ERA FHIR specification
1.0.0 - draft
ERA FHIR specification - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2026-10-28 |
XML representation of the Extension-dosageChanges extension.
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="Extension-dosageChanges"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition Extension-dosageChanges</b></p><a name="Extension-dosageChanges"> </a><a name="hcExtension-dosageChanges"> </a><table border="0" cellpadding="0" cellspacing="0" class="xhtTableBorder0"><tr class="xhtRowBorder1"><th scope="col" style="" class="hierarchy xhtCellBorder0"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th scope="col" style="" class="hierarchy xhtCellBorder0"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th scope="col" style="" class="hierarchy xhtCellBorder0"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th scope="col" style="; width: 100px" class="hierarchy xhtCellBorder0"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th scope="col" style="" class="hierarchy xhtCellBorder0"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck1.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension" title="Additional information on the change and correction of medication:
Justification of the correction of prescription
Additional notes for the correction of prescription
The reason for the change in medication
Further information on the change in medication">Extension</a><a name="Extension"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">0</span><span class="xhtPieceDeEmphasized">..</span><span class="xhtPieceDeEmphasized">*</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a></td><td style="" class="hierarchy xhtCellBorder0">Additional information on the change and correction of medication</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck13.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension">Slices for extension</a><a name="Extension.extension"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">0..<span class="xhtPieceDeEmphasized">*</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/extensibility.html#Extension" class="xhtPieceDeEmphasized">Extension</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">Extension</span><br/><span class="xhtPieceBold">Slice: </span>Unordered, Open by value:url</td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck135.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="" style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonCode" title="Slice modificationReasonCode: Justification for correcting the prescription. Reason for correcting the prescription, when the prescription message is 3 = correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">extension:modificationReasonCode</a><a name="Extension.extension:modificationReasonCode"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">0..1</td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/extensibility.html#Extension" class="xhtPieceDeEmphasized">Extension</a></td><td style="" class="hierarchy xhtCellBorder0">Justification of the correction of prescription</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck1350.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:modificationReasonCode.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonCode.url">url</a><a name="Extension.extension:modificationReasonCode.url"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">1</span><span class="xhtPieceDeEmphasized">..</span><span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDarkGreen">"modificationReasonCode"</span></td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck1341.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="" style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:modificationReasonCode.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonCode.value[x]" title="Justification for correcting the prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">value[x]</a><a name="Extension.extension:modificationReasonCode.value_x_"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#Coding">Coding</a></td><td style="" class="hierarchy xhtCellBorder0">Justification of the correction of prescription</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck13410.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:modificationReasonCode.value[x].</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonCode.value[x].system" title="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">system</a><a name="Extension.extension:modificationReasonCode.value_x_.system"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0">OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'<br/><span class="xhtPieceBold">Fixed Value: </span><span class="xhtPieceDarkGreen">urn:oid:1.2.246.537.6.600.2013</span> (no extensions allowed)</td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck13400.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:modificationReasonCode.value[x].</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonCode.value[x].code" title="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">code</a><a name="Extension.extension:modificationReasonCode.value_x_.code"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#code" class="xhtPieceDeEmphasized">code</a></td><td style="" class="hierarchy xhtCellBorder0">Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck135.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonText" title="Slice modificationReasonText: Further information on the justification of the correction of prescription.">extension:modificationReasonText</a><a name="Extension.extension:modificationReasonText"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">0..1</td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/extensibility.html#Extension" class="xhtPieceDeEmphasized">Extension</a></td><td style="" class="hierarchy xhtCellBorder0">Further information on correction of prescription</td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck1350.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:modificationReasonText.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonText.url">url</a><a name="Extension.extension:modificationReasonText.url"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">1</span><span class="xhtPieceDeEmphasized">..</span><span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDarkGreen">"modificationReasonText"</span></td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck1340.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:modificationReasonText.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:modificationReasonText.value[x]" title="Further information on the justification of the correction of prescription.">value[x]</a><a name="Extension.extension:modificationReasonText.value_x_"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">Value of extension</span></td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck135.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="" style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonCode" title="Slice dosageChangeReasonCode: The reason for a change in medication, such as a change of dosage or product, and a correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">extension:dosageChangeReasonCode</a><a name="Extension.extension:dosageChangeReasonCode"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">0..1</td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/extensibility.html#Extension" class="xhtPieceDeEmphasized">Extension</a></td><td style="" class="hierarchy xhtCellBorder0">The reason for the change in medication</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck1350.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:dosageChangeReasonCode.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonCode.url">url</a><a name="Extension.extension:dosageChangeReasonCode.url"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">1</span><span class="xhtPieceDeEmphasized">..</span><span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDarkGreen">"dosageChangeReasonCode"</span></td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck1341.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="" style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:dosageChangeReasonCode.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonCode.value[x]" title="The reason for a change in medication, such as a change of dosage or product, and a correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">value[x]</a><a name="Extension.extension:dosageChangeReasonCode.value_x_"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#Coding">Coding</a></td><td style="" class="hierarchy xhtCellBorder0">The reason for the change in medication</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck13410.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:dosageChangeReasonCode.value[x].</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonCode.value[x].system" title="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'">system</a><a name="Extension.extension:dosageChangeReasonCode.value_x_.system"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0">OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'<br/><span class="xhtPieceBold">Fixed Value: </span><span class="xhtPieceDarkGreen">urn:oid:1.2.246.537.6.600.2013</span> (no extensions allowed)</td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck13400.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:dosageChangeReasonCode.value[x].</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonCode.value[x].code" title="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'.">code</a><a name="Extension.extension:dosageChangeReasonCode.value_x_.code"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#code" class="xhtPieceDeEmphasized">code</a></td><td style="" class="hierarchy xhtCellBorder0">Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'</td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck125.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonText" title="Slice dosageChangeReasonText: Additional information related to the change in medication. The further clarification of the adverse effect behind the change may have been recorded here.">extension:dosageChangeReasonText</a><a name="Extension.extension:dosageChangeReasonText"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">0..1</td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/extensibility.html#Extension" class="xhtPieceDeEmphasized">Extension</a></td><td style="" class="hierarchy xhtCellBorder0">Further information on the change in medication</td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck1250.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:dosageChangeReasonText.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonText.url">url</a><a name="Extension.extension:dosageChangeReasonText.url"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">1</span><span class="xhtPieceDeEmphasized">..</span><span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDarkGreen">"dosageChangeReasonText"</span></td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck1240.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.Slices for extension.extension:dosageChangeReasonText.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.extension:dosageChangeReasonText.value[x]" title="Additional information related to the change in medication. The further clarification of the adverse effect behind the change may have been recorded here.">value[x]</a><a name="Extension.extension:dosageChangeReasonText.value_x_"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0">1..<span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="" class="hierarchy xhtCellBorder0">Further information on the change in medication</td></tr>
<tr class="xhtRowBorder0 xhtRowEven"><td style="background-image: url(tbl_bck10.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.url">url</a><a name="Extension.url"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDeEmphasized">1</span><span class="xhtPieceDeEmphasized">..</span><span class="xhtPieceDeEmphasized">1</span></td><td style="" class="hierarchy xhtCellBorder0"><a href="http://hl7.org/fhir/R4/datatypes.html#uri" class="xhtPieceDeEmphasized">uri</a></td><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceDarkGreen">"http://resepti.kanta.fi/fhir/StructureDefinition/extension/dosageChanges"</span></td></tr>
<tr class="xhtRowBorder0 xhtRowOdd"><td style="background-image: url(tbl_bck00.png)" class="hierarchy xhtCellBorder0 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Extension.</span><a href="StructureDefinition-Extension-dosageChanges-definitions.html#Extension.value[x]" class="xhtPieceStrikeout">value[x]</a><a name="Extension.value_x_"> </a></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceStrikeout"/><span class="xhtPieceStrikeout xhtPieceDeEmphasized">0</span><span class="xhtPieceStrikeout">..</span><span class="xhtPieceStrikeout">0</span></td><td style="" class="hierarchy xhtCellBorder0"/><td style="" class="hierarchy xhtCellBorder0"><span class="xhtPieceItalic xhtPieceDeEmphasized">Value of extension</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<url
value="http://resepti.kanta.fi/fhir/StructureDefinition/extension/dosageChanges"/>
<version value="1.0.0"/>
<name value="DosageChanges"/>
<title value="Extension dosageChanges"/>
<status value="draft"/>
<date value="2026-10-28T11:52:12+00:00"/>
<publisher value="Atostek"/>
<contact>
<name value="Atostek"/>
<telecom>
<system value="url"/>
<value value="https://atostek.com/"/>
</telecom>
</contact>
<description
value="Additional information on the change and correction of medication:
Justification of the correction of prescription
Additional notes for the correction of prescription
The reason for the change in medication
Further information on the change in medication
[Source](https://simplifier.net/prescriptionr4/dosageChanges)"/>
<purpose
value="The dosageChanges extension is used in the MedicationRequest resource."/>
<fhirVersion value="4.0.1"/>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM Mapping"/>
</mapping>
<kind value="complex-type"/>
<abstract value="false"/>
<context>
<type value="element"/>
<expression value="MedicationRequest"/>
</context>
<type value="Extension"/>
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension"/>
<derivation value="constraint"/>
<snapshot>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
<valueString value="4.0.1"/>
</extension>
<element id="Extension">
<path value="Extension"/>
<short
value="Additional information on the change and correction of medication"/>
<definition
value="Additional information on the change and correction of medication:
Justification of the correction of prescription
Additional notes for the correction of prescription
The reason for the change in medication
Further information on the change in medication"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Extension"/>
<min value="0"/>
<max value="*"/>
</base>
<condition value="ele-1"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
</element>
<element id="Extension.id">
<path value="Extension.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension">
<path value="Extension.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Extension"/>
<definition value="An Extension"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.extension:modificationReasonCode">
<path value="Extension.extension"/>
<sliceName value="modificationReasonCode"/>
<short value="Justification of the correction of prescription"/>
<definition
value="Justification for correcting the prescription. Reason for correcting the prescription, when the prescription message is 3 = correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.extension:modificationReasonCode.id">
<path value="Extension.extension.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonCode.extension">
<path value="Extension.extension.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonCode.url">
<path value="Extension.extension.url"/>
<representation value="xmlAttr"/>
<short value="identifies the meaning of the extension"/>
<definition
value="Source of the definition for the extension code - a logical name or a URL."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.url"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<fixedUri value="modificationReasonCode"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonCode.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="Justification of the correction of prescription"/>
<definition
value="Justification for correcting the prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonCode.value[x].id">
<path value="Extension.extension.value[x].id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Extension.extension:modificationReasonCode.value[x].extension">
<path value="Extension.extension.value[x].extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonCode.value[x].system">
<path value="Extension.extension.value[x].system"/>
<short
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="urn:oid:1.2.246.537.6.600.2013"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element
id="Extension.extension:modificationReasonCode.value[x].version">
<path value="Extension.extension.value[x].version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonCode.value[x].code">
<path value="Extension.extension.value[x].code"/>
<short
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element
id="Extension.extension:modificationReasonCode.value[x].display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Extension.extension.value[x].display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Extension.extension:modificationReasonCode.value[x].userSelected">
<path value="Extension.extension.value[x].userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonText">
<path value="Extension.extension"/>
<sliceName value="modificationReasonText"/>
<short value="Further information on correction of prescription"/>
<definition
value="Further information on the justification of the correction of prescription."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.extension:modificationReasonText.id">
<path value="Extension.extension.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonText.extension">
<path value="Extension.extension.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonText.url">
<path value="Extension.extension.url"/>
<representation value="xmlAttr"/>
<short value="identifies the meaning of the extension"/>
<definition
value="Source of the definition for the extension code - a logical name or a URL."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.url"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<fixedUri value="modificationReasonText"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:modificationReasonText.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="Value of extension"/>
<definition
value="Further information on the justification of the correction of prescription."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode">
<path value="Extension.extension"/>
<sliceName value="dosageChangeReasonCode"/>
<short value="The reason for the change in medication"/>
<definition
value="The reason for a change in medication, such as a change of dosage or product, and a correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.extension:dosageChangeReasonCode.id">
<path value="Extension.extension.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode.extension">
<path value="Extension.extension.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode.url">
<path value="Extension.extension.url"/>
<representation value="xmlAttr"/>
<short value="identifies the meaning of the extension"/>
<definition
value="Source of the definition for the extension code - a logical name or a URL."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.url"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<fixedUri value="dosageChangeReasonCode"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="The reason for the change in medication"/>
<definition
value="The reason for a change in medication, such as a change of dosage or product, and a correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="Coding"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x].id">
<path value="Extension.extension.value[x].id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element
id="Extension.extension:dosageChangeReasonCode.value[x].extension">
<path value="Extension.extension.value[x].extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x].system">
<path value="Extension.extension.value[x].system"/>
<short
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<comment
value="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."/>
<requirements
value="Need to be unambiguous about the source of the definition of the symbol."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.system"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri value="urn:oid:1.2.246.537.6.600.2013"/>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.3"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystem"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
</mapping>
</element>
<element
id="Extension.extension:dosageChangeReasonCode.value[x].version">
<path value="Extension.extension.value[x].version"/>
<short value="Version of the system - if relevant"/>
<definition
value="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."/>
<comment
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.version"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.7"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./codeSystemVersion"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x].code">
<path value="Extension.extension.value[x].code"/>
<short
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<requirements
value="Need to refer to a particular code in the system."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Coding.code"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="code"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.1"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="./code"/>
</mapping>
<mapping>
<identity value="orim"/>
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
</mapping>
</element>
<element
id="Extension.extension:dosageChangeReasonCode.value[x].display">
<extension
url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true"/>
</extension>
<path value="Extension.extension.value[x].display"/>
<short value="Representation defined by the system"/>
<definition
value="A representation of the meaning of the code in the system, following the rules of the system."/>
<requirements
value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.display"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="C*E.2 - but note this is not well followed"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CV.displayName"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
</mapping>
</element>
<element
id="Extension.extension:dosageChangeReasonCode.value[x].userSelected">
<path value="Extension.extension.value[x].userSelected"/>
<short value="If this coding was chosen directly by the user"/>
<definition
value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
<comment
value="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."/>
<requirements
value="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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Coding.userSelected"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="true"/>
<mapping>
<identity value="v2"/>
<map value="Sometimes implied by being first"/>
</mapping>
<mapping>
<identity value="rim"/>
<map value="CD.codingRationale"/>
</mapping>
<mapping>
<identity value="orim"/>
<map
value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonText">
<path value="Extension.extension"/>
<sliceName value="dosageChangeReasonText"/>
<short value="Further information on the change in medication"/>
<definition
value="Additional information related to the change in medication. The further clarification of the adverse effect behind the change may have been recorded here."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.extension:dosageChangeReasonText.id">
<path value="Extension.extension.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonText.extension">
<path value="Extension.extension.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<xpath
value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonText.url">
<path value="Extension.extension.url"/>
<representation value="xmlAttr"/>
<short value="identifies the meaning of the extension"/>
<definition
value="Source of the definition for the extension code - a logical name or a URL."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.url"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<fixedUri value="dosageChangeReasonText"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.extension:dosageChangeReasonText.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="Further information on the change in medication"/>
<definition
value="Additional information related to the change in medication. The further clarification of the adverse effect behind the change may have been recorded here."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.url">
<path value="Extension.url"/>
<representation value="xmlAttr"/>
<short value="identifies the meaning of the extension"/>
<definition
value="Source of the definition for the extension code - a logical name or a URL."/>
<comment
value="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."/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.url"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<fixedUri
value="http://resepti.kanta.fi/fhir/StructureDefinition/extension/dosageChanges"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]"/>
<short value="Value of extension"/>
<definition
value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Extension.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="base64Binary"/>
</type>
<type>
<code value="boolean"/>
</type>
<type>
<code value="canonical"/>
</type>
<type>
<code value="code"/>
</type>
<type>
<code value="date"/>
</type>
<type>
<code value="dateTime"/>
</type>
<type>
<code value="decimal"/>
</type>
<type>
<code value="id"/>
</type>
<type>
<code value="instant"/>
</type>
<type>
<code value="integer"/>
</type>
<type>
<code value="markdown"/>
</type>
<type>
<code value="oid"/>
</type>
<type>
<code value="positiveInt"/>
</type>
<type>
<code value="string"/>
</type>
<type>
<code value="time"/>
</type>
<type>
<code value="unsignedInt"/>
</type>
<type>
<code value="uri"/>
</type>
<type>
<code value="url"/>
</type>
<type>
<code value="uuid"/>
</type>
<type>
<code value="Address"/>
</type>
<type>
<code value="Age"/>
</type>
<type>
<code value="Annotation"/>
</type>
<type>
<code value="Attachment"/>
</type>
<type>
<code value="CodeableConcept"/>
</type>
<type>
<code value="Coding"/>
</type>
<type>
<code value="ContactPoint"/>
</type>
<type>
<code value="Count"/>
</type>
<type>
<code value="Distance"/>
</type>
<type>
<code value="Duration"/>
</type>
<type>
<code value="HumanName"/>
</type>
<type>
<code value="Identifier"/>
</type>
<type>
<code value="Money"/>
</type>
<type>
<code value="Period"/>
</type>
<type>
<code value="Quantity"/>
</type>
<type>
<code value="Range"/>
</type>
<type>
<code value="Ratio"/>
</type>
<type>
<code value="Reference"/>
</type>
<type>
<code value="SampledData"/>
</type>
<type>
<code value="Signature"/>
</type>
<type>
<code value="Timing"/>
</type>
<type>
<code value="ContactDetail"/>
</type>
<type>
<code value="Contributor"/>
</type>
<type>
<code value="DataRequirement"/>
</type>
<type>
<code value="Expression"/>
</type>
<type>
<code value="ParameterDefinition"/>
</type>
<type>
<code value="RelatedArtifact"/>
</type>
<type>
<code value="TriggerDefinition"/>
</type>
<type>
<code value="UsageContext"/>
</type>
<type>
<code value="Dosage"/>
</type>
<type>
<code value="Meta"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<xpath value="@value|f:*|h:div"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
</snapshot>
<differential>
<element id="Extension">
<path value="Extension"/>
<short
value="Additional information on the change and correction of medication"/>
<definition
value="Additional information on the change and correction of medication:
Justification of the correction of prescription
Additional notes for the correction of prescription
The reason for the change in medication
Further information on the change in medication"/>
</element>
<element id="Extension.extension">
<path value="Extension.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<rules value="open"/>
</slicing>
<min value="0"/>
</element>
<element id="Extension.extension:modificationReasonCode">
<path value="Extension.extension"/>
<sliceName value="modificationReasonCode"/>
<short value="Justification of the correction of prescription"/>
<definition
value="Justification for correcting the prescription. Reason for correcting the prescription, when the prescription message is 3 = correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="0"/>
<max value="1"/>
</element>
<element id="Extension.extension:modificationReasonCode.url">
<path value="Extension.extension.url"/>
<fixedUri value="modificationReasonCode"/>
</element>
<element id="Extension.extension:modificationReasonCode.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="Justification of the correction of prescription"/>
<definition
value="Justification for correcting the prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
<type>
<code value="Coding"/>
</type>
</element>
<element id="Extension.extension:modificationReasonCode.value[x].system">
<path value="Extension.extension.value[x].system"/>
<short
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
<fixedUri value="urn:oid:1.2.246.537.6.600.2013"/>
</element>
<element id="Extension.extension:modificationReasonCode.value[x].code">
<path value="Extension.extension.value[x].code"/>
<short
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
</element>
<element id="Extension.extension:modificationReasonText">
<path value="Extension.extension"/>
<sliceName value="modificationReasonText"/>
<short value="Further information on correction of prescription"/>
<definition
value="Further information on the justification of the correction of prescription."/>
<min value="0"/>
<max value="1"/>
</element>
<element id="Extension.extension:modificationReasonText.url">
<path value="Extension.extension.url"/>
<fixedUri value="modificationReasonText"/>
</element>
<element id="Extension.extension:modificationReasonText.value[x]">
<path value="Extension.extension.value[x]"/>
<definition
value="Further information on the justification of the correction of prescription."/>
<min value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="Extension.extension:dosageChangeReasonCode">
<path value="Extension.extension"/>
<sliceName value="dosageChangeReasonCode"/>
<short value="The reason for the change in medication"/>
<definition
value="The reason for a change in medication, such as a change of dosage or product, and a correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="0"/>
<max value="1"/>
</element>
<element id="Extension.extension:dosageChangeReasonCode.url">
<path value="Extension.extension.url"/>
<fixedUri value="dosageChangeReasonCode"/>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="The reason for the change in medication"/>
<definition
value="The reason for a change in medication, such as a change of dosage or product, and a correction of prescription.
According to the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
<type>
<code value="Coding"/>
</type>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x].system">
<path value="Extension.extension.value[x].system"/>
<short
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="OID of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<min value="1"/>
<fixedUri value="urn:oid:1.2.246.537.6.600.2013"/>
</element>
<element id="Extension.extension:dosageChangeReasonCode.value[x].code">
<path value="Extension.extension.value[x].code"/>
<short
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'"/>
<definition
value="Code of the Kanta code system 'THL - Lääkehoidon muutoksen syy'."/>
<min value="1"/>
</element>
<element id="Extension.extension:dosageChangeReasonText">
<path value="Extension.extension"/>
<sliceName value="dosageChangeReasonText"/>
<short value="Further information on the change in medication"/>
<definition
value="Additional information related to the change in medication. The further clarification of the adverse effect behind the change may have been recorded here."/>
<min value="0"/>
<max value="1"/>
</element>
<element id="Extension.extension:dosageChangeReasonText.url">
<path value="Extension.extension.url"/>
<fixedUri value="dosageChangeReasonText"/>
</element>
<element id="Extension.extension:dosageChangeReasonText.value[x]">
<path value="Extension.extension.value[x]"/>
<short value="Further information on the change in medication"/>
<definition
value="Additional information related to the change in medication. The further clarification of the adverse effect behind the change may have been recorded here."/>
<min value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="Extension.url">
<path value="Extension.url"/>
<fixedUri
value="http://resepti.kanta.fi/fhir/StructureDefinition/extension/dosageChanges"/>
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]"/>
<max value="0"/>
</element>
</differential>
</StructureDefinition>