to the Patient who is the subject of the list. |
| Mandatory | CareConnect-Patient-1 | This is the subject of the Observations details List. This MUST use the CareConnect patient profile.See patient resource reference for information on how to populate the resource. | ||
| - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL A reference to the patient resource included in the Patient demographics list within the FHIR Bundle. Note the Patient demographics list is mandatory in the FHIR bundle |
| - date | 0..1 | Required | dateTime | When the list was prepared This MUST contain a system date to indicate when the list was created or updated |
| - entry | 0..* | Required | BackboneElement | Entries in the list The entries MUST be as per the diagram for this PRSB headings list with the medicationStatement resource being the focal resource. Multiple resources MAY be present |
| - - date | 0..1 | Required | dateTime | When item added to list The SHOULD contain a system time of when the item was added to the list. |
| - - item | 1..1 | Mandatory | Reference | Actual entry Constraint (ref-1): SHALL have a contained resource if a local reference is provided A reference to an MedicationStatement resource included in the list This MUST use the CareConnect MedicationStatement profile. |
| - - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL |
Mapping for Medication Statement (Cluster)
| > | Level 1 | MedicationStatement Resource | > | Level 2 | CareConnect-MedicationStatement-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Digital Maternity Implementation |
|---|---|---|---|---|
| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource |
| - - profile | 1..1 | Mandatory | Uri | Profiles this resource claims to conform to The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-MedicationStatement-1' |
| - extension (changeSummary) | 0..* | Optional | Extension-CareConnect-MedicationChangeSummary-1 | Optional Extensions Element |
| - - extension (status) | 0..1 | Optional | Extension | The change status of a medication Constraint (ext-1): Must have either extensions or value[x], not both The nature of any change made to the medication |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: status |
| - - - valueCode | 0..1 | Optional | Code | The change status of a medication. Binding (required): A ValueSet to identify the change status of a medication. (https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-MedicationChangeStatus-1 ) |
| - - extension (indicationForChange) | 0..1 | Optional | Extension | Additional Content defined by implementations Constraint (ext-1): Must have either extensions or value[x], not both Reason for change in medication, e.g. sub-therapeutic dose, patient intolerant. |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: indicationForChange |
| - - - valueCodeableConcept | 0..1 | Optional | CodeableConcept | Value of extension |
| - - extension (dateChanged) | 0..1 | Optional | Extension | Additional Content defined by implementations Constraint (ext-1): Must have either extensions or value[x], not both The date of the latest change - addition, or amendment |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: dateChanged |
| - - - valueDateTime | 0..1 | Optional | dateTime | Value of extension |
| - - extension (detailsOfAmendment) | 0..1 | Optional | Extension | Additional Content defined by implementations Constraint (ext-1): Must have either extensions or value[x], not both Where a change is made to the medication i.e. one drug stopped and another started or e.g. dose, frequency or route is changed. |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: detailsOfAmendment |
| - - - valueString | 0..1 | Optional | String | Value of extension |
| - identifier | 0..* | Required | Identifier | External identifier |
| - - system | 1..1 | Mandatory | Uri | The namespace for the identifier value |
| - - value | 1..1 | Required | String | The value that is unique |
| - status | 1..1 | Mandatory | Code | active : completed : entered-in-error : intended : stopped : on-hold Binding (required): A coded concept indicating the current status of a MedicationStatement. MedicationStatementStatus |
| - medicationReference | 1..1 | Mandatory | Reference | What medication was taken |
| 0..1 | Mandatory | Period | ||
| - subject | 1..1 | Mandatory | Reference | Who is/was taking the medication Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| - taken | 1..1 | Mandatory | Code | y : n : unk : na Binding (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication MedicationStatementTaken |
| - dosage | 0..* | Optional | Dosage | Details of how medication is/was taken or should be taken |
| - - text | 0..1 | Optional | String | Free text dosage instructions e.g. SIG A plain text description of medication single dose amount, as described in the AoMRC medication headings. Comment: e.g. "30 mg" or "2 tabs". UK Secondary care clinicians and systems normally minimally structure their dose directions, separating Dose amount and Dose timing (often referred to as Dose and Frequency). This format is not normally used in GP systems, which will always import Dose and Frequency descriptions concatenated into the single Dose directions description. |
| - - additionalInstruction | 0..* | Optional | CodeableConcept | Supplemental instruction - e.g. “with meals” Binding (example): A coded concept identifying additional instructions such as “take with water” or “avoid operating heavy machinery”. SNOMED CT Additional Dosage Instructions |
| - - patientInstruction | 0..1 | Optional | String | Patient or consumer oriented instructions |
| - - timing | 0..1 | Optional | Timing | When medication should be administered |
| - - - - duration | 0..1 | Optional | Decimal | How long when it happens |
| - - - code | 0..1 | Optional | CodeableConcept | BID : TID : QID : AM : PM : QD : QOD : Q4H : Q6H + Binding (preferred): Code for a known / defined timing pattern. TimingAbbreviation |
| - - - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system |
| - - - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - - - display | 0..1 | Mandatory | String | Representation defined by the system |
| - - - - text | 0..1 | Optional | String | Plain text representation of the concept |
| - - site | 0..1 | Optional | CodeableConcept | Body site to administer to Binding (example): A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes The anatomical site at which the medication is to be administered. Comment: e.g. "Left eye" |
| - - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system |
| - - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - - display | 0..1 | Mandatory | String | Representation defined by the system |
| - - - text | 0..1 | Optional | String | Plain text representation of the concept |
| - - route | 0..1 | Optional | CodeableConcept | How drug should enter body Binding (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes Medication administration description (oral, IM, IV, etc.): may include method of administration (e.g., by infusion, via nebuliser, via NG tube) . |
| - - - coding | 0..* | Required | Coding | Code defined by a terminology system Slicing: Discriminator: system, Ordering: false, Rules: Open |
| - - - coding (snomedCT) | 0..1 | Required | Coding | Code defined by a terminology system Binding (example): A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. CareConnect-MedicationDosageRoute-1 |
| - - - - system | 1..1 | Mandatory | Uri | Identity of the terminology system The element MUST contain the value 'http://snomed.info/sct' |
| - - - - code | 1..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - - display | 1..1 | Mandatory | String | Representation defined by the system |
| - - - text | 0..1 | Optional | String | Plain text representation of the concept |
| - - method | 0..1 | Optional | CodeableConcept | Technique for administering medication Binding (example): A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes |
| - - - coding | 0..* | Required | Coding | Code defined by a terminology system |
| - - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system |
| - - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - - display | 0..1 | Mandatory | String | Representation defined by the system |
| - - - text | 0..1 | Optional | String | Plain text representation of the concept |
Mapping for Discontinued Medication Item Cluster
| > | Level 1 | MedicationStatement Resource | > | Level 2 | CareConnect-MedicationStatement-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Digital Maternity Implementation |
|---|---|---|---|---|
| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource |
| - - profile | 1..1 | Mandatory | Uri | Profiles this resource claims to conform to The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-MedicationStatement-1' |
| - extension (changeSummary) | 0..* | Optional | Extension-CareConnect-MedicationChangeSummary-1 | Optional Extensions Element |
| - - extension (status) | 0..1 | Optional | Extension | The change status of a medication Constraint (ext-1): Must have either extensions or value[x], not both The nature of any change made to the medication |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: status |
| - - - valueCode | 0..1 | Optional | Code | The change status of a medication. Binding (required): A ValueSet to identify the change status of a medication. https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-MedicationChangeStatus-1 |
| - - extension (indicationForChange) | 0..1 | Optional | Extension | Additional Content defined by implementations Constraint (ext-1): Must have either extensions or value[x], not both The clinical indication for any changes in medication status |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: indicationForChange |
| - - - valueCodeableConcept | 0..1 | Optional | CodeableConcept | Value of extension |
| - - extension (dateChanged) | 0..1 | Optional | Extension | Additional Content defined by implementations Constraint (ext-1): Must have either extensions or value[x], not both The date of the discontinuation |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: dateChanged |
| - - - valueDateTime | 0..1 | Optional | dateTime | Value of extension |
| - - extension (detailsOfAmendment) | 0..1 | Optional | Extension | Additional Content defined by implementations Constraint (ext-1): Must have either extensions or value[x], not both A description of any amendment |
| - - - url | 1..1 | Mandatory | Uri | Identifies The Meaning Of The Extension Fixed Value: detailsOfAmendment |
| - - - valueString | 0..1 | Optional | String | Value of extension |
| - identifier | 0..* | Required | Identifier | External identifier |
| - - system | 1..1 | Mandatory | Uri | The namespace for the identifier value |
| - - value | 1..1 | Required | String | The value that is unique |
| - status | 1..1 | Mandatory | Code | active : completed : entered-in-error : intended : stopped : on-hold Binding (required): A coded concept indicating the current status of a MedicationStatement. MedicationStatementStatus The nature of any change made to the medication. MUST contain STOPPED |
| - medicationReference | 1..1 | Mandatory | Reference | What medication was taken Name of discontinued medication |
| Mandatory | CareConnect-Medication-1 | This MUST use the CareConnect Medication profile. See Location resource for information on how to populate the resource. | ||
| 0..1 | Mandatory | Period | ||
| - subject | 1..1 | Mandatory | Reference | Who is/was taking the medication Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| - taken | 1..1 | Mandatory | Code | y : n : unk : na Binding (required): A coded concept identifying level of certainty if patient has taken or has not taken the medication MedicationStatementTaken |
| - note | 0..* | Optional | Annotation | Further information about the statement Any additional comment about the medication change. |
| - - author[x] | 0..1 | Required | Reference | Individual responsible for the annotation Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
| Required | CareConnect-Practitioner-1 | |||
| - - text | 1..1 | Mandatory | String | The annotation - text content Any additional comment about the medication change. |
Mapping for Medication
| > | Level 1 | Medication Resource | > | Level 2 | CareConnect-Medication-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Digital Maternity Implementation |
|---|---|---|---|---|
| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource |
| - - profile | 1..1 | Mandatory | Uri | Profiles this resource claims to conform to The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Medication-1' |
| - code | 0..1 | Required | CodeableConcept | Codes that identify this medication Binding (required): A code from the SNOMED Clinical Terminology UK coding system that describes a medication from the VTM/VMP/VMPP/AMP/AMPP subsets from the dm+d terminology CareConnect-MedicationCode-1 |
| - - coding | 0..* | Required | Coding | Code defined by a terminology system |
| - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system The element MUST contain the value 'http://snomed.info/sct' |
| - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - display | 0..1 | Mandatory | String | Representation defined by the system |
| - - text | 0..1 | Required | String | Plain text representation of the concept |
Mapping for Medication Administration
| > | Level 1 | MedicationAdministration Resource | > | Level 2 | CareConnect-Medication-1 | > | Level 3 | None |
| View Used FHIR Elements | View All FHIR Elements |
| Name | Card. | Conformance | Type | Description, Constraints and mapping for Digital Maternity Implementation |
|---|---|---|---|---|
| - id | 0..1 | Optional | Id | Logical id of this artifact |
| - meta | 0..1 | Mandatory | Meta | Metadata about the resource |
| - - profile | 1..1 | Mandatory | Uri | Profiles this resource claims to conform to The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-MedicationAdministration-1' |
| - identifier | 0..* | Required | Identifier | External identifier |
| - status | 1..1 | Mandatory | Code | in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding (required): A set of codes indicating the current status of a MedicationAdministration. (http://hl7.org/fhir/stu3/valueset-medication-admin-status.html ) The nature of any change made to the medication. MUST be marked as COMPLETED once administered |
| - medicationReference | 1..1 | Required | Reference | What was administered Binding (example): Codes identifying substance or product that can be administered. (http://hl7.org/fhir/stu3/valueset-medication-codes.html ) The reference to the included Organization resource |
| Mandatory | CareConnect-Medication-1 | This MUST use the CareConnect Medication profile. See Medication resource for information on how to populate the resource.” | ||
| - subject | 0..1 | Mandatory | Reference | If all resources have the same subject Constraint (ref-1): SHALL have a contained resource if a local reference is provided This is a reference to the Patient who is the subject of the list. |
| Mandatory | CareConnect-Patient-1 | This is the subject of the Observations details List. This MUST use the CareConnect patient profile.See patient resource reference for information on how to populate the resource. | ||
| - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL A reference to the patient resource included in the Patient demographics list within the FHIR Bundle. Note the Patient demographics list is mandatory in the FHIR bundle |
| - effective[x] | 1..1 | Mandatory | dateTime | Start and end time of administration |
| - performer | 0..* | Required | BackboneElement | Who administered substance |
| - - actor | 1..1 | Mandatory | Reference | Individual who was performing Constraint (ref-1): SHALL have a contained resource if a local reference is provided Name of the professional performing the administration |
| Mandatory | CareConnect-Practitioner-1 | This MUST use the CareConnect Location profile. See Practitioner resource for information on how to populate the resource.” | ||
| - - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL The reference to the included Practitioner resource |
| - - onBehalfOf | 0..1 | Required | Reference ( CareConnect-Organization-1 ) | Organization organization was acting for Constraint (ref-1): SHALL have a contained resource if a local reference is provided The site code of the organisation associated with the professional performing the administration |
| - - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL The reference to the included Organization resource |
| - dosage | 0..1 | Optional | BackboneElement | Details of how medication was taken Constraint (mad-1): SHALL have at least one of dosage.dose or dosage.rate[x] |
| - - text | 0..1 | Optional | String | Free text dosage instructions e.g. SIG A plain text description of medication single dose amount, as described in the AoMRC medication headings. Comment: e.g. "30 mg" or "2 tabs". UK Secondary care clinicians and systems normally minimally structure their dose directions, separating Dose amount and Dose timing (often referred to as Dose and Frequency). This format is not normally used in GP systems, which will always import Dose and Frequency descriptions concatenated into the single Dose directions description. |
| - - site | 0..1 | Optional | CodeableConcept | Body site administered to Binding (example): A coded concept describing the site location the medicine enters into or onto the body. ( http://hl7.org/fhir/stu3/valueset-approach-site-codes.html ) The anatomical site at which the medication is to be administered. Comment: e.g. "Left eye" |
| - - - coding | 0..* | Required | Coding | Code defined by a terminology system |
| - - - - system | 0..1 | Mandatory | Uri | Identity of the terminology system |
| - - - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - - display | 0..1 | Mandatory | String | Representation defined by the system |
| - - - text | 0..1 | Optional | String | Plain text representation of the concept |
| - - route | 0..1 | Optional | CodeableConcept | Path of substance into body Binding (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. ( http://hl7.org/fhir/stu3/valueset-route-codes.html ) Medication administration description (oral, IM, IV, etc.): may include method of administration, (e.g., by infusion, via nebuliser, via NG tube) and/or site of use, (e.g., ‘to wound’, ‘to left eye’, etc.). |
| - - - coding | 0..* | Required | Coding | Code defined by a terminology system Slicing: Discriminator: system, Ordering: false, Rules: Open |
| - - - coding (snomedCT) | 0..1 | Required | Coding | Code defined by a terminology system Binding (example): A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. ( https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-MedicationDosageRoute-1 ) |
| - - - - system | 1..1 | Mandatory | Uri | Identity of the terminology system Fixed Value: http://snomed.info/sct |
| - - - - code | 1..1 | Mandatory | Code | Symbol in syntax defined by the system |
| - - - - display | 1..1 | Mandatory | String | Representation defined by the system |
| - - - text | 0..1 | Optional | String | Plain text representation of the concept |
Mapping for Medications and Medical Devices Practitioner
The medications and medical devices details has reference(s) to the Practitioner resource. This means that any exchange of the medications and medical devices details heading data must also include the Practitioner Details
Mapping for Medications and Medical Devices Practitioner Role
The medications and medical devices details has reference(s) to the Practitioner Role resource. This means that any exchange of the medications and medical devices details heading data must also include the Practitioner Role Details
Mapping for Medications and Medical Devices Organisation
The medications and medical devices details has reference(s) to the Organization resource. This means that any exchange of the medications and medical devices details heading data must also include the Organization Details