TEMPLATE IDCR - Medication Statement List.v1 (IDCR - Medication Statement List.v1)

TEMPLATE IDIDCR - Medication Statement List.v1
ConceptIDCR - Medication Statement List.v1
DescriptionThe primary intent is to support a continuously curated life-long ‘medication statement list ', as would be found in a GP system, PHR or other regional/national CDR but this should also be usable for episodic or departmental medication lists, which are generated at admission to a service e.g hospital admission, and maintained only during that episode of care or for that department. For clarity, this is NOT intended to be used in a prescribing system for the actual process of prescribing / dispensing, but is a static list of medications the patient is currently using/taking. It is also NOT intended to be used directly for the process of medication reconciliation, which would require some additional metadata.
PurposeThe primary intent is to support a continuously curated life-long ‘medication statement list ', as would be found in a GP system, PHR or other regional/national CDR but this should also be usable for episodic or departmental medication lists, which are generated at admission to a service e.g hospital admission, and maintained only during that episode of care or for that department. For clarity, this is NOT intended to be used in a prescribing system for the actual process of prescribing / dispensing, but is a static list of medications the patient is currently using/taking. It is also NOT intended to be used directly for the process of medication reconciliation, which would require some additional metadata.
References
OtherDetails Language Independent{MetaDataSet:Sample Set =Template metadata sample set}
Language useden
Citeable Identifier1051.57.143
AllOperationalTemplate [rootArchetypeId=openEHR-EHR-COMPOSITION.medication_list.v0, otherContributors=John Meredith; Tony Shannon; Shane McKee; Paul Miller; Susan Veitch; Ian McNicoll; Hildi McNicoll, tshis=[ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0], code=at0000, itemType=COMPOSITION, level=0, text=Medication statement list, description=A persistent and managed list of medications that are reasonably assumed to be taken by the individual and that may influence clinical decision-making and care provision., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=COMPOSITION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=null, code=null, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=1, text=Other Context, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0], code=at0000, itemType=CLUSTER, level=2, text=XDS Metadata, description=Additional composition metadata aligned with IHE-XDS which is not already available from the Reference Model COMPOSITION class., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=3, text=Author specialty, description=The speciality of the author/composer of the document., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0002], code=at0002, itemType=ELEMENT, level=3, text=Class code, description=A high-level document class code, normally selected from a valueset provided by the IHE-XDS Affinity Domain., comment=For example: Report, Summary, Images, Plan, Patient Preferences, Workflow. These codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0003], code=at0003, itemType=ELEMENT, level=3, text=Document type, description=The code specifying the precise type of document from the user perspective. Normally selected from a valueset provided by the local IHE-XDS Affinity Domain or national standard., comment=for example: Pulmonary History and Physical, Discharge Summary, Ultrasound Report. These codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=Default value: SNOMED-CT::163111000000100::Medication record, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0004], code=at0004, itemType=ELEMENT, level=3, text=Confidentiality code, description=A term specifying the level of confidentiality of the XDS Document., comment=Coded text is preferred, normally specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0007], code=at0007, itemType=ELEMENT, level=3, text=Health care facility type, description=A term defining the healthcare facility type., comment=Coded text is preferred. The codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0009], code=at0009, itemType=ELEMENT, level=3, text=Practice setting code, description=The code specifying the clinical specialty where the act that resulted in the document was performed., comment=For example: Family Practice, Laboratory, Radiology. Coded text is preferred, normally specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0011], code=at0011, itemType=ELEMENT, level=3, text=Event code, description=This list of codes represents the main clinical acts., comment=For example: Colonoscopy or appendicectomy., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/context/other_context[at0005]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0010], code=at0010, itemType=ELEMENT, level=3, text=Document_media, description=Additional metadata about the document itself, including size, url., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1], code=at0000, itemType=SECTION, level=1, text=Medication and medical devices, description=Medication and medical devices heading (AoMRC)., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=SECTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1], code=at0000, itemType=INSTRUCTION, level=2, text=Medication order, description=An order for a medication, vaccine, nutritional product or other therapeutic item for an identified individual., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=INSTRUCTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001], code=at0001, itemType=ACTIVITY, level=3, text=Order, description=Details of the requested order., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTIVITY, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002], code=at0002, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=4, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0070], code=at0070, itemType=ELEMENT, level=5, text=Medication item, description=Name of the medication, vaccine or other therapeutic/prescribable item being ordered., comment=Depending on the prescribing context this field could be used for either generic- or product-based prescribing. This data field can be used to record tightly bound orders of different medications when they are prescribed as a single pack. It is strongly recommended that the 'Medication item' be coded with a terminology capable of triggering decision support, where possible. The extent of coding may vary from the simple name of the medication item through to structured details about the actual medication pack to be used. Free text entry should only be used if there is no appropriate terminology available., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[openEHR-EHR-CLUSTER.medication.v0], code=at0000, itemType=CLUSTER, level=5, text=Medication, description=Details about a medication or component of a medication, including strength, form and details of any specific constituents., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[openEHR-EHR-CLUSTER.medication.v0]/items[at0071], code=at0071, itemType=ELEMENT, level=6, text=Form, description=The formulation or presentation of the medication or medication component., comment=For example: 'tablet', 'capsule', 'cream', 'infusion fluid' or 'inhalation powder'. Coding of the form with a terminology is preferred, where possible. Medicines catalogues may differentiate between administrable form 'solution for injection' and product form 'powder for solution for injection'. The recorded form will depend on the exact context of use but administrable form is likely to be used in most instances., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0091], code=at0091, itemType=ELEMENT, level=5, text=Route, description=The route by which the ordered item is to be administered into the subject's body., comment=For example: 'oral', 'intravenous', or 'topical'. Coding of the route with a terminology is preferred, where possible. Multiple potential routes may be specified., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0092], code=at0092, itemType=ELEMENT, level=5, text=Body site, description=Name of the site of administration of the ordered item., comment=For example: 'left upper arm', 'intravenous catheter right hand'. Coding of the body site with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0009], code=at0009, itemType=ELEMENT, level=5, text=Overall directions description, description=Complete narrative description about how the ordered item is to be used., comment=This narrative should normally subsume data captured in 'Dose amount', 'Dose timing' and any additional instructions for use. Where the medication dose directions are fully carried by the structured, computable dose directions, this element should carry the narrative equivalent, generally auto-generated. If it is not possible to represent the intended 'Dose direction' fully in computable form, partial representation is not recommended, and the directions should be only recorded in narrative form using this data element., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0173 and name/value='Dose amount description'], code=at0173, itemType=ELEMENT, level=5, text=Dose amount description, description=A narrative description of a specific part of overall directions., comment=In some settings, it is common to split overall narrative directions into more specific segments of narrative. For example in hospital settings, it can be common to split the overall directions into 'Dose amount' and 'Dose timing', both as narrative text. These terms can be applied at template or run-time., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0173 and name/value='Dose timing description'], code=at0173, itemType=ELEMENT, level=5, text=Dose timing description, description=A narrative description of a specific part of overall directions., comment=In some settings, it is common to split overall narrative directions into more specific segments of narrative. For example in hospital settings, it can be common to split the overall directions into 'Dose amount' and 'Dose timing', both as narrative text. These terms can be applied at template or run-time., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[openEHR-EHR-CLUSTER.therapeutic_direction.v1]/items[at0066], code=at0066, itemType=ELEMENT, level=5, text=Direction duration, description=The length of time for which this direction should be applied., comment=For example: 'for 7 days','Indefinite'. An example of a set of multiple directions, with varying durations might be ... '1 tablet daily for 3 days, 2 tablets daily for 4 days, then 3 tablets Indefinite'., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Coded Text
    • Indefinite 
    • Indefinite - not to be discontinued 
  •  Duration>=PT0S
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0044], code=at0044, itemType=ELEMENT, level=5, text=Additional instruction, description=An additional instruction on how to use or store the ordered item., comment=For example: precautions as 'take with food', 'Avoid grapefruit', 'Dissolve in water', 'store in a cool, dry place'. This data element allows multiple occurrences and should be coded with a reference terminology, where possible., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0105], code=at0105, itemType=ELEMENT, level=5, text=Patient information, description=An additional instruction directed primarily at the individual/patient or carers., comment=For example: 'To reduce your blood pressure', 'To thin your blood'. This data element allows multiple occurrences and should be coded with a reference terminology, where possible. If required it is possible to use a LINK attribute to associate this element with, for example, the 'original diagnosis' in a separate Problem list composition but the indication should be explicitly recorded here, as the link target may change over time., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0107], code=at0107, itemType=ELEMENT, level=5, text=Monitoring instruction, description=An additional instruction which gives advice on recommended or required monitoring of the ordered item., comment=For example: 'Please check renal function in 2 weeks'. This data element allows multiple occurrences., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0018], code=at0018, itemType=ELEMENT, level=5, text=Clinical indication, description=The clinical reason for use of the ordered item., comment=For example: 'Angina'. Coding of the clinical indication with a terminology is preferred, where possible. This data element allows multiple occurrences. It is not intended to carry an indication for administrative authorisation purposes., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0113], code=at0113, itemType=CLUSTER, level=5, text=Order details, description=Details about the whole medication order., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0113]/items[at0012], code=at0012, itemType=ELEMENT, level=6, text=Order start date/time, description=The date and optional time to commence use of the ordered item., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0113]/items[at0013], code=at0013, itemType=ELEMENT, level=6, text=Order stop date/time, description=The date and optional time when it is planned to cease use of the ordered item., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0113]/items[openEHR-EHR-CLUSTER.medication_order_summary.v0], code=at0000, itemType=CLUSTER, level=6, text=Order summary, description=Overall summary of the medication order., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-INSTRUCTION.medication_order.v1]/activities[at0001]/description[at0002]/items[at0113]/items[openEHR-EHR-CLUSTER.medication_order_summary.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=7, text=Order status, description=The overall status of this order., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Active 
  • Stopped 
  • Never active 
  • Completed 
  • Obsolete 
  • Suspended 
  • Draft 
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generic section header which should be renamed in a template to suit a specific clinical context., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=SECTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.exclusion_global.v1], code=at0000, itemType=EVALUATION, level=3, text=Exclusion - global, description=An overall statement of exclusion about all Problems/diagnoses, Family history, Medications, Procedures, Adverse reactions or other clinical items that are either not currently present, or have not been present in the past., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.exclusion_global.v1]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=4, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.exclusion_global.v1]/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=5, text=Global exclusion of medication use, description=Overall statement of exclusion about the use of all medications at the time of recording., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.exclusion_global.v1]/data[at0001]/items[at0011], code=at0011, itemType=ELEMENT, level=5, text=Comment, description=Additional comment not covered in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.absence.v1], code=at0000, itemType=EVALUATION, level=3, text=Absence of Information, description=Statement that specified health information is not available for inclusion in the health record or extract at the time of recording., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.absence.v1]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=4, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.absence.v1]/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=5, text=Absence statement, description=Positive statement that no information is available., comment=For example: "No information available about adverse reactions"; No information available about problems or diagnoses"; "No information available about previous procedures performed"; or "No information available about medications used"., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=Default value: No information for known medications and medical devices, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.absence.v1]/data[at0001]/items[at0005], code=at0005, itemType=ELEMENT, level=5, text=Reason for absence, description=Narrative description of the reason why there is no information available., comment=For example: patient is unconscious or refuses to provide information., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.medication_list.v0]/content[openEHR-EHR-SECTION.medication_medical_devices_rcp.v1]/items[openEHR-EHR-SECTION.adhoc.v1]/items[openEHR-EHR-EVALUATION.absence.v1]/protocol[at0003], code=at0003, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=4, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem 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