Medication

The SHR Medication domain contains definitions related to medications taken, or not taken, by the person of record, both currently and in the past.

AdditionalDoseInstruction

Supplemental instructions - e.g. 'with meals'. C1644714

Value:  CodeableConcept from http://hl7.org/fhir/ValueSet/additional-instructions-codes A set of codes drawn from different coding systems, representing the same concept.

Adherence

A statement of the ability and cooperation of the patient in taking medicine or supplement as recommended or prescribed. This includes correct timing, dosage, and frequency. C2364172

Choice required
         |  MedicationTreatment (TBD) 0 or more Description TBD
         |  SupplementTreatment (TBD) Description TBD
AdherenceLevel required The frequency that the stated treatment plan, prescription, or protocol is followed.
NonAdherenceReason 0 or more Reason for not following the stated treatment plan, prescription, or protocol.
Details required Particulars considered individually and in relation to a whole.

AdherenceLevel

The frequency that the stated treatment plan, prescription, or protocol is followed. C1510802

Value:  CodeableConcept from QualitativeFrequencyVS A set of codes drawn from different coding systems, representing the same concept.

AdministrationBodySite

The anatomic site at which medical intervention is applied. C0229986

Value:  BodySite Location on or in the body.

AdministrationMethod

Technique for administering medication. C1547585

Value:  CodeableConcept from http://hl7.org/fhir/ValueSet/administration-method-codes A set of codes drawn from different coding systems, representing the same concept.

AmountOfMedication

A standardized measure or discrete amount of medication serving as a reference for dosing or strength, for example, 1 tablet.

Value:  Quantity A quantity with units.

AmountPerDose

The amount of medication taken at each dose, as a quantity or range.

Value:  Choice
         |  Quantity required A quantity with units.
         |  Range (TBD) required Description TBD

Brand

If the product is branded, and if so, the brand name of a product.

Value:  boolean
BrandName optional The marketing name for a brand name product

BrandName

The marketing name for a brand name product

Value:  string

Dosage

The dosage of the medication as prescribed. C0178602

AmountPerDose required The amount of medication taken at each dose, as a quantity or range.
TimingOfDoses required When doses of medication should be administered.
DoseAsNeededIndicator required Indicates that a drug or therapy should be used as often as the patient decides it is necessary.
DoseInstructionsText optional The directions (signetur) on the drug prescription or dispensing record.
AdditionalDoseInstruction 0 or more Supplemental instructions - e.g. 'with meals'.
RouteIntoBody optional The way a substance enters an organism after contact, particularly, the route of drug administration.
AdministrationMethod optional Technique for administering medication.
AdministrationBodySite optional The anatomic site at which medical intervention is applied.
MaximumDosePerTimePeriod 0 or more The maximum amount of a medication to be taken in a given period of time.

DoseAsNeededIndicator

Indicates that a drug or therapy should be used as often as the patient decides it is necessary. C1883728

Value:  boolean

DoseForm

The form in which active and/or inert ingredient(s) are physically presented. C0013058

Value:  CodeableConcept from http://hl7.org/fhir/ValueSet/medication-form-codes A set of codes drawn from different coding systems, representing the same concept.

DoseInstructionsText

The directions (signetur) on the drug prescription or dispensing record.

Value:  string

Ingredient

Specifies how many (or how much) of an ingredient there is in this Medication. For example, 250 mg per tablet is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet. C3176062

Value:  CodeableConcept from MedicationVS A set of codes drawn from different coding systems, representing the same concept.
IngredientAmount required The amount of an ingredient in a medication.
AmountOfMedication required A standardized measure or discrete amount of medication serving as a reference for dosing or strength, for example, 1 tablet.
IsActiveIngredient required True if the ingredient is an active ingredient in the medication.

IngredientAmount

The amount of an ingredient in a medication.

Value:  Quantity A quantity with units.

IsActiveIngredient

True if the ingredient is an active ingredient in the medication.

Value:  boolean

MaximumDosePerTimePeriod

The maximum amount of a medication to be taken in a given period of time.

AmountOfMedication required A standardized measure or discrete amount of medication serving as a reference for dosing or strength, for example, 1 tablet.
Duration required The length of time that something continues.

Medication

A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines. C0013227

Value:  CodeableConcept from MedicationVS A set of codes drawn from different coding systems, representing the same concept.
DoseForm optional The form in which active and/or inert ingredient(s) are physically presented.
Ingredient 0 or more Specifies how many (or how much) of an ingredient there is in this Medication. For example, 250 mg per tablet is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.
Brand optional If the product is branded, and if so, the brand name of a product.
OverTheCounter optional True if the medication is available to consumers without a prescription.

MedicationAfterChange

A medication taken, after the change.

Value:  MedicationUse Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.

MedicationBeforeChange

The medication taken, prior to the change.

Value:  MedicationUse Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.

MedicationChange [Entry]

Description of a modification or change of a medication or dosage. C0554834

EffectiveDate required The date when something is to take effect.
TypeOfChange required Whether the change is a dose change, switch to a new medication, or discontinuation.
MedicationBeforeChange 0 or more The medication taken, prior to the change.
MedicationAfterChange 0 or more A medication taken, after the change.
ReasonForMedicationChange (TBD) required Description TBD

MedicationNotAdministered [Entry]

A record of a medication NOT administered. Recorded when deviating from the care plan.

Based On MedicationUse

Medication required A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.
MedicationWasTaken is no (n) required Indicator of the certainty of whether the medication was taken by the patient.
Dosage not used The dosage of the medication as prescribed.
Adherence not used A statement of the ability and cooperation of the patient in taking medicine or supplement as recommended or prescribed. This includes correct timing, dosage, and frequency.
Reason required The justification for an action or non-action, conclusion, opinion, etc.
PeriodOfUse required A period of time when a device, medication, or other therapy is used.

MedicationNotPrescribed [Entry]

A record of a medication NOT prescribed. Recorded only when deviating from the normal expectation, care plan, or standard of care.

Based On MedicationPrescription

Medication required A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.
RequestNotToPerformActionModifier must be a MedicationNotPrescribedModifier optional If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.
         where  MedicationNotPrescribedModifier is true required True, if the medication should not, or was not prescribed for a particular reason.
RequestStatus from http://hl7.org/fhir/ValueSet/medication-request-status required The extent to which the ordering process has progressed, for this order.
PriorityOfRequest from http://hl7.org/fhir/ValueSet/medication-request-priority optional Urgency level for which results must be reported to the requestor or responsible individual.
Dosage optional The dosage of the medication as prescribed.
NumberOfRepeatsAllowed optional How many times the medication prescription can be refilled. This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus 3 repeats, then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.
QuantityPerDispense optional The amount that is to be dispensed for one fill.
SupplyDuration optional Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
RequestedPerformanceTime optional When test or tests should be done. If the tests are a series or recur (e.g. daily blood sugar testing in the morning) then a Timing can be used to describe the periodicity.
Reason optional The justification for an action or non-action, conclusion, opinion, etc.
Choice optional
         |  RequestedPerformerType required What type of actor should carry out the testing.
         |  RequestedPerformer required Who should carry out the tests. For example, the patient or caregiver.
PerformerInstructions optional Information for the performer of the test, if needed.
PatientInstructions optional Information for the patient, such as, where to get the test, how to prepare for the test, etc.
ActionCode required The code for the action, such as an intervention or test, to be carried out.
NonOccurrenceModifier optional When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.
OccurrenceTime optional The point in time or span of time in which something happens.
Participant 0 or more A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.

MedicationNotPrescribedModifier

True, if the medication should not, or was not prescribed for a particular reason.

Based On RequestNotToPerformActionModifier

Value:  boolean
Reason from ReasonMedicationNotUsedVS optional The justification for an action or non-action, conclusion, opinion, etc.

MedicationPrescription [Entry]

Report of a medication prescription.

Based On Request

Medication required A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.
RequestNotToPerformActionModifier must be a MedicationNotPrescribedModifier optional If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.
RequestStatus from http://hl7.org/fhir/ValueSet/medication-request-status required The extent to which the ordering process has progressed, for this order.
PriorityOfRequest from http://hl7.org/fhir/ValueSet/medication-request-priority optional Urgency level for which results must be reported to the requestor or responsible individual.
Dosage optional The dosage of the medication as prescribed.
NumberOfRepeatsAllowed optional How many times the medication prescription can be refilled. This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus 3 repeats, then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.
QuantityPerDispense optional The amount that is to be dispensed for one fill.
SupplyDuration optional Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.
RequestedPerformanceTime optional When test or tests should be done. If the tests are a series or recur (e.g. daily blood sugar testing in the morning) then a Timing can be used to describe the periodicity.
Reason optional The justification for an action or non-action, conclusion, opinion, etc.
Choice optional
         |  RequestedPerformerType required What type of actor should carry out the testing.
         |  RequestedPerformer required Who should carry out the tests. For example, the patient or caregiver.
PerformerInstructions optional Information for the performer of the test, if needed.
PatientInstructions optional Information for the patient, such as, where to get the test, how to prepare for the test, etc.
ActionCode required The code for the action, such as an intervention or test, to be carried out.
NonOccurrenceModifier optional When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.
OccurrenceTime optional The point in time or span of time in which something happens.
Participant 0 or more A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.

MedicationUse [Entry]

Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.

Medication required A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.
MedicationWasTaken required Indicator of the certainty of whether the medication was taken by the patient.
Reason required The justification for an action or non-action, conclusion, opinion, etc.
Dosage optional The dosage of the medication as prescribed.
Adherence optional A statement of the ability and cooperation of the patient in taking medicine or supplement as recommended or prescribed. This includes correct timing, dosage, and frequency.
PeriodOfUse required A period of time when a device, medication, or other therapy is used.

MedicationWasTaken

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

Value:  CodeableConcept from http://hl7.org/fhir/ValueSet/medication-statement-taken A set of codes drawn from different coding systems, representing the same concept.

NonAdherenceReason

Reason for not following the stated treatment plan, prescription, or protocol.

Value:  CodeableConcept from MedicationNonAdherenceReasonVS A set of codes drawn from different coding systems, representing the same concept.

NumberOfRepeatsAllowed

How many times the medication prescription can be refilled. This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus 3 repeats, then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.

Value:  positiveInt

OverTheCounter

True if the medication is available to consumers without a prescription.

Value:  boolean

QuantityPerDispense

The amount that is to be dispensed for one fill.

Value:  Quantity A quantity with units.

RouteIntoBody

The way a substance enters an organism after contact, particularly, the route of drug administration. C0013153

Value:  CodeableConcept from http://hl7.org/fhir/ValueSet/route-codes A set of codes drawn from different coding systems, representing the same concept.

SupplyDuration

Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

Value:  Duration The length of time that something continues.

TimingOfDoses

When doses of medication should be administered.

Value:  Timing (TBD) Description TBD

TypeOfChange

Whether the change is a dose change, switch to a new medication, or discontinuation.

Value:  CodeableConcept from MedicationChangeTypeVS A set of codes drawn from different coding systems, representing the same concept.