Profile Specific Implementation Guidance:

This Complex Extension is made up of three sub-extensions:

1. A required Medication Adherence Code, which is bound to the IE Core Medication Adherence ValueSet - a "starter" set of medication compliance SNOMED CT and NullValue codes. Its binding is extensible, and other concepts from SNOMED CT or another code system, including local codes, can be used. The table below illustrates basic scenarios of how an implementer can use them:

   Example Scenario	Medication Adherence Code (SCT ID)|Preferred Term
   The medication is being taken as directed.	1156699004|Complies with drug therapy (finding)
   The medication is being taken, but not as directed. For example, the patient occasionally forgets or takes two pills instead of three.	702565001|Non-compliance of drug therapy (finding)
   The medication is not being taken. For example, the patient did not pick up a prescription.	715036001|Does not take medication (finding)

2. A required date asserting when the information was provided
3. A Must Support information source code with an example binding to the IE Core Medication Adherence ValueSet - a "starter" set of informant role codes.

• Text Summary
• Differential Table
• Snapshot Table
• All

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints
Extension		0..*	Extension	IE Core Medication Adherence Extension
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:medicationAdherence	S	1..1	Extension	Medication adherence code
extension		0..0
url		1..1	uri	"medicationAdherence"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Medication Adherence (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.
extension:dateAsserted	S	1..1	Extension	When the medication adherence was asserted
extension		0..0
url		1..1	uri	"dateAsserted"
value[x]		1..1	dateTime	Value of extension
extension:informationSource	S	0..*	Extension	Who provided the information about the medication adherence
extension		0..0
url		1..1	uri	"informationSource"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Information Source for Medication Adherence (example): The person or organization that provided the information about the medication adherence
url		1..1	uri	"http://iehr.ai/fhir/ie/core/StructureDefinition/ie-core-medication-adherence"
value[x]		0..0
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Extension		0..*	Extension	IE Core Medication Adherence Extension
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:medicationAdherence	S	1..1	Extension	Medication adherence code
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"medicationAdherence"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Medication Adherence (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.
extension:dateAsserted	S	1..1	Extension	When the medication adherence was asserted
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"dateAsserted"
value[x]		1..1	dateTime	Value of extension
extension:informationSource	S	0..*	Extension	Who provided the information about the medication adherence
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"informationSource"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Information Source for Medication Adherence (example): The person or organization that provided the information about the medication adherence
url		1..1	uri	"http://iehr.ai/fhir/ie/core/StructureDefinition/ie-core-medication-adherence"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions as reported by a patient or on behalf of the patient.

• medicationAdherence: CodeableConcept: Code stating whether the patient is consuming medications according to instructions.
• dateAsserted: dateTime: When the medication adherence was asserted by the information source
• informationSource: CodeableConcept: The person or organization that provided the information about the medication adherence

Maturity: 3

Differential View

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints
Extension		0..*	Extension	IE Core Medication Adherence Extension
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:medicationAdherence	S	1..1	Extension	Medication adherence code
extension		0..0
url		1..1	uri	"medicationAdherence"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Medication Adherence (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.
extension:dateAsserted	S	1..1	Extension	When the medication adherence was asserted
extension		0..0
url		1..1	uri	"dateAsserted"
value[x]		1..1	dateTime	Value of extension
extension:informationSource	S	0..*	Extension	Who provided the information about the medication adherence
extension		0..0
url		1..1	uri	"informationSource"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Information Source for Medication Adherence (example): The person or organization that provided the information about the medication adherence
url		1..1	uri	"http://iehr.ai/fhir/ie/core/StructureDefinition/ie-core-medication-adherence"
value[x]		0..0
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Extension		0..*	Extension	IE Core Medication Adherence Extension
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:medicationAdherence	S	1..1	Extension	Medication adherence code
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"medicationAdherence"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Medication Adherence (extensible): This set of values contains terms representing whether a medication has been consumed according to instructions.
extension:dateAsserted	S	1..1	Extension	When the medication adherence was asserted
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"dateAsserted"
value[x]		1..1	dateTime	Value of extension
extension:informationSource	S	0..*	Extension	Who provided the information about the medication adherence
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"informationSource"
value[x]		1..1	CodeableConcept	Value of extension Binding: IE Core Information Source for Medication Adherence (example): The person or organization that provided the information about the medication adherence
url		1..1	uri	"http://iehr.ai/fhir/ie/core/StructureDefinition/ie-core-medication-adherence"
Documentation for this format