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Packageil.core.fhir.r4
Resource TypeMedicationStatement
IdMedicationStatement-MedicationStatement-SubDosageSteps-Invariant.json
FHIR VersionR4

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Narrative

Note: links and images are rebased to the (stated) source

Active medication statement demonstrating the use of ext-sub-dosage-step extension appearing twice, as required by the ilcore-dosage-ext invariant. Patient is taking Fluoxetine with a titration schedule decomposed into two sub-dosage steps.

Source1

{
  "resourceType": "MedicationStatement",
  "id": "MedicationStatement-SubDosageSteps-Invariant",
  "meta": {
    "profile": [
      "http://fhir.health.gov.il/StructureDefinition/il-core-medication-statement"
    ]
  },
  "extension": [
    {
      "url": "http://fhir.health.gov.il/StructureDefinition/ext-medication-course-of-therapy-type",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy",
            "code": "continuous",
            "display": "Continuous long term therapy"
          }
        ]
      }
    }
  ],
  "text": {
    "div": "<!-- snip (see above) -->",
    "status": "generated"
  },
  "status": "active",
  "category": {
    "coding": [
      {
        "code": "community-other",
        "system": "http://fhir.health.gov.il/cs/medication-category",
        "display": "Community Care/Long Term Care/Home"
      }
    ]
  },
  "medicationCodeableConcept": {
    "coding": [
      {
        "code": "372767007",
        "system": "http://snomed.info/sct",
        "display": "Fluoxetine (substance)"
      }
    ]
  },
  "informationSource": {
    "reference": "Practitioner/1",
    "type": "Practitioner"
  },
  "dateAsserted": "2022-07-30",
  "subject": {
    "reference": "Patient/patient-with-israeli-id",
    "type": "Patient",
    "display": "תמר כהן"
  },
  "context": {
    "reference": "Encounter/123",
    "type": "Encounter"
  },
  "effectivePeriod": {
    "start": "2022-10-05",
    "end": "2022-10-10"
  },
  "dosage": [
    {
      "text": "Fluoxetine titration - see sub-dosage steps",
      "route": {
        "coding": [
          {
            "code": "26643006",
            "system": "http://snomed.info/sct",
            "display": "Oral route"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "code": "738995006",
            "system": "http://snomed.info/sct",
            "display": "Swallow (administration method)"
          }
        ]
      },
      "timing": {
        "repeat": {
          "frequency": 1,
          "period": 1,
          "periodUnit": "d",
          "when": [
            "MORN"
          ]
        }
      },
      "extension": [
        {
          "url": "http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-steps",
          "valueDosage": {
            "text": "שלב ראשון: 10mg לשבועיים הראשונים",
            "timing": {
              "repeat": {
                "frequency": 1,
                "period": 1,
                "periodUnit": "d",
                "when": [
                  "MORN"
                ]
              }
            },
            "doseAndRate": [
              {
                "doseQuantity": {
                  "value": 10,
                  "unit": "mg",
                  "code": "mg",
                  "system": "http://unitsofmeasure.org"
                }
              }
            ]
          }
        },
        {
          "url": "http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-steps",
          "valueDosage": {
            "text": "שלב שני: 20mg מהשבוע השלישי",
            "timing": {
              "repeat": {
                "frequency": 1,
                "period": 1,
                "periodUnit": "d",
                "when": [
                  "MORN"
                ]
              }
            },
            "doseAndRate": [
              {
                "doseQuantity": {
                  "value": 20,
                  "unit": "mg",
                  "code": "mg",
                  "system": "http://unitsofmeasure.org"
                }
              }
            ]
          }
        }
      ]
    }
  ]
}