Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Zib MedicationUse - Detailed Descriptions

Active as of 2025-09-22

Definitions for the zib-MedicationUse resource profile.

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

0. MedicationStatement
Definition

MedicationUse is a statement on the historic, current or intended use of a certain medicine.

ShortMedicationUse
Alternate NamesMedicatiegebruik
2. MedicationStatement.extension
SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. MedicationStatement.extension:asAgreedIndicator
    Slice NameasAgreedIndicator
    Definition

    Is the medicine used as outlined in the medication agreement?

    ShortAsAgreedIndicator
    Control0..1
    TypeExtension(HCIM As AgreedIndicator) (Extension Type: boolean)
    Alternate NamesVolgensAfspraakIndicator
    6. MedicationStatement.extension:asAgreedIndicator.valueBoolean:valueBoolean
    Slice NamevalueBoolean
    ExampleExample of asAgreed: true
    8. MedicationStatement.extension:prescriber
    Slice Nameprescriber
    Definition

    The health professional that entered the medication agreement with the patient.

    ShortPrescriber
    Comments

    The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

    TypeExtension(HCIM MedicationUse Prescriber) (Extension Type: Reference)
    Alternate NamesVoorschrijver
    10. MedicationStatement.extension:author
    Slice Nameauthor
    Definition

    The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.

    ShortAuthor
    Comments

    The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

    Control0..1
    TypeExtension(HCIM MedicationUse Author) (Extension Type: Reference)
    Alternate NamesAuteur
    12. MedicationStatement.extension:medicationTreatment
    Slice NamemedicationTreatment
    Definition

    This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.

    ShortMedical Treatment
    Comments

    No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.

    Control0..1
    TypeExtension(HCIM MedicationTreatment) (Extension Type: Identifier)
    Alternate NamesMedicamenteuze Behandeling
    14. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse
    Slice NamereasonForChangeOrDiscontinuationOfUse
    Definition

    Reason for changing or discontinuing use of medication.

    ShortReasonForChangeOrDiscontinuationOfUse
    TypeExtension(HCIM MedicationUse ReasonForChangeOrDiscontinuationOfUse) (Extension Type: CodeableConcept)
    Alternate NamesRedenWijzigenOfStoppenGebruik, Reden wijzigen of stoppen gebruik
    16. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.valueCodeableConcept:valueCodeableConcept
    Slice NamevalueCodeableConcept
    ExampleExample of ReasonForChangeOrDiscontinuationOfUse: { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "79899007", "display" : "Drug interaction (finding)" }] }
    18. MedicationStatement.modifierExtension
    SlicingThis element introduces a set of slices on MedicationStatement.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule
      Slice NamerepeatPeriodCyclicalSchedule
      Definition

      The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.

      Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days. RepeatPeriodCyclicalSchedule

      ShortRepeatPeriodCyclicalSchedule
      Control0..1
      TypeExtension(HCIM Medication RepeatPeriodCyclicalSchedule) (Extension Type: Duration)
      LabelHerhaalperiodeCyclischSchema
      22. MedicationStatement.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      24. MedicationStatement.status
      ShortMedicationUseStopType
      Comments

      MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      This element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive).

      BindingThe codes SHALL be taken from MedicationStatementStatus
      (required to http://hl7.org/fhir/ValueSet/medication-statement-status)

      Allergy Intolerance critically Code list

      Alternate NamesMedicatieGebruikStopType
      26. MedicationStatement.category
      Control1..?
      28. MedicationStatement.category.coding
      SlicingThis element introduces a set of slices on MedicationStatement.category.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ code
      • 30. MedicationStatement.category.coding:medicationUseCode
        Slice NamemedicationUseCode
        Definition

        Category code used for indexing/retrieval of the HCIM MedicationUse. The system and code are stated in the Medication Process v09.

        ShortMedicationUseCode
        32. MedicationStatement.category.coding:medicationUseCode.system
        Fixed Valueurn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
        34. MedicationStatement.category.coding:medicationUseCode.code
        Fixed Value6
        36. MedicationStatement.medicationReference:medicationReference
        Slice NamemedicationReference
        ShortProductUsed
        TypeReference(HCIM PharmaceuticalProduct)
        Alternate NamesGebruiksproduct
        38. MedicationStatement.effectivePeriod:effectivePeriod
        Slice NameeffectivePeriod
        Definition

        Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.

        Start date: This is the time at which the agreement was to take effect (or took effect or will take effect).

        Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

        End date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

        ShortPeriodOfUse
        TypePeriod
        Alternate NamesGebruiksperiode
        40. MedicationStatement.effectivePeriod:effectivePeriod.extension
        SlicingThis element introduces a set of slices on MedicationStatement.effectivePeriod.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 42. MedicationStatement.effectivePeriod:effectivePeriod.extension:Duration
          Slice NameDuration
          Definition

          The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

          ShortDuration
          Control0..1
          TypeExtension(HCIM MedicationUse Duration) (Extension Type: Duration)
          Alternate NamestijdsDuur
          44. MedicationStatement.effectivePeriod:effectivePeriod.extension:Duration.valueDuration:valueDuration
          Slice NamevalueDuration
          ExampleExample of Duration: { "value" : 3, "unit" : "day", "system" : "http://unitsofmeasure.org", "code" : "d" }
          46. MedicationStatement.effectivePeriod:effectivePeriod.start
          Definition

          This is the time at which the agreement was to take effect (or took effect or will take effect).

          ShortStartDate
          Alternate NamesIngangsdatum
          48. MedicationStatement.effectivePeriod:effectivePeriod.end
          Definition

          The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

          ShortEndDate
          Alternate NamesEinddatum
          50. MedicationStatement.dateAsserted
          Definition

          Date on which this use is entered.

          ShortMedicationUseDateTime
          Control1..?
          Alternate NamesRegistratiedatum
          ExampleExample of MedicationUseDateTime: 2017-06-14
          52. MedicationStatement.informationSource
          Comments

          If a health professional is the informationSource the PractitionerRole reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

          TypeReference(nl-core-patient, nl-core-practitioner, nl-core-relatedperson, nl-core-organization)
          54. MedicationStatement.informationSource.extension
          SlicingThis element introduces a set of slices on MedicationStatement.informationSource.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 56. MedicationStatement.informationSource.extension:practitionerRole
            Slice NamepractitionerRole
            Control0..1
            TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
            58. MedicationStatement.subject
            TypeReference(nl-core-patient)
            60. MedicationStatement.taken
            Definition

            Is this medicine used or not?

            ShortUseIndicator
            Alternate NamesGebruikIndicator
            ExampleExample of taken: y
            62. MedicationStatement.reasonCode
            64. MedicationStatement.reasonCode.text
            Definition

            The reason for using the medication, particularly in self-care medicine purchased by the patient themselves.

            ShortReasonForUse
            Alternate NamesRedenGebruik
            66. MedicationStatement.note
            Definition

            Comments on the medication use.

            ShortComment
            Alternate NamesToelichting
            68. MedicationStatement.dosage
            TypeDosage(HCIM InstructionsForUse)

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

            0. MedicationStatement
            Definition

            MedicationUse is a statement on the historic, current or intended use of a certain medicine.


            A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now, or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains

            The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

            ShortMedicationUseRecord of medication being taken by a patient
            Comments

            When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

            Control0..*
            Alternate NamesMedicatiegebruik
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
            mst-1: Reason not taken is only permitted if Taken is No (reasonNotTaken.exists().not() or (taken = 'n'))
            dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
            mst-1: Reason not taken is only permitted if Taken is No (reasonNotTaken.exists().not() or (taken = 'n'))
            2. MedicationStatement.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

            ShortA set of rules under which this content was created
            Comments

            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

            This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

            Control0..1
            Typeuri
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            4. MedicationStatement.extension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

            ShortExtensionAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 6. MedicationStatement.extension:asAgreedIndicator
              Slice NameasAgreedIndicator
              Definition

              Is the medicine used as outlined in the medication agreement?

              ShortAsAgreedIndicator
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(HCIM As AgreedIndicator) (Extension Type: boolean)
              Alternate NamesVolgensAfspraakIndicator
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              8. MedicationStatement.extension:asAgreedIndicator.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator
              10. MedicationStatement.extension:asAgreedIndicator.value[x]
              Definition

              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

              ShortValue of extension
              Control0..1
              Typeboolean, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              SlicingThis element introduces a set of slices on MedicationStatement.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 12. MedicationStatement.extension:asAgreedIndicator.value[x]:valueBoolean
                Slice NamevalueBoolean
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control0..1
                Typeboolean, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                ExampleExample of asAgreed: true
                14. MedicationStatement.extension:prescriber
                Slice Nameprescriber
                Definition

                The health professional that entered the medication agreement with the patient.

                ShortPrescriber
                Comments

                The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(HCIM MedicationUse Prescriber) (Extension Type: Reference)
                Alternate NamesVoorschrijver
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                16. MedicationStatement.extension:author
                Slice Nameauthor
                Definition

                The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.

                ShortAuthor
                Comments

                The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(HCIM MedicationUse Author) (Extension Type: Reference)
                Alternate NamesAuteur
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                18. MedicationStatement.extension:medicationTreatment
                Slice NamemedicationTreatment
                Definition

                This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.

                ShortMedical Treatment
                Comments

                No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(HCIM MedicationTreatment) (Extension Type: Identifier)
                Alternate NamesMedicamenteuze Behandeling
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                20. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse
                Slice NamereasonForChangeOrDiscontinuationOfUse
                Definition

                Reason for changing or discontinuing use of medication.

                ShortReasonForChangeOrDiscontinuationOfUse
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(HCIM MedicationUse ReasonForChangeOrDiscontinuationOfUse) (Extension Type: CodeableConcept)
                Alternate NamesRedenWijzigenOfStoppenGebruik, Reden wijzigen of stoppen gebruik
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                22. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse
                24. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control0..1
                TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                SlicingThis element introduces a set of slices on MedicationStatement.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 26. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]:valueCodeableConcept
                  Slice NamevalueCodeableConcept
                  Definition

                  Reason for changing or discontinuing use of medication.


                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                  ShortReasonForChangeOrDiscontinuationOfUseValue of extension
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from For codes, see RedenWijzigenOfStoppenGebruikCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.11.2--20171231000000)
                  TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Alternate NamesReden wijzigen of stoppen gebruik
                  ExampleExample of ReasonForChangeOrDiscontinuationOfUse: { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "79899007", "display" : "Drug interaction (finding)" }] }
                  28. MedicationStatement.modifierExtension
                  Definition

                  An Extension


                  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. Usually modifier elements provide negation or qualification. In order 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.

                  ShortExtensionExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on MedicationStatement.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 30. MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule
                    Slice NamerepeatPeriodCyclicalSchedule
                    Definition

                    The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.

                    Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days. RepeatPeriodCyclicalSchedule

                    ShortRepeatPeriodCyclicalSchedule
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(HCIM Medication RepeatPeriodCyclicalSchedule) (Extension Type: Duration)
                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                    LabelHerhaalperiodeCyclischSchema
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    32. MedicationStatement.identifier
                    Definition

                    External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.

                    ShortExternal identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier
                    Summarytrue
                    34. MedicationStatement.status
                    Definition

                    A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally this will be active or completed.

                    ShortMedicationUseStopTypeactive | completed | entered-in-error | intended | stopped | on-hold
                    Comments

                    MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

                    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                    This element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive).


                    MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

                    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                    Control1..1
                    BindingThe codes SHALL be taken from MedicationStatementStatushttp://hl7.org/fhir/ValueSet/medication-statement-status|3.0.2
                    (required to http://hl7.org/fhir/ValueSet/medication-statement-status)

                    Allergy Intolerance critically Code list


                    A coded concept indicating the current status of a MedicationStatement.

                    Typecode
                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Alternate NamesMedicatieGebruikStopType
                    36. MedicationStatement.category
                    Definition

                    Indicates where type of medication statement and where the medication is expected to be consumed or administered.

                    ShortType of medication usage
                    Control10..1
                    BindingThe codes SHOULD be taken from MedicationStatementCategoryhttp://hl7.org/fhir/ValueSet/medication-statement-category|3.0.2
                    (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category|3.0.2)

                    A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered

                    TypeCodeableConcept
                    Summarytrue
                    38. MedicationStatement.category.coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..*
                    TypeCoding
                    Summarytrue
                    Requirements

                    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                    SlicingThis element introduces a set of slices on MedicationStatement.category.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ code
                    • 40. MedicationStatement.category.coding:medicationUseCode
                      Slice NamemedicationUseCode
                      Definition

                      Category code used for indexing/retrieval of the HCIM MedicationUse. The system and code are stated in the Medication Process v09.


                      A reference to a code defined by a terminology system.

                      ShortMedicationUseCodeCode defined by a terminology system
                      Comments

                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                      Control0..*
                      TypeCoding
                      Summarytrue
                      Requirements

                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                      42. MedicationStatement.category.coding:medicationUseCode.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                      Control0..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
                      44. MedicationStatement.category.coding:medicationUseCode.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control0..1
                      Typecode
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Fixed Value6
                      46. MedicationStatement.medication[x]
                      Definition

                      Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                      ShortWhat medication was taken
                      Comments

                      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .

                      Control1..1
                      TypeReference(Medication), CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Summarytrue
                      SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 48. MedicationStatement.medication[x]:medicationReference
                        Slice NamemedicationReference
                        Definition

                        Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                        ShortProductUsedWhat medication was taken
                        Comments

                        If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .

                        Control1..1
                        TypeReference(HCIM PharmaceuticalProduct, Medication), CodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Summarytrue
                        Alternate NamesGebruiksproduct
                        50. MedicationStatement.effective[x]
                        Definition

                        The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).

                        ShortThe date/time or interval when the medication was taken
                        Comments

                        This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted.

                        Control0..1
                        TypePeriod, dateTime
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Summarytrue
                        SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 52. MedicationStatement.effective[x]:effectivePeriod
                          Slice NameeffectivePeriod
                          Definition

                          Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.

                          Start date: This is the time at which the agreement was to take effect (or took effect or will take effect).

                          Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

                          End date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.


                          The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).

                          ShortPeriodOfUseThe date/time or interval when the medication was taken
                          Comments

                          This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted.

                          Control0..1
                          TypePeriod, dateTime
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Summarytrue
                          Alternate NamesGebruiksperiode
                          54. MedicationStatement.effective[x]:effectivePeriod.extension:Duration
                          Slice NameDuration
                          Definition

                          The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

                          ShortDuration
                          Control0..1
                          TypeExtension(HCIM MedicationUse Duration) (Extension Type: Duration)
                          Alternate NamestijdsDuur
                          56. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.url
                          Definition

                          Source of the definition for the extension code - a logical name or a URL.

                          Shortidentifies the meaning of the extension
                          Comments

                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                          Control1..1
                          Typeuri
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration
                          58. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.value[x]
                          Definition

                          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                          ShortValue of extension
                          Control0..1
                          TypeDuration, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          SlicingThis element introduces a set of slices on MedicationStatement.effective[x].extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 60. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.value[x]:valueDuration
                            Slice NamevalueDuration
                            Definition

                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                            ShortUsageDurationValue of extension
                            Control0..1
                            TypeDuration, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Alternate NamesGebruiksduur
                            ExampleExample of Duration: { "value" : 3, "unit" : "day", "system" : "http://unitsofmeasure.org", "code" : "d" }
                            62. MedicationStatement.dateAsserted
                            Definition

                            Date on which this use is entered.


                            The date when the medication statement was asserted by the information source.

                            ShortMedicationUseDateTimeWhen the statement was asserted?
                            Control10..1
                            TypedateTime
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesRegistratiedatum
                            ExampleExample of MedicationUseDateTime: 2017-06-14
                            64. MedicationStatement.informationSource
                            Definition

                            The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequest.

                            ShortPerson or organization that provided the information about the taking of this medication
                            Comments

                            If a health professional is the informationSource the PractitionerRole reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

                            Control0..1
                            TypeReference(nl-core-patient, nl-core-practitioner, nl-core-relatedperson, nl-core-organization, Patient, Practitioner, RelatedPerson, Organization)
                            66. MedicationStatement.informationSource.extension
                            Definition

                            An Extension


                            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                            ShortExtensionAdditional Content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Alternate Namesextensions, user content
                            SlicingThis element introduces a set of slices on MedicationStatement.informationSource.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 68. MedicationStatement.informationSource.extension:practitionerRole
                              Slice NamepractitionerRole
                              Definition

                              Optional Extension Element - found in all resources.

                              ShortOptional Extensions Element
                              Control0..1
                              TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                              70. MedicationStatement.subject
                              Definition

                              The person, animal or group who is/was taking the medication.

                              ShortWho is/was taking the medication
                              Control1..1
                              TypeReference(nl-core-patient, Patient, Group)
                              Summarytrue
                              72. MedicationStatement.taken
                              Definition

                              Is this medicine used or not?


                              Indicator of the certainty of whether the medication was taken by the patient.

                              ShortUseIndicatory | n | unk | na
                              Comments

                              This element is labeled as a modifier because it indicates that the medication was not taken.

                              Control1..1
                              BindingThe codes SHALL be taken from MedicationStatementTakenhttp://hl7.org/fhir/ValueSet/medication-statement-taken|3.0.2
                              (required to http://hl7.org/fhir/ValueSet/medication-statement-taken|3.0.2)

                              A coded concept identifying level of certainty if patient has taken or has not taken the medication

                              Typecode
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Alternate NamesGebruikIndicator
                              ExampleExample of taken: y
                              74. MedicationStatement.note
                              Definition

                              Comments on the medication use.


                              Provides extra information about the medication statement that is not conveyed by the other attributes.

                              ShortCommentFurther information about the statement
                              Control0..*
                              TypeAnnotation
                              Alternate NamesToelichting
                              76. MedicationStatement.dosage
                              Definition

                              Indicates how the medication is/was or should be taken by the patient.

                              ShortDetails of how medication is/was taken or should be taken
                              Comments

                              The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

                              Control0..*
                              TypeDosage(HCIM InstructionsForUse)

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

                              0. MedicationStatement
                              Definition

                              MedicationUse is a statement on the historic, current or intended use of a certain medicine.

                              ShortMedicationUse
                              Comments

                              When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

                              Control0..*
                              Alternate NamesMedicatiegebruik
                              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                              dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
                              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
                              mst-1: Reason not taken is only permitted if Taken is No (reasonNotTaken.exists().not() or (taken = 'n'))
                              2. MedicationStatement.id
                              Definition

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

                              ShortLogical id of this artifact
                              Comments

                              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                              Control0..1
                              Typeid
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              4. MedicationStatement.meta
                              Definition

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

                              ShortMetadata about the resource
                              Control0..1
                              TypeMeta
                              Summarytrue
                              6. MedicationStatement.implicitRules
                              Definition

                              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

                              ShortA set of rules under which this content was created
                              Comments

                              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

                              This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

                              Control0..1
                              Typeuri
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              8. MedicationStatement.language
                              Definition

                              The base language in which the resource is written.

                              ShortLanguage of the resource content
                              Comments

                              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Common Languages
                              (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

                              A human language.

                              Additional BindingsPurpose
                              All LanguagesMax Binding
                              Typecode
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              10. MedicationStatement.text
                              Definition

                              A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                              ShortText summary of the resource, for human interpretation
                              Comments

                              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

                              Control0..1
                              This element is affected by the following invariants: dom-1
                              TypeNarrative
                              Alternate Namesnarrative, html, xhtml, display
                              12. MedicationStatement.contained
                              Definition

                              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                              ShortContained, inline Resources
                              Comments

                              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

                              Control0..*
                              TypeResource
                              Alternate Namesinline resources, anonymous resources, contained resources
                              14. MedicationStatement.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..*
                              TypeExtension
                              SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 16. MedicationStatement.extension:asAgreedIndicator
                                Slice NameasAgreedIndicator
                                Definition

                                Is the medicine used as outlined in the medication agreement?

                                ShortAsAgreedIndicator
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(HCIM As AgreedIndicator) (Extension Type: boolean)
                                Alternate NamesVolgensAfspraakIndicator
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                18. MedicationStatement.extension:asAgreedIndicator.id
                                Definition

                                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                Shortxml:id (or equivalent in JSON)
                                Control0..1
                                Typestring
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                XML FormatIn the XML format, this property is represented as an attribute.
                                20. MedicationStatement.extension:asAgreedIndicator.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                ShortAdditional Content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Alternate Namesextensions, user content
                                SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 22. MedicationStatement.extension:asAgreedIndicator.url
                                  Definition

                                  Source of the definition for the extension code - a logical name or a URL.

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                  Control1..1
                                  Typeuri
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-AsAgreedIndicator
                                  24. MedicationStatement.extension:asAgreedIndicator.value[x]
                                  Definition

                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                  ShortValue of extension
                                  Control0..1
                                  Typeboolean
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  SlicingThis element introduces a set of slices on MedicationStatement.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 26. MedicationStatement.extension:asAgreedIndicator.value[x]:valueBoolean
                                    Slice NamevalueBoolean
                                    Definition

                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                    ShortValue of extension
                                    Control0..1
                                    Typeboolean
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    ExampleExample of asAgreed: true
                                    28. MedicationStatement.extension:prescriber
                                    Slice Nameprescriber
                                    Definition

                                    The health professional that entered the medication agreement with the patient.

                                    ShortPrescriber
                                    Comments

                                    The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(HCIM MedicationUse Prescriber) (Extension Type: Reference)
                                    Alternate NamesVoorschrijver
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    30. MedicationStatement.extension:author
                                    Slice Nameauthor
                                    Definition

                                    The author of this MedicationStatement. This is either a patient, a health professional or a healthcare provicer.

                                    ShortAuthor
                                    Comments

                                    The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(HCIM MedicationUse Author) (Extension Type: Reference)
                                    Alternate NamesAuteur
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    32. MedicationStatement.extension:medicationTreatment
                                    Slice NamemedicationTreatment
                                    Definition

                                    This extension is to describe which overarching medical treatment this information is part of. This is done by the use of an identifier of that medical treatment.

                                    ShortMedical Treatment
                                    Comments

                                    No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(HCIM MedicationTreatment) (Extension Type: Identifier)
                                    Alternate NamesMedicamenteuze Behandeling
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    34. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse
                                    Slice NamereasonForChangeOrDiscontinuationOfUse
                                    Definition

                                    Reason for changing or discontinuing use of medication.

                                    ShortReasonForChangeOrDiscontinuationOfUse
                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(HCIM MedicationUse ReasonForChangeOrDiscontinuationOfUse) (Extension Type: CodeableConcept)
                                    Alternate NamesRedenWijzigenOfStoppenGebruik, Reden wijzigen of stoppen gebruik
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    36. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.id
                                    Definition

                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    38. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                    ShortAdditional Content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Alternate Namesextensions, user content
                                    SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 40. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.url
                                      Definition

                                      Source of the definition for the extension code - a logical name or a URL.

                                      Shortidentifies the meaning of the extension
                                      Comments

                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                      Control1..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-ReasonForChangeOrDiscontinuationOfUse
                                      42. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]
                                      Definition

                                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                      ShortValue of extension
                                      Control0..1
                                      TypeCodeableConcept
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      SlicingThis element introduces a set of slices on MedicationStatement.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                      • type @ $this
                                      • 44. MedicationStatement.extension:reasonForChangeOrDiscontinuationOfUse.value[x]:valueCodeableConcept
                                        Slice NamevalueCodeableConcept
                                        Definition

                                        Reason for changing or discontinuing use of medication.

                                        ShortReasonForChangeOrDiscontinuationOfUse
                                        Control0..1
                                        BindingUnless not suitable, these codes SHALL be taken from RedenWijzigenOfStoppenGebruikCodelijst
                                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.11.2--20171231000000)
                                        TypeCodeableConcept
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Alternate NamesReden wijzigen of stoppen gebruik
                                        ExampleExample of ReasonForChangeOrDiscontinuationOfUse: { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "79899007", "display" : "Drug interaction (finding)" }] }
                                        46. MedicationStatement.modifierExtension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                        SlicingThis element introduces a set of slices on MedicationStatement.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 48. MedicationStatement.modifierExtension:repeatPeriodCyclicalSchedule
                                          Slice NamerepeatPeriodCyclicalSchedule
                                          Definition

                                          The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.

                                          Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days. RepeatPeriodCyclicalSchedule

                                          ShortRepeatPeriodCyclicalSchedule
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(HCIM Medication RepeatPeriodCyclicalSchedule) (Extension Type: Duration)
                                          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                          LabelHerhaalperiodeCyclischSchema
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          50. MedicationStatement.identifier
                                          Definition

                                          External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.

                                          ShortExternal identifier
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..*
                                          TypeIdentifier
                                          Summarytrue
                                          52. MedicationStatement.basedOn
                                          Definition

                                          A plan, proposal or order that is fulfilled in whole or in part by this event.

                                          ShortFulfils plan, proposal or order
                                          Control0..*
                                          TypeReference(MedicationRequest, CarePlan, ProcedureRequest, ReferralRequest)
                                          Summarytrue
                                          Requirements

                                          Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                                          54. MedicationStatement.partOf
                                          Definition

                                          A larger event of which this particular event is a component or step.

                                          ShortPart of referenced event
                                          Control0..*
                                          TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
                                          Summarytrue
                                          Requirements

                                          This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

                                          56. MedicationStatement.context
                                          Definition

                                          The encounter or episode of care that establishes the context for this MedicationStatement.

                                          ShortEncounter / Episode associated with MedicationStatement
                                          Control0..1
                                          TypeReference(Encounter, EpisodeOfCare)
                                          Summarytrue
                                          58. MedicationStatement.status
                                          Definition

                                          A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally this will be active or completed.

                                          ShortMedicationUseStopType
                                          Comments

                                          MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

                                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                          This element is also used for the concept 'Stop type'; the manner in which this medication is discontinued (temporary or definitive).

                                          Control1..1
                                          BindingThe codes SHALL be taken from MedicationStatementStatus
                                          (required to http://hl7.org/fhir/ValueSet/medication-statement-status)

                                          Allergy Intolerance critically Code list

                                          Typecode
                                          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Alternate NamesMedicatieGebruikStopType
                                          60. MedicationStatement.category
                                          Definition

                                          Indicates where type of medication statement and where the medication is expected to be consumed or administered.

                                          ShortType of medication usage
                                          Control1..1
                                          BindingThe codes SHOULD be taken from MedicationStatementCategory
                                          (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category|3.0.2)

                                          A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered

                                          TypeCodeableConcept
                                          Summarytrue
                                          62. MedicationStatement.category.id
                                          Definition

                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          Shortxml:id (or equivalent in JSON)
                                          Control0..1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          64. MedicationStatement.category.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                          ShortAdditional Content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Alternate Namesextensions, user content
                                          SlicingThis element introduces a set of slices on MedicationStatement.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 66. MedicationStatement.category.coding
                                            Definition

                                            A reference to a code defined by a terminology system.

                                            ShortCode defined by a terminology system
                                            Comments

                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                            Control0..*
                                            TypeCoding
                                            Summarytrue
                                            Requirements

                                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                            SlicingThis element introduces a set of slices on MedicationStatement.category.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ code
                                            • 68. MedicationStatement.category.coding:medicationUseCode
                                              Slice NamemedicationUseCode
                                              Definition

                                              Category code used for indexing/retrieval of the HCIM MedicationUse. The system and code are stated in the Medication Process v09.

                                              ShortMedicationUseCode
                                              Comments

                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                              Control0..*
                                              TypeCoding
                                              Summarytrue
                                              Requirements

                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                              70. MedicationStatement.category.coding:medicationUseCode.id
                                              Definition

                                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              Shortxml:id (or equivalent in JSON)
                                              Control0..1
                                              Typestring
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              72. MedicationStatement.category.coding:medicationUseCode.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                              ShortAdditional Content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Alternate Namesextensions, user content
                                              SlicingThis element introduces a set of slices on MedicationStatement.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 74. MedicationStatement.category.coding:medicationUseCode.system
                                                Definition

                                                The identification of the code system that defines the meaning of the symbol in the code.

                                                ShortIdentity of the terminology system
                                                Comments

                                                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                                Control0..1
                                                Typeuri
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need to be unambiguous about the source of the definition of the symbol.

                                                Fixed Valueurn:oid:2.16.840.1.113883.2.4.3.11.60.20.77.5.3
                                                76. MedicationStatement.category.coding:medicationUseCode.version
                                                Definition

                                                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                ShortVersion of the system - if relevant
                                                Comments

                                                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                NoteThis is a business version Id, not a resource version Id (see discussion)
                                                Control0..1
                                                Typestring
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                78. MedicationStatement.category.coding:medicationUseCode.code
                                                Definition

                                                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                ShortSymbol in syntax defined by the system
                                                Control0..1
                                                Typecode
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need to refer to a particular code in the system.

                                                Fixed Value6
                                                80. MedicationStatement.category.coding:medicationUseCode.display
                                                Definition

                                                A representation of the meaning of the code in the system, following the rules of the system.

                                                ShortRepresentation defined by the system
                                                Control0..1
                                                Typestring
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                82. MedicationStatement.category.coding:medicationUseCode.userSelected
                                                Definition

                                                Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                ShortIf this coding was chosen directly by the user
                                                Comments

                                                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                Control0..1
                                                Typeboolean
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                84. MedicationStatement.category.text
                                                Definition

                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                ShortPlain text representation of the concept
                                                Comments

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

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

                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                86. MedicationStatement.medication[x]
                                                Definition

                                                Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                                                ShortWhat medication was taken
                                                Comments

                                                If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .

                                                Control1..1
                                                TypeReference
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Summarytrue
                                                SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 88. MedicationStatement.medication[x]:medicationReference
                                                  Slice NamemedicationReference
                                                  Definition

                                                  Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                                                  ShortProductUsed
                                                  Control1..1
                                                  TypeReference(HCIM PharmaceuticalProduct)
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Summarytrue
                                                  Alternate NamesGebruiksproduct
                                                  90. MedicationStatement.effective[x]
                                                  Definition

                                                  The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).

                                                  ShortThe date/time or interval when the medication was taken
                                                  Comments

                                                  This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted.

                                                  Control0..1
                                                  TypePeriod
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Summarytrue
                                                  SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                  • type @ $this
                                                  • 92. MedicationStatement.effective[x]:effectivePeriod
                                                    Slice NameeffectivePeriod
                                                    Definition

                                                    Medication use can be recorded for a certain moment or over a certain period. Thus, medication use can be recorded multiple times during the use of medication. The usage period is the period or moment over which the data is recorded.

                                                    Start date: This is the time at which the agreement was to take effect (or took effect or will take effect).

                                                    Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

                                                    End date: The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

                                                    ShortPeriodOfUse
                                                    Comments

                                                    This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted.

                                                    Control0..1
                                                    TypePeriod
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Summarytrue
                                                    Alternate NamesGebruiksperiode
                                                    94. MedicationStatement.effective[x]:effectivePeriod.id
                                                    Definition

                                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    Shortxml:id (or equivalent in JSON)
                                                    Control0..1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    96. MedicationStatement.effective[x]:effectivePeriod.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    SlicingThis element introduces a set of slices on MedicationStatement.effective[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 98. MedicationStatement.effective[x]:effectivePeriod.extension:Duration
                                                      Slice NameDuration
                                                      Definition

                                                      The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

                                                      ShortDuration
                                                      Control0..1
                                                      TypeExtension(HCIM MedicationUse Duration) (Extension Type: Duration)
                                                      Alternate NamestijdsDuur
                                                      100. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.id
                                                      Definition

                                                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      Shortxml:id (or equivalent in JSON)
                                                      Control0..1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      102. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                      ShortAdditional Content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Alternate Namesextensions, user content
                                                      SlicingThis element introduces a set of slices on MedicationStatement.effective[x].extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 104. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.url
                                                        Definition

                                                        Source of the definition for the extension code - a logical name or a URL.

                                                        Shortidentifies the meaning of the extension
                                                        Comments

                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                        Control1..1
                                                        Typeuri
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationUse-Duration
                                                        106. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.value[x]
                                                        Definition

                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                        ShortValue of extension
                                                        Control0..1
                                                        TypeDuration
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        SlicingThis element introduces a set of slices on MedicationStatement.effective[x].extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                        • type @ $this
                                                        • 108. MedicationStatement.effective[x]:effectivePeriod.extension:Duration.value[x]:valueDuration
                                                          Slice NamevalueDuration
                                                          Definition

                                                          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                          ShortUsageDuration
                                                          Control0..1
                                                          TypeDuration
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Alternate NamesGebruiksduur
                                                          ExampleExample of Duration: { "value" : 3, "unit" : "day", "system" : "http://unitsofmeasure.org", "code" : "d" }
                                                          110. MedicationStatement.effective[x]:effectivePeriod.start
                                                          Definition

                                                          This is the time at which the agreement was to take effect (or took effect or will take effect).

                                                          ShortStartDate
                                                          Comments

                                                          If the low element is missing, the meaning is that the low boundary is not known.

                                                          Control0..1
                                                          This element is affected by the following invariants: per-1
                                                          TypedateTime
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Alternate NamesIngangsdatum
                                                          112. MedicationStatement.effective[x]:effectivePeriod.end
                                                          Definition

                                                          The time at which the period of use ends (or ended or will end). To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

                                                          ShortEndDate
                                                          Comments

                                                          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

                                                          Control0..1
                                                          This element is affected by the following invariants: per-1
                                                          TypedateTime
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Alternate NamesEinddatum
                                                          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                          114. MedicationStatement.dateAsserted
                                                          Definition

                                                          Date on which this use is entered.

                                                          ShortMedicationUseDateTime
                                                          Control1..1
                                                          TypedateTime
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Alternate NamesRegistratiedatum
                                                          ExampleExample of MedicationUseDateTime: 2017-06-14
                                                          116. MedicationStatement.informationSource
                                                          Definition

                                                          The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequest.

                                                          ShortPerson or organization that provided the information about the taking of this medication
                                                          Comments

                                                          If a health professional is the informationSource the PractitionerRole reference extension can be used for a PractitionerRole reference. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

                                                          Control0..1
                                                          TypeReference(nl-core-patient, nl-core-practitioner, nl-core-relatedperson, nl-core-organization)
                                                          118. MedicationStatement.informationSource.id
                                                          Definition

                                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          120. MedicationStatement.informationSource.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..*
                                                          TypeExtension
                                                          SlicingThis element introduces a set of slices on MedicationStatement.informationSource.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 122. MedicationStatement.informationSource.extension:practitionerRole
                                                            Slice NamepractitionerRole
                                                            Definition

                                                            Optional Extension Element - found in all resources.

                                                            ShortOptional Extensions Element
                                                            Control0..1
                                                            TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                                            124. MedicationStatement.informationSource.reference
                                                            Definition

                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                            Comments

                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                            Control0..1
                                                            This element is affected by the following invariants: ref-1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            126. MedicationStatement.informationSource.identifier
                                                            Definition

                                                            An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                            ShortLogical reference, when literal reference is not known
                                                            Comments

                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                            Control0..1
                                                            TypeIdentifier
                                                            Summarytrue
                                                            128. MedicationStatement.informationSource.display
                                                            Definition

                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                            ShortText alternative for the resource
                                                            Comments

                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            130. MedicationStatement.subject
                                                            Definition

                                                            The person, animal or group who is/was taking the medication.

                                                            ShortWho is/was taking the medication
                                                            Control1..1
                                                            TypeReference(nl-core-patient)
                                                            Summarytrue
                                                            132. MedicationStatement.derivedFrom
                                                            Definition

                                                            Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

                                                            ShortAdditional supporting information
                                                            Comments

                                                            Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

                                                            Control0..*
                                                            TypeReference(Resource)
                                                            134. MedicationStatement.taken
                                                            Definition

                                                            Is this medicine used or not?

                                                            ShortUseIndicator
                                                            Comments

                                                            This element is labeled as a modifier because it indicates that the medication was not taken.

                                                            Control1..1
                                                            BindingThe codes SHALL be taken from MedicationStatementTaken
                                                            (required to http://hl7.org/fhir/ValueSet/medication-statement-taken|3.0.2)

                                                            A coded concept identifying level of certainty if patient has taken or has not taken the medication

                                                            Typecode
                                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Alternate NamesGebruikIndicator
                                                            ExampleExample of taken: y
                                                            136. MedicationStatement.reasonNotTaken
                                                            Definition

                                                            A code indicating why the medication was not taken.

                                                            ShortTrue if asserting medication was not given
                                                            Control0..*
                                                            This element is affected by the following invariants: mst-1
                                                            BindingFor example codes, see SNOMED CT Drugs not taken/completed Codes
                                                            (example to http://hl7.org/fhir/ValueSet/reason-medication-not-taken-codes|3.0.2)

                                                            A coded concept indicating the reason why the medication was not taken

                                                            TypeCodeableConcept
                                                            138. MedicationStatement.reasonCode
                                                            Definition

                                                            A reason for why the medication is being/was taken.

                                                            ShortReason for why the medication is being/was taken
                                                            Comments

                                                            This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

                                                            Control0..*
                                                            BindingFor example codes, see Condition/Problem/Diagnosis Codes
                                                            (example to http://hl7.org/fhir/ValueSet/condition-code|3.0.2)

                                                            A coded concept identifying why the medication is being taken.

                                                            TypeCodeableConcept
                                                            140. MedicationStatement.reasonCode.id
                                                            Definition

                                                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            Shortxml:id (or equivalent in JSON)
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            142. MedicationStatement.reasonCode.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                            ShortAdditional Content defined by implementations
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Alternate Namesextensions, user content
                                                            SlicingThis element introduces a set of slices on MedicationStatement.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 144. MedicationStatement.reasonCode.coding
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                              Control0..*
                                                              TypeCoding
                                                              Summarytrue
                                                              Requirements

                                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                              146. MedicationStatement.reasonCode.text
                                                              Definition

                                                              The reason for using the medication, particularly in self-care medicine purchased by the patient themselves.

                                                              ShortReasonForUse
                                                              Comments

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

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

                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                              Alternate NamesRedenGebruik
                                                              148. MedicationStatement.reasonReference
                                                              Definition

                                                              Condition or observation that supports why the medication is being/was taken.

                                                              ShortCondition or observation that supports why the medication is being/was taken
                                                              Comments

                                                              This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

                                                              Control0..*
                                                              TypeReference(Condition, Observation)
                                                              150. MedicationStatement.note
                                                              Definition

                                                              Comments on the medication use.

                                                              ShortComment
                                                              Control0..*
                                                              TypeAnnotation
                                                              Alternate NamesToelichting
                                                              152. MedicationStatement.dosage
                                                              Definition

                                                              Indicates how the medication is/was or should be taken by the patient.

                                                              ShortDetails of how medication is/was taken or should be taken
                                                              Comments

                                                              The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

                                                              Control0..*
                                                              TypeDosage(HCIM InstructionsForUse)