An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

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.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

CDA R2 header specification templateId (specification package version).

Need to refer to a particular code in the system.

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.

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.

An Extension

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Lääkitysasiakirjan versiointinumero.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Lääkitysasiakirjan versiointinumero.

The creation time of a document.

Identifiers of medicine continuum: The identifier of the medicine in use and part identifier of medicine continuum.

An Extension

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Identifier.system is always case sensitive.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Automatically produced by the information system. Separates the different continuums of the same drug (that is, simultaneously used prescriptions for the same drug). As a rule, the drug used has only one medicine continuum at a time (only one active prescription). When it is necessary to have two or more active prescriptions for a drug, for example, when the patient uses two different strengths of the drug, the medicine continuums are separated by the part identifier of the medicine continuum.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Automatically produced by the information system. Separates the different continuums of the same drug (that is, simultaneously used prescriptions for the same drug). As a rule, the drug used has only one medicine continuum at a time (only one active prescription). When it is necessary to have two or more active prescriptions for a drug, for example, when the patient uses two different strengths of the drug, the medicine continuums are separated by the part identifier of the medicine continuum.

Information maintained by the Kanta Prescription Centre on what is the latest prescription in the medicine continuum. The value True says that the prescription is the latest prescription in the continuum.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Lääkkeen lopetuspäivämäärä ja tarvittaessa kellonaika. Päivämäärätieto kertoo lääkehoidon voimassaolon (riippumatta reseptin voimassaolosta). Lopetuspäivämäärä voidaan kirjata lääkkeen käytön lopettamishetkellä tai merkitä suunnitellusti tulevaisuuteen. Tietoa hyödynnetään lääkityslistan muodostamisessa ja potilaan voimassa olevan lääkityksen näyttämisessä.

Lääkkeen lopetuksen syy. THL - Lääkehoidon muutoksen syy -koodiston mukaan.

Lääkkeen lopetukseen liittyvät lisätiedot. Lopetuksen perumisen perustelu ja lopetuksen syynä olevan haittavaikutuksen lisäselvitys on voitu kirjata tähän.

Diagnosis code and the corresponding name for the adverse effect of the drug. According to the Kanta code system 'THL - Tautiluokitus ICD-10'. Repeated information, there may be several diagnosis codes linked to an adverse effect.

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).

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.

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.

Identifiers associated with this medication request 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.

This is a business identifier, not a resource identifier.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Unique identifier of the document of prescription discontinuation. The identifier may be, for example, a unique identifier of a particular version of the discontinuation document.

This is a business identifier, not a resource identifier.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Unique OID identifier of a document of prescription discontinuation.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

Identifier of the original document of prescription discontinuation that connects different versions of the document.

This is a business identifier, not a resource identifier.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Identifier of the original document of prescription discontinuation that connects different versions of the document.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

Information is encoded as values of the Kanta code system 'Sähköinen lääkemääräys - Lopettamismerkinnän voimassaolotila' (1.2.246.537.5.xxxxxx): 1 = active, 3 = completed, 4 = on-hold.

Used status values: active, cancelled, completed, on-hold

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

A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

This information describes the type of prescription message that is recorded in the prescription discontinuation. Information is encoded as a value of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

Identifies the reasons for a given status.

Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

OID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

Need to refer to a particular code in the system.

A standard value is used: order

It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

The kind of medication order.

Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

The category can be used to include where the medication is expected to be consumed or other types of requests.

A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

Indicates how quickly the Medication Request should be addressed with respect to other requests.

Identifies the level of importance to be assigned to actioning the request.

If true indicates that the provider is asking for the medication request not to occur.

If do not perform is not specified, the request is a positive request e.g. "do perform".

Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

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 or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

A link to a resource representing the person or set of individuals to whom the medication will be given.

The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

Include additional information (for example, patient height and weight) that supports the ordering of the medication.

The date (and perhaps time) when the prescription was initially written or authored on.

The individual, organization, or device that initiated the request and has responsibility for its activation.

The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

Indicates the type of performer of the administration of the medication.

If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

Identifies the type of individual that is desired to administer the medication.

The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

The reason or the indication for ordering or not ordering the medication.

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

A coded concept indicating why the medication was ordered.

Condition or observation that supports why the medication was ordered.

This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

A plan or request that is fulfilled in whole or in part by this medication request.

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

The description of the overall patte3rn of the administration of the medication to the patient.

This attribute should not be confused with the protocol of the medication.

Identifies the overall pattern of medication administratio.

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

Extra information about the prescription that could not be conveyed by the other attributes.

Indicates how the medication is to be used by the patient.

There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

A link to a resource representing an earlier order related order or prescription.

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

CDA R2 header specification templateId (specification package version).

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

The creation time of a document.

Identifiers of medicine continuum: The identifier of the medicine in use and part identifier of medicine continuum.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Unique identifier of the document of prescription discontinuation. The identifier may be, for example, a unique identifier of a particular version of the discontinuation document.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

Unique OID identifier of a document of prescription discontinuation.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

Identifier of the original document of prescription discontinuation that connects different versions of the document.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId).

Identifier of the original document of prescription discontinuation that connects different versions of the document.

Note. Here a separate namespace has been created, another option would have been to put urn:ietf:rfc:3986 as the system and encode identifiers with the type element (separate codes for id and setId). (If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.)

Information is encoded as values of the Kanta code system 'Sähköinen lääkemääräys - Lopettamismerkinnän voimassaolotila' (1.2.246.537.5.xxxxxx): 1 = active, 3 = completed, 4 = on-hold.

Used status values: active, cancelled, completed, on-hold

This information describes the type of prescription message that is recorded in the prescription discontinuation. Information is encoded as a value of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

OID of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi'.

Code of the Kanta code system 'Sähköinen lääkemääräys - Reseptisanoman tyyppi': 23 = Prescription discontinuation

A standard value is used: order

An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

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

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

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.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

When the resource last changed - e.g. when the version changed.

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

CDA R2 header specification templateId (specification package version).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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.

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.

The base language in which the resource is written.

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).

A human language.

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.

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.

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.

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.

An Extension

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Lääkitysasiakirjan versiointinumero.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Lääkitysasiakirjan versiointinumero.

The creation time of a document.

Identifiers of medicine continuum: The identifier of the medicine in use and part identifier of medicine continuum.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Automatically produced by an information system, a technical OID identifier that combines the entries of the same prescribed drug.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.