Nictiz FHIR NL R4 Zib2020
0.9.0 - CI Build
Nictiz FHIR NL R4 Zib2020
0.9.0 - CI Build
Nictiz FHIR NL R4 Zib2020 - Local Development build (v0.9.0). See the Directory of published versions
| Draft as of 2023-10-17 |
XML representation of the zib-PharmaceuticalProduct resource profile.
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="zib-PharmaceuticalProduct"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication">Medication</a><a name="Medication"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/medication.html">Medication</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">This is an abstract profile. Child profiles: <a href="StructureDefinition-nl-core-PharmaceuticalProduct.html">NlcorePharmaceuticalProduct</a><br/>PharmaceuticalProduct</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.extension:description" title="Extension URL = http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalProduct.Description">description</a><a name="Medication.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Extension</span><br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/R4/StructureDefinition-ext-PharmaceuticalProduct.Description.html">http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalProduct.Description</a></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.code" title="Coding medication in the Netherlands is done on the basis of the G standard (issued by Z-index), which is filled under the direction of KNMP.
The coded medication can be expressed as:
* GTIN International Article Number
* ZI-nummer (2.16.840.1.113883.2.4.4.8)
* Trade product code (HPK)
* Prescription code (PRK)
* Generic product code (GPK)
* Anatomic Therapeutic Classification code (ATC)
* Substance Name Code (SNK)
* Substance Name Code, in combination with Route of Administration (SSK)
* SNOMED CT code
The GTIN enables identification of the product including its origin with a barcode. The ZI number represents the tradeproduct and the package size. The HPK is the code for the trade product (with the brand name) as used per dose/per time the medication is taken (1 pill, 1 puff, 1ml) The PRK contains als GPK information supplemented with information needed to prescribe the right product. this level is intended to facilitate generic prescription of drugs. The GPK defines the pharmaceutical characteristics of a product: ingredients, strengths, units, pharmaceutical form and route of administration. The Substance Name Code (SNK) is the (active) compound. Further information about the G-Standaard levels see https://www.z-index.nl So called 90.000.000 numbers are used in local IT systems. These numbers shall not be used for external communication. In the this is necessary only the description (not the code) may be included. This is in accordance with national agreements (Nictiz Standard).
The bound ValueSet includes the NullFlavor code 'OTH', which is not allowed for the zib concept 'MedicationCode'. However, FHIR explicitly defines 'a textual description if no code is available', which is equivalent to the zib concept 'Medication', to be placed on `.code.text`. The 'OTH' code is included to allow this.">code</a><a name="Medication.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">MedicationCode<br/><span style="font-weight:bold">Binding: </span><a href="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.12--20200901000000">http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.12--20200901000000</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">required</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.code.text" title="For medication which has no code, enter the complete name of the pharmaceutical product here.">text</a><a name="Medication.code.text"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Medication</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.form" title="The pharmaceutical form indicates the form of the medication. Examples include: tablet, suppository, infusion liquid, ointment. If the product has a GPK code in the G standard, the form will be known in the G standard. For products without a code (free text, preparation by the pharmacy), the means of administration can be entered.">form</a><a name="Medication.form"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PharmaceuticalForm<br/><span style="font-weight:bold">Binding: </span><a href="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.7.8--20200901000000">http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.7.8--20200901000000</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">required</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.ingredient" title="A product contains one or more active substances and excipients. These are usually determined by the product code. For medication prepared or compounded by the local pharmacy, each ingredient must be entered separately.
The active substances play an important role, as they: a) determine the pharmacotherapeutic effect of the medication and b) serve as the basis for the indication of the strength of the medication (e.g. 200mg).">ingredient</a><a name="Medication.ingredient"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Ingredient</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck013.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.ingredient.item[x]">Slices for item[x]</a><a name="Medication.ingredient.item_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="opacity: 0.5; font-style: italic">1</span><span style="opacity: 0.5; font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a><span style="opacity: 0.5; font-style: italic">, </span><a style="font-style: italic" href="http://hl7.org/fhir/R4/references.html">Reference</a><span style="font-style: italic">(</span><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/substance.html">Substance</a><span style="font-style: italic"> | </span><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/medication.html">Medication</a><span style="font-style: italic">)</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">The actual ingredient or content</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by type:$this</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0124.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.ingredient.item[x]:itemCodeableConcept" title="Slice itemCodeableConcept: Active substance or excipient. Here, the same codes can be used as for the ProductCode (for dilutions and compounds in particular), but now, the ATC, SSK and SNK codes can also be used to indicate a substance (to list ingredients of local products prepared by the pharmacy).
* GTIN International Article Number
* KNMP article number
* Trade product code (HPK)
* Prescription code (PRK)
* Generic product code (GPK)
* ATC (anatomic therapeutic classification)
* SSK (substance name code with route of administration)
* SNK (substance name code)
For further explanation about ATC see <https://www.whocc.no/atc/structure_and_principles/>">item[x]:itemCodeableConcept</a><a name="Medication.ingredient.item_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">SubstanceCode<br/><span style="font-weight:bold">Binding: </span><a href="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.13--20200901000000">http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.13--20200901000000</a> (<a href="http://hl7.org/fhir/R4/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">required</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.ingredient.strength" title="The relative amount of this ingredient in this product.
Calculation of Concentration = Ingredient Amount ÷ Product Amount.
This could be a concentration if the medication is dissolved in liquid, for example.">strength</a><a name="Medication.ingredient.strength"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#Ratio">Ratio</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Concentration</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.ingredient.strength.numerator" title="The amount and unit of this ingredient. This is the numerator for the calculation of the concentration. The unit should be selected from the G-Standard (Table 902).">numerator</a><a name="Medication.ingredient.strength.numerator"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-pattern-GstdQuantity.html" title="Quantity">PatternGstdQuantity</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">IngredientAmount</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-zib-PharmaceuticalProduct-definitions.html#Medication.ingredient.strength.denominator" title="Amount of the product. This is the denominator for the calculation of the concentration. Optionally a translation to NHG table Gebruiksvoorschriften(Table 25) is also allowed.">denominator</a><a name="Medication.ingredient.strength.denominator"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-pattern-GstdQuantity.html" title="Quantity">PatternGstdQuantity</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">ProductAmount</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<url
value="http://nictiz.nl/fhir/StructureDefinition/zib-PharmaceuticalProduct"/>
<version value="0.9.0"/>
<name value="ZibPharmaceuticalProduct"/>
<title value="zib PharmaceuticalProduct"/>
<status value="draft"/>
<date value="2023-10-17T18:06:34+02:00"/>
<publisher value="HL7NL"/>
<contact>
<name value="HL7NL"/>
<telecom>
<system value="url"/>
<value value="https://hl7.nl"/>
</telecom>
</contact>
<description
value="The prescribed substance is usually medication. However, medical aids and bandages can also be prescribed and supplied via the pharmacy. Food and blood products do not strictly belong in the medication category, but can be prescribed and supplied by a pharmacy as well.
A type of medication can be indicated with **a single code**. That code can be chosen from several possible coding systems (concretely: GPK, PRK, HPK or article numbers). Correct use of these codes in the software systems will sufficiently record the composition of the product used, making a complete product specification unnecessary.
In addition to a primary code, **alternative codes** from other coding systems can also be entered (so that the GPK can be sent along in the event that the patient was registered based on PRK, for example).
Entering multiple ingredients will enable you to display a compound product. If one of the composite parts is liquid, the dosage will be given in milliliters; otherwise it will be given in ‘units’.
In that case, the **composition of the medication** can be specified implicitly (with the use of a medication code) or explicitly, for example by listing the (active) ingredient(s) of the medication.
**Magistral prescriptions** can be entered as well. This can be done by means of the option listed above to enter coded ingredients and/or by entering the composition and preparation method as free text.
This is a partial information model."/>
<purpose
value="This Medication resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) PharmaceuticalProduct v2.1.2 (2020)](https://zibs.nl/wiki/PharmaceuticalProduct-v2.1.2(2020EN))."/>
<copyright
value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise."/>
<fhirVersion value="4.0.1"/>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<uri value="https://zibs.nl/wiki/PharmaceuticalProduct-v2.1.2(2020EN)"/>
<name value="zib PharmaceuticalProduct-v2.1.2(2020EN)"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<uri value="http://ncpdp.org/SCRIPT10_6"/>
<name value="Mapping to NCPDP SCRIPT 10.6"/>
</mapping>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM Mapping"/>
</mapping>
<mapping>
<identity value="w5"/>
<uri value="http://hl7.org/fhir/fivews"/>
<name value="FiveWs Pattern Mapping"/>
</mapping>
<mapping>
<identity value="v2"/>
<uri value="http://hl7.org/v2"/>
<name value="HL7 v2 Mapping"/>
</mapping>
<kind value="resource"/>
<abstract value="true"/>
<type value="Medication"/>
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Medication"/>
<derivation value="constraint"/>
<snapshot>
<element id="Medication">
<path value="Medication"/>
<short value="PharmaceuticalProduct"/>
<definition
value="This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use."/>
<alias value="FarmaceutischProduct"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Medication"/>
<min value="0"/>
<max value="*"/>
</base>
<constraint>
<key value="dom-2"/>
<severity value="error"/>
<human
value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
<expression value="contained.contained.empty()"/>
<xpath value="not(parent::f:contained and f:contained)"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-3"/>
<severity value="error"/>
<human
value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/>
<expression
value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
<xpath
value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-4"/>
<severity value="error"/>
<human
value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
<expression
value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
<xpath
value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<key value="dom-5"/>
<severity value="error"/>
<human
value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
<expression value="contained.meta.security.empty()"/>
<xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<constraint>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown
value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
</extension>
<key value="dom-6"/>
<severity value="warning"/>
<human
value="A resource should have narrative for robust management"/>
<expression value="text.`div`.exists()"/>
<xpath value="exists(f:text/h:div)"/>
<source
value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Entity. Role, or Act"/>
</mapping>
<mapping>
<identity value="script10.6"/>
<map
value="NewRx/MedicationPrescribed
-or-
RxFill/MedicationDispensed
-or-
RxHistoryResponse/MedicationDispensed
-or-
RxHistoryResponse/MedicationPrescribed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="ManufacturedProduct[classCode=ADMM]"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19926"/>
<comment value="PharmaceuticalProduct"/>
</mapping>
</element>
<element id="Medication.id">
<path value="Medication.id"/>
<short value="Logical id of this artifact"/>
<definition
value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
<comment
value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Medication.meta">
<path value="Medication.meta"/>
<short value="Metadata about the resource"/>
<definition
value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.meta"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Meta"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
</element>
<element id="Medication.implicitRules">
<path value="Medication.implicitRules"/>
<short value="A set of rules under which this content was created"/>
<definition
value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
<comment
value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.implicitRules"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
<isSummary value="true"/>
</element>
<element id="Medication.language">
<path value="Medication.language"/>
<short value="Language of the resource content"/>
<definition
value="The base language in which the resource is written."/>
<comment
value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Resource.language"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true"/>
</extension>
<strength value="preferred"/>
<description value="A human language."/>
<valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
</binding>
</element>
<element id="Medication.text">
<path value="Medication.text"/>
<short value="Text summary of the resource, for human interpretation"/>
<definition
value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
<comment
value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later."/>
<alias value="narrative"/>
<alias value="html"/>
<alias value="xhtml"/>
<alias value="display"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="DomainResource.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Narrative"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="Act.text?"/>
</mapping>
</element>
<element id="Medication.contained">
<path value="Medication.contained"/>
<short value="Contained, inline Resources"/>
<definition
value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
<comment
value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
<alias value="inline resources"/>
<alias value="anonymous resources"/>
<alias value="contained resources"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.contained"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Resource"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Medication.extension">
<path value="Medication.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<ordered value="false"/>
<rules value="open"/>
</slicing>
<short value="Extension"/>
<definition value="An Extension"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Medication.extension:description">
<path value="Medication.extension"/>
<sliceName value="description"/>
<short value="Extension"/>
<definition value="An Extension"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="DomainResource.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
<profile
value="http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalProduct.Description"/>
</type>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
</element>
<element id="Medication.modifierExtension">
<path value="Medication.modifierExtension"/>
<short value="Extensions that cannot be ignored"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<requirements
value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="DomainResource.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Medication.identifier">
<path value="Medication.identifier"/>
<short value="Business identifier for this medication"/>
<definition value="Business identifier for this medication."/>
<comment value="The serial number could be included as an identifier."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Medication.identifier"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Identifier"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="w5"/>
<map value="FiveWs.identifier"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".id"/>
</mapping>
</element>
<element id="Medication.code">
<path value="Medication.code"/>
<short value="MedicationCode"/>
<definition
value="Coding medication in the Netherlands is done on the basis of the G standard (issued by Z-index), which is filled under the direction of KNMP.
The coded medication can be expressed as:
* GTIN International Article Number
* ZI-nummer (2.16.840.1.113883.2.4.4.8)
* Trade product code (HPK)
* Prescription code (PRK)
* Generic product code (GPK)
* Anatomic Therapeutic Classification code (ATC)
* Substance Name Code (SNK)
* Substance Name Code, in combination with Route of Administration (SSK)
* SNOMED CT code
The GTIN enables identification of the product including its origin with a barcode. The ZI number represents the tradeproduct and the package size. The HPK is the code for the trade product (with the brand name) as used per dose/per time the medication is taken (1 pill, 1 puff, 1ml) The PRK contains als GPK information supplemented with information needed to prescribe the right product. this level is intended to facilitate generic prescription of drugs. The GPK defines the pharmaceutical characteristics of a product: ingredients, strengths, units, pharmaceutical form and route of administration. The Substance Name Code (SNK) is the (active) compound. Further information about the G-Standaard levels see https://www.z-index.nl So called 90.000.000 numbers are used in local IT systems. These numbers shall not be used for external communication. In the this is necessary only the description (not the code) may be included. This is in accordance with national agreements (Nictiz Standard).
The bound ValueSet includes the NullFlavor code 'OTH', which is not allowed for the zib concept 'MedicationCode'. However, FHIR explicitly defines 'a textual description if no code is available', which is equivalent to the zib concept 'Medication', to be placed on `.code.text`. The 'OTH' code is included to allow this."/>
<comment
value="Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one)."/>
<alias value="ProductCode"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<binding>
<strength value="required"/>
<valueSet
value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.12--20200901000000"/>
</binding>
<mapping>
<identity value="script10.6"/>
<map
value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode
coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier
coding.display = //element(*,MedicationType)/DrugDescription"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.class"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXO-1.1-Requested Give Code.code / RXE-2.1-Give Code.code / RXD-2.1-Dispense/Give Code.code / RXG-4.1-Give Code.code /RXA-5.1-Administered Code.code / RXC-2.1 Component Code"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".code"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19927"/>
<comment value="MedicationCode"/>
</mapping>
</element>
<element id="Medication.code.id">
<path value="Medication.code.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.code.extension">
<path value="Medication.code.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.code.coding">
<path value="Medication.code.coding"/>
<short value="Code defined by a terminology system"/>
<definition
value="A reference to a code defined by a terminology system."/>
<comment
value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/>
<requirements
value="Allows for alternative encodings within a code system, and translations to other code systems."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="CodeableConcept.coding"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1-8, C*E.10-22"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="union(., ./translation)"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
</mapping>
</element>
<element id="Medication.code.text">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Medication.code.text"/>
<short value="Medication"/>
<definition
value="For medication which has no code, enter the complete name of the pharmaceutical product here."/>
<comment
value="Very often the text is the same as a displayName of one of the codings."/>
<requirements
value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
<alias value="ProductNaam"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="CodeableConcept.text"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.9. But note many systems use C*E.2 for this"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="./originalText[mediaType/code="text/plain"]/data"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19929"/>
<comment value="Medication"/>
</mapping>
</element>
<element id="Medication.status">
<path value="Medication.status"/>
<short value="active | inactive | entered-in-error"/>
<definition
value="A code to indicate if the medication is in active use."/>
<comment
value="This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.status"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="This element changes the interpretation of all descriptive attributes."/>
<isSummary value="true"/>
<binding>
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MedicationStatus"/>
</extension>
<strength value="required"/>
<description
value="A coded concept defining if the medication is in active use."/>
<valueSet
value="http://hl7.org/fhir/ValueSet/medication-status|4.0.1"/>
</binding>
<mapping>
<identity value="rim"/>
<map value=".statusCode"/>
</mapping>
</element>
<element id="Medication.manufacturer">
<path value="Medication.manufacturer"/>
<short value="Manufacturer of the item"/>
<definition
value="Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.manufacturer"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Organization"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="script10.6"/>
<map value="no mapping"/>
</mapping>
<mapping>
<identity value="w5"/>
<map value="FiveWs.actor"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".player.scopingRole[typeCode=MANU].scoper"/>
</mapping>
</element>
<element id="Medication.form">
<path value="Medication.form"/>
<short value="PharmaceuticalForm"/>
<definition
value="The pharmaceutical form indicates the form of the medication. Examples include: tablet, suppository, infusion liquid, ointment. If the product has a GPK code in the G standard, the form will be known in the G standard. For products without a code (free text, preparation by the pharmacy), the means of administration can be entered."/>
<comment
value="When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form."/>
<alias value="FarmaceutischeVorm"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.form"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<strength value="required"/>
<valueSet
value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.7.8--20200901000000"/>
</binding>
<mapping>
<identity value="script10.6"/>
<map
value="coding.code = //element(*,DrugCodedType)/FormCode
coding.system = //element(*,DrugCodedType)/FormSourceCode"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXO-5-Requested Dosage Form / RXE-6-Give Dosage Form / RXD-6-Actual Dosage Form / RXG-8-Give Dosage Form / RXA-8-Administered Dosage Form"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".formCode"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19931"/>
<comment value="PharmaceuticalForm"/>
</mapping>
</element>
<element id="Medication.amount">
<path value="Medication.amount"/>
<short value="Amount of drug in package"/>
<definition
value="Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.amount"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Ratio"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value=".quantity"/>
</mapping>
</element>
<element id="Medication.ingredient">
<path value="Medication.ingredient"/>
<short value="Ingredient"/>
<definition
value="A product contains one or more active substances and excipients. These are usually determined by the product code. For medication prepared or compounded by the local pharmacy, each ingredient must be entered separately.
The active substances play an important role, as they: a) determine the pharmacotherapeutic effect of the medication and b) serve as the basis for the indication of the strength of the medication (e.g. 200mg)."/>
<comment
value="The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients."/>
<alias value="Ingredient"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Medication.ingredient"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value=".scopesRole[typeCode=INGR]"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19932"/>
<comment value="Ingredient"/>
</mapping>
</element>
<element id="Medication.ingredient.id">
<path value="Medication.ingredient.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.ingredient.extension">
<path value="Medication.ingredient.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.ingredient.modifierExtension">
<path value="Medication.ingredient.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<requirements
value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Medication.ingredient.item[x]">
<path value="Medication.ingredient.item[x]"/>
<slicing>
<discriminator>
<type value="type"/>
<path value="$this"/>
</discriminator>
<ordered value="false"/>
<rules value="open"/>
</slicing>
<short value="The actual ingredient or content"/>
<definition
value="The actual ingredient - either a substance (simple ingredient) or another medication of a medication."/>
<requirements
value="The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base)."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Medication.ingredient.item[x]"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<type>
<code value="Reference"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Substance"/>
<targetProfile
value="http://hl7.org/fhir/StructureDefinition/Medication"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map
value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode
coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier
coding.display = //element(*,MedicationType)/DrugDescription"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".player"/>
</mapping>
</element>
<element id="Medication.ingredient.item[x]:itemCodeableConcept">
<path value="Medication.ingredient.item[x]"/>
<sliceName value="itemCodeableConcept"/>
<short value="SubstanceCode"/>
<definition
value="Active substance or excipient. Here, the same codes can be used as for the ProductCode (for dilutions and compounds in particular), but now, the ATC, SSK and SNK codes can also be used to indicate a substance (to list ingredients of local products prepared by the pharmacy).
* GTIN International Article Number
* KNMP article number
* Trade product code (HPK)
* Prescription code (PRK)
* Generic product code (GPK)
* ATC (anatomic therapeutic classification)
* SSK (substance name code with route of administration)
* SNK (substance name code)
For further explanation about ATC see <https://www.whocc.no/atc/structure_and_principles/>"/>
<requirements
value="The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base)."/>
<alias value="IngredientCode"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Medication.ingredient.item[x]"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="CodeableConcept"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<binding>
<strength value="required"/>
<valueSet
value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.13--20200901000000"/>
</binding>
<mapping>
<identity value="script10.6"/>
<map
value="coding.code = //element(*,MedicationType)/DrugCoded/ProductCode
coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier
coding.display = //element(*,MedicationType)/DrugDescription"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".player"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19934"/>
<comment value="SubstanceCode"/>
</mapping>
</element>
<element id="Medication.ingredient.isActive">
<path value="Medication.ingredient.isActive"/>
<short value="Active ingredient indicator"/>
<definition
value="Indication of whether this ingredient affects the therapeutic action of the drug."/>
<requirements
value="True indicates that the ingredient affects the therapeutic action of the drug (i.e. active).
False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.ingredient.isActive"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="NA"/>
</mapping>
</element>
<element id="Medication.ingredient.strength">
<path value="Medication.ingredient.strength"/>
<short value="Concentration"/>
<definition
value="The relative amount of this ingredient in this product.
Calculation of Concentration = Ingredient Amount ÷ Product Amount.
This could be a concentration if the medication is dissolved in liquid, for example."/>
<alias value="Sterkte"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.ingredient.strength"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Ratio"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="//element(*,DrugCodedType)/Strength"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXC-3-Component Amount & RXC-4-Component Units if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".quantity"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19933"/>
<comment value="Concentration"/>
</mapping>
</element>
<element id="Medication.ingredient.strength.id">
<path value="Medication.ingredient.strength.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.ingredient.strength.extension">
<path value="Medication.ingredient.strength.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.ingredient.strength.numerator">
<path value="Medication.ingredient.strength.numerator"/>
<short value="IngredientAmount"/>
<definition
value="The amount and unit of this ingredient. This is the numerator for the calculation of the concentration. The unit should be selected from the G-Standard (Table 902)."/>
<comment
value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator."/>
<alias value="IngredientHoeveelheid"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Ratio.numerator"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdQuantity"/>
</type>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="qty-3"/>
<severity value="error"/>
<human
value="If a code for the unit is present, the system SHALL also be present"/>
<expression value="code.empty() or system.exists()"/>
<xpath value="not(exists(f:code)) or exists(f:system)"/>
<source value="http://hl7.org/fhir/StructureDefinition/Quantity"/>
</constraint>
<isModifier value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="SN (see also Range) or CQ"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ, IVL<PQ>, MO, CO, depending on the values"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.22277"/>
<comment value="IngredientAmount"/>
</mapping>
</element>
<element id="Medication.ingredient.strength.denominator">
<path value="Medication.ingredient.strength.denominator"/>
<short value="ProductAmount"/>
<definition
value="Amount of the product. This is the denominator for the calculation of the concentration. Optionally a translation to NHG table Gebruiksvoorschriften(Table 25) is also allowed."/>
<comment
value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator."/>
<alias value="ProductHoeveelheid"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Ratio.denominator"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Quantity"/>
<profile
value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdQuantity"/>
</type>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="qty-3"/>
<severity value="error"/>
<human
value="If a code for the unit is present, the system SHALL also be present"/>
<expression value="code.empty() or system.exists()"/>
<xpath value="not(exists(f:code)) or exists(f:system)"/>
<source value="http://hl7.org/fhir/StructureDefinition/Quantity"/>
</constraint>
<isModifier value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
<mapping>
<identity value="v2"/>
<map value="SN (see also Range) or CQ"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="PQ, IVL<PQ>, MO, CO, depending on the values"/>
</mapping>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.22278"/>
<comment value="ProductAmount"/>
</mapping>
</element>
<element id="Medication.batch">
<path value="Medication.batch"/>
<short value="Details about packaged medications"/>
<definition
value="Information that only applies to packages (not products)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.batch"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="no mapping"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".player[classCode=CONT]"/>
</mapping>
</element>
<element id="Medication.batch.id">
<path value="Medication.batch.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.batch.extension">
<path value="Medication.batch.extension"/>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Medication.batch.modifierExtension">
<path value="Medication.batch.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<requirements
value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Medication.batch.lotNumber">
<path value="Medication.batch.lotNumber"/>
<short value="Identifier assigned to batch"/>
<definition
value="The assigned lot number of a batch of the specified product."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.batch.lotNumber"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="no mapping"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXA-15 Substance Lot Number / RXG-19 Substance Lot Number"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value=".id"/>
</mapping>
</element>
<element id="Medication.batch.expirationDate">
<path value="Medication.batch.expirationDate"/>
<short value="When batch will expire"/>
<definition value="When this specific batch of product will expire."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Medication.batch.expirationDate"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="dateTime"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="script10.6"/>
<map value="no mapping"/>
</mapping>
<mapping>
<identity value="v2"/>
<map
value="RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date"/>
</mapping>
<mapping>
<identity value="rim"/>
<map
value="participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"/>
</mapping>
</element>
</snapshot>
<differential>
<element id="Medication">
<path value="Medication"/>
<short value="PharmaceuticalProduct"/>
<alias value="FarmaceutischProduct"/>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19926"/>
<comment value="PharmaceuticalProduct"/>
</mapping>
</element>
<element id="Medication.extension:description">
<path value="Medication.extension"/>
<sliceName value="description"/>
<type>
<code value="Extension"/>
<profile
value="http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalProduct.Description"/>
</type>
</element>
<element id="Medication.code">
<path value="Medication.code"/>
<short value="MedicationCode"/>
<definition
value="Coding medication in the Netherlands is done on the basis of the G standard (issued by Z-index), which is filled under the direction of KNMP.
The coded medication can be expressed as:
* GTIN International Article Number
* ZI-nummer (2.16.840.1.113883.2.4.4.8)
* Trade product code (HPK)
* Prescription code (PRK)
* Generic product code (GPK)
* Anatomic Therapeutic Classification code (ATC)
* Substance Name Code (SNK)
* Substance Name Code, in combination with Route of Administration (SSK)
* SNOMED CT code
The GTIN enables identification of the product including its origin with a barcode. The ZI number represents the tradeproduct and the package size. The HPK is the code for the trade product (with the brand name) as used per dose/per time the medication is taken (1 pill, 1 puff, 1ml) The PRK contains als GPK information supplemented with information needed to prescribe the right product. this level is intended to facilitate generic prescription of drugs. The GPK defines the pharmaceutical characteristics of a product: ingredients, strengths, units, pharmaceutical form and route of administration. The Substance Name Code (SNK) is the (active) compound. Further information about the G-Standaard levels see https://www.z-index.nl So called 90.000.000 numbers are used in local IT systems. These numbers shall not be used for external communication. In the this is necessary only the description (not the code) may be included. This is in accordance with national agreements (Nictiz Standard).
The bound ValueSet includes the NullFlavor code 'OTH', which is not allowed for the zib concept 'MedicationCode'. However, FHIR explicitly defines 'a textual description if no code is available', which is equivalent to the zib concept 'Medication', to be placed on `.code.text`. The 'OTH' code is included to allow this."/>
<alias value="ProductCode"/>
<binding>
<strength value="required"/>
<valueSet
value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.12--20200901000000"/>
</binding>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19927"/>
<comment value="MedicationCode"/>
</mapping>
</element>
<element id="Medication.code.text">
<path value="Medication.code.text"/>
<short value="Medication"/>
<definition
value="For medication which has no code, enter the complete name of the pharmaceutical product here."/>
<alias value="ProductNaam"/>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19929"/>
<comment value="Medication"/>
</mapping>
</element>
<element id="Medication.form">
<path value="Medication.form"/>
<short value="PharmaceuticalForm"/>
<definition
value="The pharmaceutical form indicates the form of the medication. Examples include: tablet, suppository, infusion liquid, ointment. If the product has a GPK code in the G standard, the form will be known in the G standard. For products without a code (free text, preparation by the pharmacy), the means of administration can be entered."/>
<alias value="FarmaceutischeVorm"/>
<binding>
<strength value="required"/>
<valueSet
value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.7.8--20200901000000"/>
</binding>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19931"/>
<comment value="PharmaceuticalForm"/>
</mapping>
</element>
<element id="Medication.ingredient">
<path value="Medication.ingredient"/>
<short value="Ingredient"/>
<definition
value="A product contains one or more active substances and excipients. These are usually determined by the product code. For medication prepared or compounded by the local pharmacy, each ingredient must be entered separately.
The active substances play an important role, as they: a) determine the pharmacotherapeutic effect of the medication and b) serve as the basis for the indication of the strength of the medication (e.g. 200mg)."/>
<alias value="Ingredient"/>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19932"/>
<comment value="Ingredient"/>
</mapping>
</element>
<element id="Medication.ingredient.item[x]">
<path value="Medication.ingredient.item[x]"/>
<slicing>
<discriminator>
<type value="type"/>
<path value="$this"/>
</discriminator>
<rules value="open"/>
</slicing>
</element>
<element id="Medication.ingredient.item[x]:itemCodeableConcept">
<path value="Medication.ingredient.item[x]"/>
<sliceName value="itemCodeableConcept"/>
<short value="SubstanceCode"/>
<definition
value="Active substance or excipient. Here, the same codes can be used as for the ProductCode (for dilutions and compounds in particular), but now, the ATC, SSK and SNK codes can also be used to indicate a substance (to list ingredients of local products prepared by the pharmacy).
* GTIN International Article Number
* KNMP article number
* Trade product code (HPK)
* Prescription code (PRK)
* Generic product code (GPK)
* ATC (anatomic therapeutic classification)
* SSK (substance name code with route of administration)
* SNK (substance name code)
For further explanation about ATC see <https://www.whocc.no/atc/structure_and_principles/>"/>
<alias value="IngredientCode"/>
<type>
<code value="CodeableConcept"/>
</type>
<binding>
<strength value="required"/>
<valueSet
value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.13--20200901000000"/>
</binding>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19934"/>
<comment value="SubstanceCode"/>
</mapping>
</element>
<element id="Medication.ingredient.strength">
<path value="Medication.ingredient.strength"/>
<short value="Concentration"/>
<definition
value="The relative amount of this ingredient in this product.
Calculation of Concentration = Ingredient Amount ÷ Product Amount.
This could be a concentration if the medication is dissolved in liquid, for example."/>
<alias value="Sterkte"/>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.19933"/>
<comment value="Concentration"/>
</mapping>
</element>
<element id="Medication.ingredient.strength.numerator">
<path value="Medication.ingredient.strength.numerator"/>
<short value="IngredientAmount"/>
<definition
value="The amount and unit of this ingredient. This is the numerator for the calculation of the concentration. The unit should be selected from the G-Standard (Table 902)."/>
<alias value="IngredientHoeveelheid"/>
<type>
<code value="Quantity"/>
<profile
value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdQuantity"/>
</type>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.22277"/>
<comment value="IngredientAmount"/>
</mapping>
</element>
<element id="Medication.ingredient.strength.denominator">
<path value="Medication.ingredient.strength.denominator"/>
<short value="ProductAmount"/>
<definition
value="Amount of the product. This is the denominator for the calculation of the concentration. Optionally a translation to NHG table Gebruiksvoorschriften(Table 25) is also allowed."/>
<alias value="ProductHoeveelheid"/>
<type>
<code value="Quantity"/>
<profile
value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdQuantity"/>
</type>
<mapping>
<identity value="zib-pharmaceuticalproduct-v2.1.2-2020EN"/>
<map value="NL-CM:9.7.22278"/>
<comment value="ProductAmount"/>
</mapping>
</element>
</differential>
</StructureDefinition>
IG © 2023+ HL7NL. Package zibs2020#0.9.0 based on FHIR 4.0.1. Generated 2023-10-17
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