Medication Card document
In a primary system, different medications are documented in a treatment context. Primary systems can use this Exchange Format to generate a Medication Card document with the help of the Content Creator.
Bundle
Profile information
In the resource "Bundle", all resources are collected in a container.
- id: Local id of the resource (line 3)
- meta: Shows the metadata of the document (line 4 to 9).
- identifier: Unique identifier for the bundle - fixed Value: "urn:ietf:rfc:3986" (line 10 to 13).
- type: Indicates the purpose of this bundle - fixed Value: "document"; binding: BundleType (line 14).
- timestamp: The date/time the bundle was composed (line 15).
- entry: The list to add all resources belonging to the document (line 16-18).
| {
"resourceType" : "Bundle",
"id" : "2-7-MedicationCard",
"meta" : {
"lastUpdated" : "2020-02-21T12:31:59.738+00:00",
"profile" : [
"http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-document-medicationcard"
]
},
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:6b6ed376-a7da-44cb-92d1-e75ce1ae73b0"
},
"type" : "document",
"timestamp" : "2012-02-04T14:05:00+01:00",
"entry" : [
{
"fullUrl" : "http://test.fhir.ch/r4/Composition/2-7-MedicationCard",
|
Composition
Profile information
In the resource "Composition", general information about the document is specified.
- entry: An entry in a bundle resource - will either contain a resource or information about a resource (line 1)
- id: Local id of the resource (line 6).
- language: Specifies the language of the document - binding: CommonLanguages (line 7).
- text: Presents the narrative text of the resource (line 8 to 11).
- extension: Extension to Information Recipient (line 12 to 19).
- identifier: A version-independent identifier for the Composition (line 20 to 23).
- status: The status of the document - fixed Value: "final"; binding: CompositionStatus (line 24).
- type: Specifies the particular kind of composition - binding: DocumentEntry.typeCode(line 25 to 38).
| "entry" : [
{
"fullUrl" : "http://test.fhir.ch/r4/Composition/2-7-MedicationCard",
"resource" : {
"resourceType" : "Composition",
"id" : "2-7-MedicationCard",
"language" : "de-CH",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"de-CH\" lang=\"de-CH\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"2-7-MedicationCard\" (Language \"de-CH\") </p></div><p><b>EPR Information Recipient</b>: <a href=\"#Patient_MonikaWegmuellerRecipient\">See above (Patient/MonikaWegmuellerRecipient)</a></p><p><b>identifier</b>: id: urn:uuid:6b6ed376-a7da-44cb-92d1-e75ce1ae73b0</p><p><b>status</b>: final</p><p><b>type</b>: Medication summary <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#56445-0; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#721912009\"Medication summary document (record artifact)\")</span></p><p><b>date</b>: 2012-02-04T14:05:00+01:00</p><p><b>author</b>: </p><ul><li><a href=\"#Practitioner_FamilienHausarzt\">See above (Practitioner/FamilienHausarzt)</a></li><li><a href=\"#Organization_Hausarzt\">See above (Organization/Hausarzt)</a></li></ul><p><b>title</b>: Medikationsplan</p><p><b>confidentiality</b>: N</p><p><b>custodian</b>: <a href=\"#Organization_Custodian\">See above (Organization/Custodian)</a></p></div>"
},
"extension" : [
{
"url" : "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-informationrecipient",
"valueReference" : {
"reference" : "Patient/MonikaWegmuellerRecipient"
}
}
],
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:6b6ed376-a7da-44cb-92d1-e75ce1ae73b0"
},
"status" : "final",
"type" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "56445-0",
"display" : "Medication summary"
},
{
"system" : "http://snomed.info/sct",
"code" : "721912009",
"display" : "Medication summary document (record artifact)"
}
]
},
|
- subject: Who the composition is about. Its a reference to the resource contained as entry in the bundle (line 39 to 44).
- date The date of the composition creation (line 42).
- author: Identifies who is responsible for the information in the composition (line 43 to 56).
- extension: Extension to EPR Time (line 45 to 50).
| "subject": {
"reference": "Patient/MonikaWegmueller"
},
"date": "2012-02-04T14:05:00+01:00",
"author": [
{
"extension": [
{
"url": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-time",
"valueDateTime": "2012-02-04T13:55:00+01:00"
}
],
"reference": "Practitioner/FamilienHausarzt"
},
{
"reference": "Organization/Hausarzt"
}
],
|
- title: Human readable label for the composition.
| "title": "Medikationsplan",
|
| "confidentiality": "N",
"_confidentiality": {
"extension": [
{
"url": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-confidentialitycode",
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "17621005",
"display": "Normally accessible"
}
]
}
}
]
},
|
- custodian: Organization who is responsible for the document and access.
| "custodian": {
"reference": "Organization/Custodian"
},
|
- section: The root of the sections that make up the composition.
| "section": [
{
"title": "Medikamentenliste",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "10160-0",
"display": "History of medication use"
}
]
},
"entry": [
{
"reference": "MedicationStatement/2-7-MedStatBeloczok"
},
{
"reference": "MedicationStatement/2-7-MedStatNorvasc"
}
]
},
{
"title": "Kommentar",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "48767-8",
"display": "Annotation comment"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <span id=\"co1\">\n Kommentar zu Medication Treatment\n </span>\n </div>"
}
},
{
"title": "Original Darstellung",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55108-5",
"display": "Clinical presentation"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <a href=\"Binary/2-7-pdf\">Representation of the original view</a>\n </div>"
},
"entry": [
{
"reference": "Binary/2-7-pdf"
}
]
}
]
}
},
|
In the "Patient" resource, the demographic and administrative data of a patient are specified.
Profile information
| "resource": {
"resourceType": "Patient",
"id": "MonikaWegmueller",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: Medical record number: 11111111</p><p><b>name</b>: Monika Wegmüller </p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1943-05-15</p><p><b>address</b>: Wiesenstr. 12 Zürich 8003 CH </p></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR"
}
]
},
"system": "urn:oid:2.999",
"value": "11111111"
}
],
"name": [
{
"family": "Wegmüller",
"given": [
"Monika"
]
}
],
"gender": "female",
"birthDate": "1943-05-15",
"address": [
{
"line": [
"Wiesenstr. 12"
],
"city": "Zürich",
"postalCode": "8003",
"country": "CH"
}
]
}
},
|
The resource Practitioner indicates which practitioner has prescribed a medication.
Profile information
| "resource" : {
"resourceType" : "Practitioner",
"id" : "FamilienHausarzt",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"FamilienHausarzt\" </p></div><p><b>identifier</b>: id: 7601000234438</p><p><b>name</b>: Familien Hausarzt </p><p><b>address</b>: Krankenstrasse 2 Zürich 8005 CH </p></div>"
},
"identifier" : [
{
"system" : "urn:oid:2.51.1.3",
"value" : "7601000234438"
}
],
"name" : [
{
"family" : "Hausarzt",
"given" : [
"Familien"
]
}
],
"address" : [
{
"line" : [
"Krankenstrasse 2"
],
"city" : "Zürich",
"postalCode" : "8005",
"country" : "CH"
}
]
}
|
The resource stores the information about the organization that create the Medication Card document.
Profile information
| "resource" : {
"resourceType" : "Organization",
"id" : "Hausarzt",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"Hausarzt\" </p></div><p><b>identifier</b>: id: 7601000234438</p><p><b>name</b>: Hausarzt</p><p><b>address</b>: Krankenstrasse 2 Zürich 8005 CH </p></div>"
},
"identifier" : [
{
"system" : "urn:oid:2.51.1.3",
"value" : "7601000234438"
}
],
"name" : "Hausarzt",
"address" : [
{
"line" : [
"Krankenstrasse 2"
],
"city" : "Zürich",
"postalCode" : "8005",
"country" : "CH"
}
]
}
|
Medication
In the resource "MedicationStatement" the data of the patient's medication are specified.
Profile information
- id: Local id of the resource (line 2).
- text: Presents the narrative text of the resource (line 3, 19, 54).
- contained: The resource cannot be identified independently and therefore cannot exist independently apart from the resource it contains (line 7 to 73).
- code: A code (or set of codes) that specify this medication, or a textual description if no code is available. (line 11, 25, 35, 41, 50, 67).
- coding A reference to a code defined by a terminology system. (line 12,22, 47).
- form Describes the form of the medication. Powder; tablets; capsule. (line 21 to 29).
- amount: A relationship of two Quantity values - expressed as a numerator and a denominator. (line 30 to 36).
- ingredient: Particular ingredient of a medication (line 44 to 71).
- strength: A relationship of two Quantity values - expressed as a numerator and a denominator (line 56 to 69).
| "resourceType": "MedicationStatement",
"id": "2-7-MedStatBeloczok",
"text": {
"status": "extensions",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><blockquote><p><b>CH EMED Extension Treatment Plan</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: id: urn:uuid:5712fffe-20c6-11e6-b67b-9e71128cae77</p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: id: urn:uuid:5712fffe-20c6-11e6-b67b-9e71128cae77</p></blockquote><p><b>identifier</b>: id: urn:uuid:d0f885ca-afa6-4e7e-905d-f7698f9607aa</p><p><b>status</b>: completed</p><p><b>medication</b>: <a name=\"med\"> </a></p><blockquote><p><b>code</b>: <span title=\"Codes: {urn:oid:2.51.1.1 7680521101306}\">BELOC ZOK Ret Tabl 50 mg</span></p><p><b>form</b>: <span title=\"Codes: {urn:oid:0.4.0.127.0.16.1.1.2.1 10219000}\">Tablet</span></p><p><b>amount</b>: 30 Tablet (unit of presentation)/1 Package</p><h3>Ingredients</h3><table class=\"grid\"><tr><td>-</td><td><b>Item[x]</b></td><td><b>Strength</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://snomed.info/sct 372826007}\">Metoprolol</span></td><td>50 milligram/1 Tablet (unit of presentation)</td></tr></table></blockquote><p><b>subject</b>: <a href=\"#Patient_MonikaWegmueller\">See above (Patient/MonikaWegmueller)</a></p><p><b>reasonCode</b>: <span title=\"Codes: \">Bluthochdruck</span></p><p><b>note</b>: -</p><h3>Dosages</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></div>"
},
"contained": [
{
"resourceType": "Medication",
"id": "med",
"code": {
"coding": [
{
"system": "urn:oid:2.51.1.1",
"code": "7680521101306",
"display": "BELOC ZOK Ret Tabl 50 mg 30 Stk"
}
],
"text": "BELOC ZOK Ret Tabl 50 mg"
},
"form": {
"coding": [
{
"system": "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code": "10219000",
"display": "Tablet"
}
]
},
"amount": {
"numerator": {
"value": 30,
"unit": "Tablet (unit of presentation)",
"system": "http://snomed.info/sct",
"code": "732936001"
},
"denominator": {
"value": 1,
"unit": "Package",
"system": "http://unitsofmeasure.org",
"code": "{Package}"
}
},
"ingredient": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "372826007",
"display": "Metoprolol (substance)"
}
],
"text": "Metoprolol"
},
"strength": {
"numerator": {
"value": 50,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
},
"denominator": {
"value": 1,
"unit": "Tablet (unit of presentation)",
"system": "http://snomed.info/sct",
"code": "732936001"
}
}
}
]
}
],
|
- indentifier: Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate -fixed Value "urn:ietf:rfc:3986".
| "identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:d0f885ca-afa6-4e7e-905d-f7698f9607aa"
}
],
|
- status: A code representing the status of the use of the medication - fixed Value: "completed"; binding: Medication Status Codes.
- subject: The person who is taking the medication.
| "subject": {
"reference": "Patient/69d661eb-e3ed-4e86-b34c-b5e747c13021"
},
|
| "reasonCode": [{
"text": "Bluthochdruck/Herz"
}
|
- note: Provides extra information about the medication statement that is not conveyed by the other attributes.
| "note": [
{
"text": "-"
}
],
|
Dosage
- text: Non-structured dosage element (line 3).
- timing: when the medication should be taken (line 6 to 16).
- route: Indicates the route of administration - binding: SNOMEDCTRouteCodes; EDQM - RouteOfAdministration (line 17 to 25).
- doseAndRate: The amount of medication administered (line 26 to 36).
Example normal Dosing (incl. Dosage Non-Structured):
Profile information (normal Dosing)
Profile information (Dosage Non-Structured)
| "dosage" : [
{
"text" : "Morgens und abends je 1 Tablette einnehmen"
},
{
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2012-02-04"
},
"when" : [
"MORN",
"EVE"
]
}
},
"route" : {
"coding" : [
{
"system" : "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code" : "20053000",
"display" : "Oral use"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 1,
"unit" : "Tablet (unit of presentation)",
"system" : "http://snomed.info/sct",
"code" : "732936001"
}
}
]
}
]
|
- text: Non-structured dosage element (line 3).
- timing: when the medication should be taken (line 7 to 16).
- route: Indicates the route of administration - binding: SNOMEDCTRouteCodes; EDQM - RouteOfAdministration (line 17 to 25).
- doseAndRate: The amount of medication administered (line 26 to 36).
Example split Dosing (incl. Dosage Non-Structured):
Profile information (split Dosing)
Profile information (Dosage Non-Structured)
| "dosage": [
{
"text": "Morgens 1 und abends 1/2 Tablette nehmen"
},
{
"sequence": 1,
"timing": {
"repeat": {
"boundsPeriod": {
"start": "2012-02-04"
},
"when": [
"MORN"
]
}
},
"route": {
"coding": [
{
"system": "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code": "20053000",
"display": "Oral use"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "Tablet (unit of presentation)",
"system": "http://snomed.info/sct",
"code": "732936001"
}
}
]
},
{
"sequence": 2,
"timing": {
"repeat": {
"boundsPeriod": {
"start": "2012-02-04"
},
"when": [
"EVE"
]
}
},
"route": {
"coding": [
{
"system": "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code": "20053000",
"display": "Oral use"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 0.5,
"unit": "Tablet (unit of presentation)",
"system": "http://snomed.info/sct",
"code": "732936001"
}
}
]
}
]
}
},
|
The resource "Binary" represents the original representation of the Medication Card document.
| "resource": {
"resourceType": "Binary",
"id": "2-7-pdf",
"language": "de-CH",
"contentType": "application/pdf",
"data": "JVBERi0xLjQKMSAwIG9iago8PAovVGl0bGU..."
}
|
Last update: 2024-08-09