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.
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).
1 {
2 "resourceType" : "Bundle",
3 "id" : "2-7-MedicationCard",
4 "meta" : {
5 "lastUpdated" : "2020-02-21T12:31:59.738+00:00",
6 "profile" : [
7 "http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-document-medicationcard"
8 ]
9 },
10 "identifier" : {
11 "system" : "urn:ietf:rfc:3986",
12 "value" : "urn:uuid:6b6ed376-a7da-44cb-92d1-e75ce1ae73b0"
13 },
14 "type" : "document",
15 "timestamp" : "2012-02-04T14:05:00+01:00",
16 "entry" : [
17 {
18 "fullUrl" : "http://test.fhir.ch/r4/Composition/2-7-MedicationCard",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).
1 "entry" : [
2 {
3 "fullUrl" : "http://test.fhir.ch/r4/Composition/2-7-MedicationCard",
4 "resource" : {
5 "resourceType" : "Composition",
6 "id" : "2-7-MedicationCard",
7 "language" : "de-CH",
8 "text" : {
9 "status" : "extensions",
10 "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>"
11 },
12 "extension" : [
13 {
14 "url" : "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-informationrecipient",
15 "valueReference" : {
16 "reference" : "Patient/MonikaWegmuellerRecipient"
17 }
18 }
19 ],
20 "identifier" : {
21 "system" : "urn:ietf:rfc:3986",
22 "value" : "urn:uuid:6b6ed376-a7da-44cb-92d1-e75ce1ae73b0"
23 },
24 "status" : "final",
25 "type" : {
26 "coding" : [
27 {
28 "system" : "http://loinc.org",
29 "code" : "56445-0",
30 "display" : "Medication summary"
31 },
32 {
33 "system" : "http://snomed.info/sct",
34 "code" : "721912009",
35 "display" : "Medication summary document (record artifact)"
36 }
37 ]
38 },- 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).
39 "subject": {
40 "reference": "Patient/MonikaWegmueller"
41 },
42 "date": "2012-02-04T14:05:00+01:00",
43 "author": [
44 {
45 "extension": [
46 {
47 "url": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-time",
48 "valueDateTime": "2012-02-04T13:55:00+01:00"
49 }
50 ],
51 "reference": "Practitioner/FamilienHausarzt"
52 },
53 {
54 "reference": "Organization/Hausarzt"
55 }
56 ],- title: Human readable label for the composition.
57 "title": "Medikationsplan",- confidentiality: Level of confidentiality of the Composition - binding: v3.ConfidentialityClassification (2014-03-26).
- extension EPR Confidentiality Code
58 "confidentiality": "N",
59 "_confidentiality": {
60 "extension": [
61 {
62 "url": "http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-confidentialitycode",
63 "valueCodeableConcept": {
64 "coding": [
65 {
66 "system": "http://snomed.info/sct",
67 "code": "17621005",
68 "display": "Normally accessible"
69 }
70 ]
71 }
72 }
73 ]
74 },- custodian: Organization who is responsible for the document and access.
75 "custodian": {
76 "reference": "Organization/Custodian"
77 },- section: The root of the sections that make up the composition.
78 "section": [
79 {
80 "title": "Medikamentenliste",
81 "code": {
82 "coding": [
83 {
84 "system": "http://loinc.org",
85 "code": "10160-0",
86 "display": "History of medication use"
87 }
88 ]
89 },
90 "entry": [
91 {
92 "reference": "MedicationStatement/2-7-MedStatBeloczok"
93 },
94 {
95 "reference": "MedicationStatement/2-7-MedStatNorvasc"
96 }
97 ]
98 },
99 {
100 "title": "Kommentar",
101 "code": {
102 "coding": [
103 {
104 "system": "http://loinc.org",
105 "code": "48767-8",
106 "display": "Annotation comment"
107 }
108 ]
109 },
110 "text": {
111 "status": "generated",
112 "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <span id=\"co1\">\n Kommentar zu Medication Treatment\n </span>\n </div>"
113 }
114 },
115 {
116 "title": "Original Darstellung",
117 "code": {
118 "coding": [
119 {
120 "system": "http://loinc.org",
121 "code": "55108-5",
122 "display": "Clinical presentation"
123 }
124 ]
125 },
126 "text": {
127 "status": "generated",
128 "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <a href=\"Binary/2-7-pdf\">Representation of the original view</a>\n </div>"
129 },
130 "entry": [
131 {
132 "reference": "Binary/2-7-pdf"
133 }
134 ]
135 }
136 ]
137 }
138 },In the "Patient" resource, the demographic and administrative data of a patient are specified.
1 "resource": {
2 "resourceType": "Patient",
3 "id": "MonikaWegmueller",
4 "text": {
5 "status": "generated",
6 "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>"
7 },
8 "identifier": [
9 {
10 "type": {
11 "coding": [
12 {
13 "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
14 "code": "MR"
15 }
16 ]
17 },
18 "system": "urn:oid:2.999",
19 "value": "11111111"
20 }
21 ],
22 "name": [
23 {
24 "family": "Wegmüller",
25 "given": [
26 "Monika"
27 ]
28 }
29 ],
30 "gender": "female",
31 "birthDate": "1943-05-15",
32 "address": [
33 {
34 "line": [
35 "Wiesenstr. 12"
36 ],
37 "city": "Zürich",
38 "postalCode": "8003",
39 "country": "CH"
40 }
41 ]
42 }
43 },The resource Practitioner indicates which practitioner has prescribed a medication.
1 "resource" : {
2 "resourceType" : "Practitioner",
3 "id" : "FamilienHausarzt",
4 "text" : {
5 "status" : "generated",
6 "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>"
7 },
8 "identifier" : [
9 {
10 "system" : "urn:oid:2.51.1.3",
11 "value" : "7601000234438"
12 }
13 ],
14 "name" : [
15 {
16 "family" : "Hausarzt",
17 "given" : [
18 "Familien"
19 ]
20 }
21 ],
22 "address" : [
23 {
24 "line" : [
25 "Krankenstrasse 2"
26 ],
27 "city" : "Zürich",
28 "postalCode" : "8005",
29 "country" : "CH"
30 }
31 ]
32 }The resource stores the information about the organization that create the Medication Card document.
1 "resource" : {
2 "resourceType" : "Organization",
3 "id" : "Hausarzt",
4 "text" : {
5 "status" : "generated",
6 "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>"
7 },
8 "identifier" : [
9 {
10 "system" : "urn:oid:2.51.1.3",
11 "value" : "7601000234438"
12 }
13 ],
14 "name" : "Hausarzt",
15 "address" : [
16 {
17 "line" : [
18 "Krankenstrasse 2"
19 ],
20 "city" : "Zürich",
21 "postalCode" : "8005",
22 "country" : "CH"
23 }
24 ]
25 }In the resource "MedicationStatement" the data of the patient's medication are specified.
- 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).
1 "resourceType": "MedicationStatement",
2 "id": "2-7-MedStatBeloczok",
3 "text": {
4 "status": "extensions",
5 "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>"
6 },
7 "contained": [
8 {
9 "resourceType": "Medication",
10 "id": "med",
11 "code": {
12 "coding": [
13 {
14 "system": "urn:oid:2.51.1.1",
15 "code": "7680521101306",
16 "display": "BELOC ZOK Ret Tabl 50 mg 30 Stk"
17 }
18 ],
19 "text": "BELOC ZOK Ret Tabl 50 mg"
20 },
21 "form": {
22 "coding": [
23 {
24 "system": "urn:oid:0.4.0.127.0.16.1.1.2.1",
25 "code": "10219000",
26 "display": "Tablet"
27 }
28 ]
29 },
30 "amount": {
31 "numerator": {
32 "value": 30,
33 "unit": "Tablet (unit of presentation)",
34 "system": "http://snomed.info/sct",
35 "code": "732936001"
36 },
37 "denominator": {
38 "value": 1,
39 "unit": "Package",
40 "system": "http://unitsofmeasure.org",
41 "code": "{Package}"
42 }
43 },
44 "ingredient": [
45 {
46 "itemCodeableConcept": {
47 "coding": [
48 {
49 "system": "http://snomed.info/sct",
50 "code": "372826007",
51 "display": "Metoprolol (substance)"
52 }
53 ],
54 "text": "Metoprolol"
55 },
56 "strength": {
57 "numerator": {
58 "value": 50,
59 "unit": "milligram",
60 "system": "http://unitsofmeasure.org",
61 "code": "mg"
62 },
63 "denominator": {
64 "value": 1,
65 "unit": "Tablet (unit of presentation)",
66 "system": "http://snomed.info/sct",
67 "code": "732936001"
68 }
69 }
70 }
71 ]
72 }
73 ],- 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".
1 "identifier": [
2 {
3 "system": "urn:ietf:rfc:3986",
4 "value": "urn:uuid:d0f885ca-afa6-4e7e-905d-f7698f9607aa"
5 }
6 ],- status: A code representing the status of the use of the medication - fixed Value: "completed"; binding: Medication Status Codes.
1 "status": "completed",- subject: The person who is taking the medication.
1 "subject": {
2 "reference": "Patient/69d661eb-e3ed-4e86-b34c-b5e747c13021"
3 },- reasonCode: A reason for why the medication is taken - binding: Condition/Problem/DiagnosisCodes .
1 "reasonCode": [{
2 "text": "Bluthochdruck/Herz"
3 }- note: Provides extra information about the medication statement that is not conveyed by the other attributes.
1 "note": [
2 {
3 "text": "-"
4 }
5 ],- 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)
1 "dosage" : [
2 {
3 "text" : "Morgens und abends je 1 Tablette einnehmen"
4 },
5 {
6 "timing" : {
7 "repeat" : {
8 "boundsPeriod" : {
9 "start" : "2012-02-04"
10 },
11 "when" : [
12 "MORN",
13 "EVE"
14 ]
15 }
16 },
17 "route" : {
18 "coding" : [
19 {
20 "system" : "urn:oid:0.4.0.127.0.16.1.1.2.1",
21 "code" : "20053000",
22 "display" : "Oral use"
23 }
24 ]
25 },
26 "doseAndRate" : [
27 {
28 "doseQuantity" : {
29 "value" : 1,
30 "unit" : "Tablet (unit of presentation)",
31 "system" : "http://snomed.info/sct",
32 "code" : "732936001"
33 }
34 }
35 ]
36 }
37 ]- 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)
1 "dosage": [
2 {
3 "text": "Morgens 1 und abends 1/2 Tablette nehmen"
4 },
5 {
6 "sequence": 1,
7 "timing": {
8 "repeat": {
9 "boundsPeriod": {
10 "start": "2012-02-04"
11 },
12 "when": [
13 "MORN"
14 ]
15 }
16 },
17 "route": {
18 "coding": [
19 {
20 "system": "urn:oid:0.4.0.127.0.16.1.1.2.1",
21 "code": "20053000",
22 "display": "Oral use"
23 }
24 ]
25 },
26 "doseAndRate": [
27 {
28 "doseQuantity": {
29 "value": 1,
30 "unit": "Tablet (unit of presentation)",
31 "system": "http://snomed.info/sct",
32 "code": "732936001"
33 }
34 }
35 ]
36 },
37 {
38 "sequence": 2,
39 "timing": {
40 "repeat": {
41 "boundsPeriod": {
42 "start": "2012-02-04"
43 },
44 "when": [
45 "EVE"
46 ]
47 }
48 },
49 "route": {
50 "coding": [
51 {
52 "system": "urn:oid:0.4.0.127.0.16.1.1.2.1",
53 "code": "20053000",
54 "display": "Oral use"
55 }
56 ]
57 },
58 "doseAndRate": [
59 {
60 "doseQuantity": {
61 "value": 0.5,
62 "unit": "Tablet (unit of presentation)",
63 "system": "http://snomed.info/sct",
64 "code": "732936001"
65 }
66 }
67 ]
68 }
69 ]
70 }
71 },The resource "Binary" represents the original representation of the Medication Card document.
1 "resource": {
2 "resourceType": "Binary",
3 "id": "2-7-pdf",
4 "language": "de-CH",
5 "contentType": "application/pdf",
6 "data": "JVBERi0xLjQKMSAwIG9iago8PAovVGl0bGU..."
7 }