NP Core Implementation Guide
1.0.0 - Release Nepal flag

NP Core Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: NP Core MedicationStatement - Detailed Descriptions

Active as of 2026-10-14

Definitions for the np-core-medicationstatement resource profile

See the documentation on how to interpret the contents of this table

0. MedicationStatement
Definition

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

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

ShortRecord of medication being taken by a patient
Comments

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

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationStatement.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationStatement.modifierExtension
Definition

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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationStatement.basedOn
Definition

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

ShortFulfils plan, proposal or order
Control0..*
TypeReference(NP Core MedicationRequest, NP Core Service Request, CarePlan, MedicationRequest, CarePlan, ServiceRequest)
Is Modifierfalse
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationStatement.status
Definition

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

Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Comments

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

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

Control1..1
BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

A coded concept indicating the current status of a MedicationStatement.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:able-to-populateNP Core Creator
    SHALL:handleNP Core Consumer
    SHALL:handleNP Core Server
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. MedicationStatement.medication[x]
    Definition

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

    ShortWhat medication was taken
    Comments

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

    Control1..1
    BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
    (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

    A coded concept identifying the substance or product being taken.

    TypeChoice of: CodeableConcept, Reference(Medication)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Obligations
      ObligationsActor
      SHALL:able-to-populateNP Core Creator
      SHALL:handleNP Core Consumer
      SHALL:handleNP Core Server
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

        12. MedicationStatement.medication[x]:medicationReference
        Slice NamemedicationReference
        Definition

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

        ShortWhat medication was taken
        Comments

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

        Control01..1
        TypeReference(NP Core Medication, Medication), CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. MedicationStatement.medication[x]:medicationCodeableConcept
        Slice NamemedicationCodeableConcept
        Definition

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

        ShortWhat medication was taken
        Comments

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

        Control01..1
        BindingThe codes SHOULD be taken from For example codes, see Nepal Drug Value Sethttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
        (preferred to http://fhir.digitalhealth.gov.np/core/ValueSet/nepal-drug-vs)
        TypeCodeableConcept, Reference(Medication)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. MedicationStatement.subject
        Definition

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

        ShortWho is/was taking the medication
        Control1..1
        TypeReference(NP Core Patient, Patient, Group)
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:able-to-populateNP Core Creator
          SHALL:handleNP Core Consumer
          SHALL:handleNP Core Server
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. MedicationStatement.context
          Definition

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

          ShortEncounter / Episode associated with MedicationStatement
          Control0..1
          TypeReference(NP Core Encounter, Encounter, EpisodeOfCare)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. MedicationStatement.effective[x]
          Definition

          The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

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

          This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

          Control0..1
          TypeChoice of: dateTime, Period
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Obligations
            ObligationsActor
            SHOULD:able-to-populateNP Core Creator
            SHALL:handleNP Core Consumer
            SHALL:handleNP Core Server
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. MedicationStatement.informationSource
            Definition

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

            ShortPerson or organization that provided the information about the taking of this medication
            Control0..1
            TypeReference(NP Core Patient, NP Core Practitioner, NP Core PractitionerRole, NP Core Organization, NP Core RelatedPerson, Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Obligations
              ObligationsActor
              SHOULD:able-to-populateNP Core Creator
              SHALL:handleNP Core Consumer
              SHALL:handleNP Core Server
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. MedicationStatement.reasonReference
              Definition

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

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

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

              Control0..*
              TypeReference(NP Core Condition, NP Core Observation, NP Core Laboratory Report, DiagnosticReport, Condition, Observation, DiagnosticReport)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              See the documentation on how to interpret the contents of this table

              0. MedicationStatement
              2. MedicationStatement.basedOn
              TypeReference(NP Core MedicationRequest, NP Core Service Request, CarePlan)
              4. MedicationStatement.status
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:able-to-populateNP Core Creator
                SHALL:handleNP Core Consumer
                SHALL:handleNP Core Server
                6. MedicationStatement.medication[x]
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:able-to-populateNP Core Creator
                  SHALL:handleNP Core Consumer
                  SHALL:handleNP Core Server
                  SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                    8. MedicationStatement.medication[x]:medicationReference
                    Slice NamemedicationReference
                    Control0..1
                    TypeReference(NP Core Medication)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Must Supporttrue
                    10. MedicationStatement.medication[x]:medicationCodeableConcept
                    Slice NamemedicationCodeableConcept
                    Control0..1
                    BindingThe codes SHOULD be taken from Nepal Drug Value Set
                    (preferred to http://fhir.digitalhealth.gov.np/core/ValueSet/nepal-drug-vs)
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Must Supporttrue
                    12. MedicationStatement.subject
                    TypeReference(NP Core Patient)
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:able-to-populateNP Core Creator
                      SHALL:handleNP Core Consumer
                      SHALL:handleNP Core Server
                      14. MedicationStatement.context
                      TypeReference(NP Core Encounter)
                      16. MedicationStatement.effective[x]
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHOULD:able-to-populateNP Core Creator
                        SHALL:handleNP Core Consumer
                        SHALL:handleNP Core Server
                        18. MedicationStatement.informationSource
                        TypeReference(NP Core Patient, NP Core Practitioner, NP Core PractitionerRole, NP Core Organization, NP Core RelatedPerson)
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Obligations
                          ObligationsActor
                          SHOULD:able-to-populateNP Core Creator
                          SHALL:handleNP Core Consumer
                          SHALL:handleNP Core Server
                          20. MedicationStatement.reasonReference
                          TypeReference(NP Core Condition, NP Core Observation, NP Core Laboratory Report, DiagnosticReport)

                          See the documentation on how to interpret the contents of this table

                          0. MedicationStatement
                          Definition

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

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

                          ShortRecord of medication being taken by a patient
                          Comments

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

                          Control0..*
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                          dom-6: A resource should have narrative for robust management (text.`div`.exists())
                          2. MedicationStatement.id
                          Definition

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

                          ShortLogical id of this artifact
                          Comments

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

                          Control0..1
                          Typeid
                          Is Modifierfalse
                          Summarytrue
                          4. MedicationStatement.meta
                          Definition

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

                          ShortMetadata about the resource
                          Control0..1
                          TypeMeta
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          6. MedicationStatement.implicitRules
                          Definition

                          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                          ShortA set of rules under which this content was created
                          Comments

                          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                          Control0..1
                          Typeuri
                          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          8. MedicationStatement.language
                          Definition

                          The base language in which the resource is written.

                          ShortLanguage of the resource content
                          Comments

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

                          Control0..1
                          BindingThe codes SHOULD be taken from CommonLanguages
                          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          10. MedicationStatement.text
                          Definition

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

                          ShortText summary of the resource, for human interpretation
                          Comments

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

                          Control0..1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesnarrative, html, xhtml, display
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          12. MedicationStatement.contained
                          Definition

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

                          ShortContained, inline Resources
                          Comments

                          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

                          May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          16. MedicationStatement.modifierExtension
                          Definition

                          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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                          Summaryfalse
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          18. MedicationStatement.identifier
                          Definition

                          Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                          ShortExternal identifier
                          Comments

                          This is a business identifier, not a resource identifier.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          20. MedicationStatement.basedOn
                          Definition

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

                          ShortFulfils plan, proposal or order
                          Control0..*
                          TypeReference(NP Core MedicationRequest, NP Core Service Request, CarePlan)
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          22. MedicationStatement.partOf
                          Definition

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

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

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          24. MedicationStatement.status
                          Definition

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

                          Shortactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
                          Comments

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

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

                          Control1..1
                          BindingThe codes SHALL be taken from Medication Status Codes
                          (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

                          A coded concept indicating the current status of a MedicationStatement.

                          Typecode
                          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:able-to-populateNP Core Creator
                            SHALL:handleNP Core Consumer
                            SHALL:handleNP Core Server
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            26. MedicationStatement.statusReason
                            Definition

                            Captures the reason for the current state of the MedicationStatement.

                            ShortReason for current status
                            Comments

                            This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

                            Control0..*
                            BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodes
                            (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes|4.0.1)

                            A coded concept indicating the reason for the status of the statement.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            28. MedicationStatement.category
                            Definition

                            Indicates where the medication is expected to be consumed or administered.

                            ShortType of medication usage
                            Control0..1
                            BindingThe codes SHOULD be taken from Medication usage category codes
                            (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category|4.0.1)

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

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            30. MedicationStatement.medication[x]
                            Definition

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

                            ShortWhat medication was taken
                            Comments

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

                            Control1..1
                            BindingFor example codes, see SNOMEDCTMedicationCodes
                            (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                            A coded concept identifying the substance or product being taken.

                            TypeChoice of: CodeableConcept, Reference(Medication)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Obligations
                              ObligationsActor
                              SHALL:able-to-populateNP Core Creator
                              SHALL:handleNP Core Consumer
                              SHALL:handleNP Core Server
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                              • type @ $this
                              • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                                32. MedicationStatement.medication[x]:medicationReference
                                Slice NamemedicationReference
                                Definition

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

                                ShortWhat medication was taken
                                Comments

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

                                Control0..1
                                TypeReference(NP Core Medication)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                34. MedicationStatement.medication[x]:medicationCodeableConcept
                                Slice NamemedicationCodeableConcept
                                Definition

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

                                ShortWhat medication was taken
                                Comments

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

                                Control0..1
                                BindingThe codes SHOULD be taken from Nepal Drug Value Set
                                (preferred to http://fhir.digitalhealth.gov.np/core/ValueSet/nepal-drug-vs)
                                TypeCodeableConcept
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                36. MedicationStatement.subject
                                Definition

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

                                ShortWho is/was taking the medication
                                Control1..1
                                TypeReference(NP Core Patient)
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:able-to-populateNP Core Creator
                                  SHALL:handleNP Core Consumer
                                  SHALL:handleNP Core Server
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  38. MedicationStatement.context
                                  Definition

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

                                  ShortEncounter / Episode associated with MedicationStatement
                                  Control0..1
                                  TypeReference(NP Core Encounter)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  40. MedicationStatement.effective[x]
                                  Definition

                                  The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

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

                                  This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

                                  Control0..1
                                  TypeChoice of: dateTime, Period
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                  Obligations
                                    ObligationsActor
                                    SHOULD:able-to-populateNP Core Creator
                                    SHALL:handleNP Core Consumer
                                    SHALL:handleNP Core Server
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    42. MedicationStatement.dateAsserted
                                    Definition

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

                                    ShortWhen the statement was asserted?
                                    Control0..1
                                    TypedateTime
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    44. MedicationStatement.informationSource
                                    Definition

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

                                    ShortPerson or organization that provided the information about the taking of this medication
                                    Control0..1
                                    TypeReference(NP Core Patient, NP Core Practitioner, NP Core PractitionerRole, NP Core Organization, NP Core RelatedPerson)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                    Obligations
                                      ObligationsActor
                                      SHOULD:able-to-populateNP Core Creator
                                      SHALL:handleNP Core Consumer
                                      SHALL:handleNP Core Server
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      46. MedicationStatement.derivedFrom
                                      Definition

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

                                      ShortAdditional supporting information
                                      Comments

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

                                      Control0..*
                                      TypeReference(Resource)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      48. MedicationStatement.reasonCode
                                      Definition

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

                                      ShortReason for why the medication is being/was taken
                                      Comments

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

                                      Control0..*
                                      BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                      (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                      A coded concept identifying why the medication is being taken.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      50. MedicationStatement.reasonReference
                                      Definition

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

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

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

                                      Control0..*
                                      TypeReference(NP Core Condition, NP Core Observation, NP Core Laboratory Report, DiagnosticReport)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      52. MedicationStatement.note
                                      Definition

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

                                      ShortFurther information about the statement
                                      Control0..*
                                      TypeAnnotation
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      54. MedicationStatement.dosage
                                      Definition

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

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

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

                                      Control0..*
                                      TypeDosage
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))