Profile-medicationstatement-de-basis-0.2.xml

<?xml version="1.0" encoding="utf-8"?>
<StructureDefinition xmlns="http://hl7.org/fhir">
  <url value="http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2" />
 <version value="0.2.4" />
  <name value="medicationstatement-de-basis-0.2" />
  <title value="MedicationStatement, deutsches Basisprofil (Version 0.2)" />
  <status value="draft" />
  <experimental value="true" />
  <date value="2018-06-05" />
  <publisher value="HL7 Deutschland e.V. (Technisches Komitee FHIR)" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://hl7.de/technische-komitees/fhir/" />
    </telecom>
  </contact>
  <description value="Basisprofil für die Verwendung der MedicationStatement Ressource in Deutschland" />
  <copyright value="HL7 Deutschland e.V." />
  <fhirVersion value="3.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="MedicationStatement" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
  <derivation value="constraint" />
  <snapshot>
    <element id="MedicationStatement">
      <path value="MedicationStatement" />
      <short value="Record of medication being taken by a patient" />
      <definition value="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 &#xD;&#xD;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." />
      <comment value="When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:&#xD;MedicationStatement.status + MedicationStatement.wasNotTaken&#xD;Status=Active + NotTaken=T = Not currently taking&#xD;Status=Completed + NotTaken=T = Not taken in the past&#xD;Status=Intended + NotTaken=T = No intention of taking&#xD;Status=Active + NotTaken=F = Taking, but not as prescribed&#xD;Status=Active + NotTaken=F = Taking&#xD;Status=Intended +NotTaken= F = Will be taking (not started)&#xD;Status=Completed + NotTaken=F = Taken in past&#xD;Status=In Error + NotTaken=N/A = In Error." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Resource" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <xpath value="not(parent::f:contained and f:contained)" />
      </constraint>
      <constraint>
        <key value="dom-1" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
        <expression value="contained.text.empty()" />
        <xpath value="not(parent::f:contained and f:text)" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource" />
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()" />
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" />
      </constraint>
      <constraint>
        <key value="mst-1" />
        <severity value="error" />
        <human value="Reason not taken is only permitted if Taken is No" />
        <expression value="reasonNotTaken.exists().not() or (taken = 'n')" />
        <xpath value="not(exists(f:reasonNotTaken)) or f:taken/@value='n'" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="..Event" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="SubstanceAdministration" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.medication" />
      </mapping>
    </element>
    <element id="MedicationStatement.id">
      <path value="MedicationStatement.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.meta">
      <path value="MedicationStatement.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.implicitRules">
      <path value="MedicationStatement.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." />
      <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. &#xA;&#xA;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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.language">
      <path value="MedicationStatement.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages" />
          </valueReference>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true" />
        </extension>
        <strength value="extensible" />
        <description value="A human language." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.text">
      <path value="MedicationStatement.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource, and 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="ele-1" />
      <condition value="dom-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="MedicationStatement.contained">
      <path value="MedicationStatement.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
      <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.extension">
      <path value="MedicationStatement.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the 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." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.modifierExtension">
      <path value="MedicationStatement.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.identifier">
      <path value="MedicationStatement.identifier" />
      <short value="External identifier" />
      <definition value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…identifer" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element id="MedicationStatement.basedOn">
      <path value="MedicationStatement.basedOn" />
      <short value="Fulfils plan, proposal or order" />
      <definition value="A plan, proposal or order that is fulfilled in whole or in part by this event." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.basedOn" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…basedOn" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]" />
      </mapping>
    </element>
    <element id="MedicationStatement.partOf">
      <path value="MedicationStatement.partOf" />
      <short value="Part of referenced event" />
      <definition value="A larger event of which this particular event is a component or step." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.partOf" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…part of" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]" />
      </mapping>
    </element>
    <element id="MedicationStatement.context">
      <path value="MedicationStatement.context" />
      <short value="Encounter / Episode associated with MedicationStatement" />
      <definition value="The encounter or episode of care that establishes the context for this MedicationStatement." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.context" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…context" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type of encounter or episode&quot;]" />
      </mapping>
    </element>
    <element id="MedicationStatement.status">
      <path value="MedicationStatement.status" />
      <short value="active | completed | entered-in-error | intended | stopped | on-hold" />
      <definition value="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." />
      <comment value="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).&#xA;&#xA;This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementStatus" />
        </extension>
        <strength value="required" />
        <description value="A coded concept indicating the current status of a MedicationStatement." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-statement-status" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…status" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".statusCode" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element id="MedicationStatement.category">
      <path value="MedicationStatement.category" />
      <short value="Type of medication usage" />
      <definition value="Indicates where type of medication statement and where the medication is expected to be consumed or administered." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.category" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementCategory" />
        </extension>
        <strength value="preferred" />
        <description value="A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-statement-category" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type of medication usage&quot;].value" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="class" />
      </mapping>
    </element>
    <element id="MedicationStatement.medication[x]">
      <path value="MedicationStatement.medication[x]" />
      <short value="What medication was taken" />
      <definition value="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." />
      <comment value="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. ." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.medication[x]" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/medication-de-basis/0.2" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode" />
        </extension>
        <strength value="example" />
        <description value="A coded concept identifying the substance or product being taken." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…code" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
    </element>
    <element id="MedicationStatement.effective[x]">
      <path value="MedicationStatement.effective[x]" />
      <short value="The date/time or interval when the medication was taken" />
      <definition value="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)." />
      <comment value="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 &quot;end&quot; date will be omitted." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.effective[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".effectiveTime" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.done" />
      </mapping>
    </element>
    <element id="MedicationStatement.dateAsserted">
      <path value="MedicationStatement.dateAsserted" />
      <short value="When the statement was asserted?" />
      <definition value="The date when the medication statement was asserted by the information source." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.dateAsserted" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=AUT].time" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.recorded" />
      </mapping>
    </element>
    <element id="MedicationStatement.informationSource">
      <path value="MedicationStatement.informationSource" />
      <short value="Person or organization that provided the information about the taking of this medication" />
      <definition value="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." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.informationSource" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/patient-de-basis/0.2" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/practitioner-de-basis/0.2" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.source" />
      </mapping>
    </element>
    <element id="MedicationStatement.subject">
      <path value="MedicationStatement.subject" />
      <short value="Who is/was taking  the medication" />
      <definition value="The person, animal or group who is/was taking the medication." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.subject" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/patient-de-basis/0.2" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…subject" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="PID-3-Patient ID List" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who" />
      </mapping>
    </element>
    <element id="MedicationStatement.derivedFrom">
      <path value="MedicationStatement.derivedFrom" />
      <short value="Additional supporting information" />
      <definition value="Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement." />
      <comment value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.derivedFrom" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" />
      </mapping>
    </element>
    <element id="MedicationStatement.taken">
      <path value="MedicationStatement.taken" />
      <short value="y | n | unk | na" />
      <definition value="Indicator of the certainty of whether the medication was taken by the patient." />
      <comment value="This element is labeled as a modifier because it indicates that the medication was not taken." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationStatement.taken" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementTaken" />
        </extension>
        <strength value="required" />
        <description value="A coded concept identifying level of certainty if patient has taken or has not taken the medication" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-statement-taken" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…notDone" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".actionNegationInd" />
      </mapping>
    </element>
    <element id="MedicationStatement.reasonNotTaken">
      <path value="MedicationStatement.reasonNotTaken" />
      <short value="True if asserting medication was not given" />
      <definition value="A code indicating why the medication was not taken." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.reasonNotTaken" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <condition value="mst-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationStatementNotTakenReason" />
        </extension>
        <strength value="example" />
        <description value="A coded concept indicating the reason why the medication was not taken" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/reason-medication-not-taken-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;reason not taken&quot;].value" />
      </mapping>
    </element>
    <element id="MedicationStatement.reasonCode">
      <path value="MedicationStatement.reasonCode" />
      <short value="Reason for why the medication is being/was taken" />
      <definition value="A reason for why the medication is being/was taken." />
      <comment value="This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.reasonCode" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationReason" />
        </extension>
        <strength value="example" />
        <description value="A coded concept identifying why the medication is being taken." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…reasoneCodeableConcept" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".reasonCode" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="why" />
      </mapping>
    </element>
    <element id="MedicationStatement.reasonReference">
      <path value="MedicationStatement.reasonReference" />
      <short value="Condition or observation that supports why the medication is being/was taken" />
      <definition value="Condition or observation that supports why the medication is being/was taken." />
      <comment value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.reasonReference" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/condition-de-basis/0.2" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/observation-de-basis/0.2" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…reasonReference" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;reason for use&quot;].value" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="why" />
      </mapping>
    </element>
    <element id="MedicationStatement.note">
      <path value="MedicationStatement.note" />
      <short value="Further information about the statement" />
      <definition value="Provides extra information about the medication statement that is not conveyed by the other attributes." />
      <comment value="For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate &quot;modifying&quot; information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.note" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Annotation" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="…note" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=&quot;annotation&quot;].value" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage">
      <path value="MedicationStatement.dosage" />
      <short value="Details of how medication is/was taken or should be taken" />
      <definition value="Indicates how the medication is/was or should be taken by the patient." />
      <comment value="The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, &quot;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.&quot;  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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationStatement.dosage" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Dosage" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="refer dosageInstruction mapping" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.id">
      <path value="MedicationStatement.dosage.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.extension">
      <path value="MedicationStatement.dosage.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.sequence">
      <path value="MedicationStatement.dosage.sequence" />
      <short value="The order of the dosage instructions" />
      <definition value="Indicates the order in which the dosage instructions should be applied or interpreted." />
      <comment value="32 bit number; for values larger than this, use decimal" />
      <requirements value="If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.sequence" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.text">
      <path value="MedicationStatement.dosage.text" />
      <short value="Free text dosage instructions e.g. SIG" />
      <definition value="Free text dosage instructions e.g. SIG." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <requirements value="Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.additionalInstruction">
      <path value="MedicationStatement.dosage.additionalInstruction" />
      <short value="Supplemental instruction - e.g. &quot;with meals&quot;" />
      <definition value="Supplemental instruction - e.g. &quot;with meals&quot;." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <requirements value="Additional instruction such as &quot;Swallow with plenty of water&quot; which may or may not be coded." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Dosage.additionalInstruction" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdditionalInstruction" />
        </extension>
        <strength value="example" />
        <description value="A coded concept identifying additional instructions such as &quot;take with water&quot; or &quot;avoid operating heavy machinery&quot;." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/additional-instruction-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.patientInstruction">
      <path value="MedicationStatement.dosage.patientInstruction" />
      <short value="Patient or consumer oriented instructions" />
      <definition value="Instructions in terms that are understood by the patient or consumer." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.patientInstruction" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing">
      <path value="MedicationStatement.dosage.timing" />
      <short value="When medication should be administered" />
      <definition value="When medication should be administered." />
      <comment value="This attribute may not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing." />
      <requirements value="The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: &quot;Every 8 hours&quot;; &quot;Three times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;; &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.timing" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Timing" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="QSET&lt;TS&gt; (GTS)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".effectiveTime" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.id">
      <path value="MedicationStatement.dosage.timing.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.extension">
      <path value="MedicationStatement.dosage.timing.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.event">
      <path value="MedicationStatement.dosage.timing.event" />
      <short value="When the event occurs" />
      <definition value="Identifies specific times when the event occurs." />
      <requirements value="In an MAR, for instance, you need to take a general specification, and turn it into a precise specification." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Timing.event" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="QLIST&lt;TS&gt;" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat">
      <path value="MedicationStatement.dosage.timing.repeat" />
      <short value="When the event is to occur" />
      <definition value="A set of rules that describe when the event is scheduled." />
      <requirements value="Many timing schedules are determined by regular repetitions." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Element" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="tim-9" />
        <severity value="error" />
        <human value="If there's an offset, there must be a when (and not C, CM, CD, CV)" />
        <expression value="offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))" />
        <xpath value="not(exists(f:offset)) or exists(f:when)" />
      </constraint>
      <constraint>
        <key value="tim-5" />
        <severity value="error" />
        <human value="period SHALL be a non-negative value" />
        <expression value="period.exists() implies period &gt;= 0" />
        <xpath value="f:period/@value &gt;= 0 or not(f:period/@value)" />
      </constraint>
      <constraint>
        <key value="tim-6" />
        <severity value="error" />
        <human value="If there's a periodMax, there must be a period" />
        <expression value="periodMax.empty() or period.exists()" />
        <xpath value="not(exists(f:periodMax)) or exists(f:period)" />
      </constraint>
      <constraint>
        <key value="tim-7" />
        <severity value="error" />
        <human value="If there's a durationMax, there must be a duration" />
        <expression value="durationMax.empty() or duration.exists()" />
        <xpath value="not(exists(f:durationMax)) or exists(f:duration)" />
      </constraint>
      <constraint>
        <key value="tim-8" />
        <severity value="error" />
        <human value="If there's a countMax, there must be a count" />
        <expression value="countMax.empty() or count.exists()" />
        <xpath value="not(exists(f:countMax)) or exists(f:count)" />
      </constraint>
      <constraint>
        <key value="tim-1" />
        <severity value="error" />
        <human value="if there's a duration, there needs to be duration units" />
        <expression value="duration.empty() or durationUnit.exists()" />
        <xpath value="not(exists(f:duration)) or exists(f:durationUnit)" />
      </constraint>
      <constraint>
        <key value="tim-10" />
        <severity value="error" />
        <human value="If there's a timeOfDay, there cannot be be a when, or vice versa" />
        <expression value="timeOfDay.empty() or when.empty()" />
        <xpath value="not(exists(f:timeOfDay)) or not(exists(f:when))" />
      </constraint>
      <constraint>
        <key value="tim-2" />
        <severity value="error" />
        <human value="if there's a period, there needs to be period units" />
        <expression value="period.empty() or periodUnit.exists()" />
        <xpath value="not(exists(f:period)) or exists(f:periodUnit)" />
      </constraint>
      <constraint>
        <key value="tim-4" />
        <severity value="error" />
        <human value="duration SHALL be a non-negative value" />
        <expression value="duration.exists() implies duration &gt;= 0" />
        <xpath value="f:duration/@value &gt;= 0 or not(f:duration/@value)" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Implies PIVL or EIVL" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.id">
      <path value="MedicationStatement.dosage.timing.repeat.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.extension">
      <path value="MedicationStatement.dosage.timing.repeat.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.bounds[x]">
      <path value="MedicationStatement.dosage.timing.repeat.bounds[x]" />
      <short value="Length/Range of lengths, or (Start and/or end) limits" />
      <definition value="Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule." />
      <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.bounds[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Duration" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="qty-3" />
        <severity value="error" />
        <human value="If a code for the unit is present, the system SHALL also be present" />
        <expression value="code.empty() or system.exists()" />
        <xpath value="not(exists(f:code)) or exists(f:system)" />
      </constraint>
      <constraint>
        <key value="drt-1" />
        <severity value="error" />
        <human value="There SHALL be a code if there is a value and it SHALL be an expression of time.  If system is present, it SHALL be UCUM." />
        <expression value="code.exists() implies ((system = %ucum) and value.exists())" />
        <xpath value="(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org')" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="SN (see also Range) or CQ" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ, IVL&lt;PQ&gt; depending on the values" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL(TS) used in a QSI" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.count">
      <path value="MedicationStatement.dosage.timing.repeat.count" />
      <short value="Number of times to repeat" />
      <definition value="A total count of the desired number of repetitions." />
      <comment value="If you have both bounds and count, then this should be understood as within the bounds period, until count times happens." />
      <requirements value="Repetitions may be limited by end time or total occurrences." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.count" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.count" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.countMax">
      <path value="MedicationStatement.dosage.timing.repeat.countMax" />
      <short value="Maximum number of times to repeat" />
      <definition value="A maximum value for the count of the desired repetitions (e.g. do something 6-8 times)." />
      <comment value="32 bit number; for values larger than this, use decimal" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.countMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.count" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.duration">
      <path value="MedicationStatement.dosage.timing.repeat.duration" />
      <short value="How long when it happens" />
      <definition value="How long this thing happens for when it happens." />
      <comment value="For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise)." />
      <requirements value="Some activities are not instantaneous and need to be maintained for a period of time." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.duration" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.durationMax">
      <path value="MedicationStatement.dosage.timing.repeat.durationMax" />
      <short value="How long when it happens (Max)" />
      <definition value="The upper limit of how long this thing happens for when it happens." />
      <comment value="For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise)." />
      <requirements value="Some activities are not instantaneous and need to be maintained for a period of time." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.durationMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.durationUnit">
      <path value="MedicationStatement.dosage.timing.repeat.durationUnit" />
      <short value="s | min | h | d | wk | mo | a - unit of time (UCUM)" />
      <definition value="The units of time for the duration, in UCUM units." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.durationUnit" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="UnitsOfTime" />
        </extension>
        <strength value="required" />
        <description value="A unit of time (units from UCUM)." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/units-of-time" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase.unit" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.frequency">
      <path value="MedicationStatement.dosage.timing.repeat.frequency" />
      <short value="Event occurs frequency times per period" />
      <definition value="The number of times to repeat the action within the specified period / period range (i.e. both period and periodMax provided)." />
      <comment value="32 bit number; for values larger than this, use decimal" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.frequency" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <defaultValueInteger value="1" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.frequencyMax">
      <path value="MedicationStatement.dosage.timing.repeat.frequencyMax" />
      <short value="Event occurs up to frequencyMax times per period" />
      <definition value="If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range." />
      <comment value="32 bit number; for values larger than this, use decimal" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.frequencyMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="integer" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.period">
      <path value="MedicationStatement.dosage.timing.repeat.period" />
      <short value="Event occurs frequency times per period" />
      <definition value="Indicates the duration of time over which repetitions are to occur; e.g. to express &quot;3 times per day&quot;, 3 would be the frequency and &quot;1 day&quot; would be the period." />
      <comment value="Do not use a IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.periodMax">
      <path value="MedicationStatement.dosage.timing.repeat.periodMax" />
      <short value="Upper limit of period (3-4 hours)" />
      <definition value="If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as &quot;do this once every 3-5 days." />
      <comment value="Do not use a IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.periodMax" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="decimal" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.periodUnit">
      <path value="MedicationStatement.dosage.timing.repeat.periodUnit" />
      <short value="s | min | h | d | wk | mo | a - unit of time (UCUM)" />
      <definition value="The units of time for the period in UCUM units." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.periodUnit" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="UnitsOfTime" />
        </extension>
        <strength value="required" />
        <description value="A unit of time (units from UCUM)." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/units-of-time" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PIVL.phase.unit" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.dayOfWeek">
      <path value="MedicationStatement.dosage.timing.repeat.dayOfWeek" />
      <short value="mon | tue | wed | thu | fri | sat | sun" />
      <definition value="If one or more days of week is provided, then the action happens only on the specified day(s)." />
      <comment value="If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Timing.repeat.dayOfWeek" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DayOfWeek" />
        </extension>
        <strength value="required" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/days-of-week" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.timeOfDay">
      <path value="MedicationStatement.dosage.timing.repeat.timeOfDay" />
      <short value="Time of day for action" />
      <definition value="Specified time of day for action to take place." />
      <comment value="When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Timing.repeat.timeOfDay" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="time" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.when">
      <path value="MedicationStatement.dosage.timing.repeat.when" />
      <short value="Regular life events the event is tied to" />
      <definition value="Real world events that the occurrence of the event should be tied to." />
      <comment value="When more than one event is listed, the event is tied to the union of the specified events." />
      <requirements value="Timings are frequently determined by occurrences such as waking, eating and sleep." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Timing.repeat.when" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="EventTiming" />
        </extension>
        <strength value="required" />
        <description value="Real world event relating to the schedule." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/event-timing" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="EIVL.event" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.repeat.offset">
      <path value="MedicationStatement.dosage.timing.repeat.offset" />
      <short value="Minutes from event (before or after)" />
      <definition value="The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event." />
      <comment value="32 bit number; for values larger than this, use decimal" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.repeat.offset" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="unsignedInt" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="EIVL.offset" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.timing.code">
      <path value="MedicationStatement.dosage.timing.code" />
      <short value="Einnahmezeitpunkt" />
      <definition value="Einnahmezeitpunkt (morgens, mittags, ...)" />
      <comment value="BID etc are defined as 'at institutionally specified times'. For example, an institution may choose that BID is &quot;always at 7am and 6pm&quot;.  If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or the a structured representation should be used (in this case, specifying the two event times)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Timing.code" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TimingAbbreviation" />
        </extension>
        <strength value="extensible" />
        <description value="Code for a known / defined timing pattern." />
        <valueSetUri value="http://fhir.de/ValueSet/einnahmezeitpunkte" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="QSC.code" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.asNeeded[x]">
      <path value="MedicationStatement.dosage.asNeeded[x]" />
      <short value="Take &quot;as needed&quot; (for x)" />
      <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept)." />
      <comment value="Can express &quot;as needed&quot; without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express &quot;as needed&quot; with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not &quot;prn&quot; or &quot;as needed&quot;." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.asNeeded[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAsNeededReason" />
        </extension>
        <strength value="example" />
        <description value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30 minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=&quot;as needed&quot;].value=boolean or codable concept" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.site">
      <path value="MedicationStatement.dosage.site" />
      <short value="Body site to administer to" />
      <definition value="Body site to administer to." />
      <comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both." />
      <requirements value="A coded specification of the anatomic site where the medication first enters the body." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.site" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationSite" />
        </extension>
        <strength value="example" />
        <description value="A coded concept describing the site location the medicine enters into or onto the body." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/approach-site-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".approachSiteCode" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.route">
      <path value="MedicationStatement.dosage.route" />
      <short value="How drug should enter body" />
      <definition value="How drug should enter body." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <requirements value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.route" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RouteOfAdministration" />
        </extension>
        <strength value="example" />
        <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/route-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".routeCode" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.method">
      <path value="MedicationStatement.dosage.method" />
      <short value="Technique for administering medication" />
      <definition value="Technique for administering medication." />
      <comment value="Terminologies used often pre-coordinate this term with the route and or form of administration." />
      <requirements value="A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.method" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationMethod" />
        </extension>
        <strength value="example" />
        <description value="A coded concept describing the technique by which the medicine is administered." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/administration-method-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.dose[x]">
      <path value="MedicationStatement.dosage.dose[x]" />
      <short value="Amount of medication per dose" />
      <definition value="Amount of medication per dose." />
      <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours." />
      <requirements value="The amount of therapeutic or other substance given at one administration event." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.dose[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="rng-2" />
        <severity value="error" />
        <human value="If present, low SHALL have a lower value than high" />
        <expression value="low.empty() or high.empty() or (low &lt;= high)" />
        <xpath value="not(exists(f:low/f:value/@value)) or not(exists(f:high/f:value/@value)) or (number(f:low/f:value/@value) &lt;= number(f:high/f:value/@value))" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="NR and also possibly SN (but see also quantity)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;QTY[not(type=&quot;TS&quot;)]&gt; [lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]or URG&lt;QTY[not(type=&quot;TS&quot;)]&gt;" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerPeriod">
      <path value="MedicationStatement.dosage.maxDosePerPeriod" />
      <short value="Upper limit on medication per unit of time" />
      <definition value="Upper limit on medication per unit of time." />
      <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example &quot;2 tablets every 4 hours to a maximum of 8/day&quot;." />
      <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.maxDosePerPeriod" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Ratio" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="rat-1" />
        <severity value="error" />
        <human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" />
        <expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" />
        <xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) &gt; 0) or (count(f:extension) &gt; 0))" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="RTO" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".maxDoseQuantity" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerAdministration">
      <path value="MedicationStatement.dosage.maxDosePerAdministration" />
      <short value="Upper limit on medication per administration" />
      <definition value="Upper limit on medication per administration." />
      <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg." />
      <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.maxDosePerAdministration" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="qty-3" />
        <severity value="error" />
        <human value="If a code for the unit is present, the system SHALL also be present" />
        <expression value="code.empty() or system.exists()" />
        <xpath value="not(exists(f:code)) or exists(f:system)" />
      </constraint>
      <constraint>
        <key value="sqty-1" />
        <severity value="error" />
        <human value="The comparator is not used on a SimpleQuantity" />
        <expression value="comparator.empty()" />
        <xpath value="not(exists(f:comparator))" />
      </constraint>
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="SN (see also Range) or CQ" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="not supported" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.maxDosePerLifetime">
      <path value="MedicationStatement.dosage.maxDosePerLifetime" />
      <short value="Upper limit on medication per lifetime of the patient" />
      <definition value="Upper limit on medication per lifetime of the patient." />
      <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
      <requirements value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.maxDosePerLifetime" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="qty-3" />
        <severity value="error" />
        <human value="If a code for the unit is present, the system SHALL also be present" />
        <expression value="code.empty() or system.exists()" />
        <xpath value="not(exists(f:code)) or exists(f:system)" />
      </constraint>
      <constraint>
        <key value="sqty-1" />
        <severity value="error" />
        <human value="The comparator is not used on a SimpleQuantity" />
        <expression value="comparator.empty()" />
        <xpath value="not(exists(f:comparator))" />
      </constraint>
      <isModifier value="false" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="SN (see also Range) or CQ" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="not supported" />
      </mapping>
    </element>
    <element id="MedicationStatement.dosage.rate[x]">
      <path value="MedicationStatement.dosage.rate[x]" />
      <short value="Amount of medication per unit of time" />
      <definition value="Amount of medication per unit of time." />
      <comment value="It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate." />
      <requirements value="Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.rate[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Quantity" />
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <constraint>
        <key value="rat-1" />
        <severity value="error" />
        <human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" />
        <expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" />
        <xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) &gt; 0) or (count(f:extension) &gt; 0))" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="RTO" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".rateQuantity" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="MedicationStatement.partOf">
      <path value="MedicationStatement.partOf" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2" />
      </type>
    </element>
    <element id="MedicationStatement.medication[x]">
      <path value="MedicationStatement.medication[x]" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/medication-de-basis/0.2" />
      </type>
    </element>
    <element id="MedicationStatement.informationSource">
      <path value="MedicationStatement.informationSource" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/patient-de-basis/0.2" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/practitioner-de-basis/0.2" />
      </type>
    </element>
    <element id="MedicationStatement.subject">
      <path value="MedicationStatement.subject" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/patient-de-basis/0.2" />
      </type>
    </element>
    <element id="MedicationStatement.reasonReference">
      <path value="MedicationStatement.reasonReference" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/condition-de-basis/0.2" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.de/StructureDefinition/observation-de-basis/0.2" />
      </type>
    </element>
    <element id="MedicationStatement.dosage.timing.code">
      <path value="MedicationStatement.dosage.timing.code" />
      <short value="Einnahmezeitpunkt" />
      <definition value="Einnahmezeitpunkt (morgens, mittags, ...)" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="TimingAbbreviation" />
        </extension>
        <strength value="extensible" />
        <valueSetUri value="http://fhir.de/ValueSet/einnahmezeitpunkte" />
      </binding>
    </element>
  </differential>
</StructureDefinition>