MedicationStatement

Overview

For the MedicationStatement resource query, the API returns a consolidated list of medications that the provider has defined for the patient. The list represents the most current discharge medication reconciliation (DMR) list the provider has charted in Soarian.

As the most current medication list, if a patient was taking a medication prior to admission or was given a medication during his or her stay, but during the discharge process the physician determined the medication no longer applies, it will be marked stopped. Soarian clients can configure a preference to only show active medications or to also show stopped medications.

To avoid patient confusion about the definitive active medication list, no in-progress medications during an active visit are returned; these medications are managed by providers. If there is an active visit without a DMR, an Informational Message indicating that Medication reconciliation has not been performed will be returned.

Terminology Bindings

Contained Medication Bindings

Medication.code
  • Description
    • A code that defines the type of medication.
  • Details: RxNorm
    System: http://www.nlm.nih.gov/research/umls/rxnorm

Custom Extensions

The bundle extension can be returned, see possible codes in the errors section below.

Status Extension:

The URL for this status extension is defined as http://cerner.hs.fhir.com/StructureDefinition/additional-status

ID Value[x] Type Description
additional-status string This element further qualifies medications that have a status of “active” by adding the more specific state of the MedicationOrder determined during medication reconciliation. Possible values are new, continued and modified.
GET /MedicationStatement?:parameters

Implementation Notes

Parameters

Name Required? Type Description
patientId Y reference The patient identifier provided in a pre-requisite authorization step.

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-myrecord.sandboxcerner.com/dstu2/123abc/MedicationStatement?patientId=393EC770-CFC9-4F5A-8B3A-784F2508F245

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "7b5ba1a8-8d5f-4122-83fb-1e6192d1662b",
  "meta": {
    "lastUpdated": "2016-07-29T15:55:32.360-04:00"
  },
  "extension": [
    {
      "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
      "valueExtension": {
        "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
        "extension": [
          {
            "url": "Severity",
            "valueString": "info"
          },
          {
            "url": "Code",
            "valueString": "papi025"
          },
          {
            "url": "Message",
            "valueString": "This is the most current, known medication list and may not reflect the state of medications known at a previous date. It is the responsibility of the patient or patient representative to confirm the list of medications with either the patient's personal care provider or the patient's follow-up care provider to ensure the patient has an appropriate list of medications to take at home."
          }
        ]
      }
    }
  ],
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "base-url/a7a929b8-2a11-4ed4-9803-c22906517844/MedicationStatement?patientId=393EC770-CFC9-4F5A-8B3A-784F2508F245&_format=json"
    }
  ],
  "entry": [
    {
      "resource": {
        "resourceType": "MedicationStatement",
        "text": {
          "status": "additional",
          "div": "<div>acetaminophen (Tylenol Extra Strength) 500 mg Tablet, Ordered By: Admin  Admin<br/>Directions: 2 tablet oral daily</div>"
        },
        "contained": [
          {
            "resourceType": "Medication",
            "id": "1",
            "code": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "code": "209459",
                  "display": "acetaminophen (Tylenol Extra Strength) 500 mg Tablet"
                }
              ]
            }
          }
        ],
        "identifier": [
          {
            "use": "official",
            "value": "I607_p_64533_1"
          }
        ],
        "patient": {
          "reference": "Patient/JacksonHerman324567"
        },
        "status": "active",
        "_status": {
          "extension": [
            {
              "url": "http://cerner.hs.fhir.com/StructureDefinition/additional-status",
              "valueString": "modified"
            }
          ]
        },
        "wasNotTaken": false,
        "medicationReference": {
          "reference": "#1",
          "display": "Medication/I607_p_64533_1"
        }
      }
    },
    {
      "resource": {
        "resourceType": "MedicationStatement",
        "text": {
          "status": "additional",
          "div": "<div>diltiazem HCl (Cardizem) 180 mg Tablet, Ordered By: Admin  Admin<br/>Directions: 1 tablet oral daily</div>"
        },
        "contained": [
          {
            "resourceType": "Medication",
            "id": "1",
            "code": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "display": "diltiazem HCl (Cardizem) 180 mg Tablet"
                }
              ]
            }
          }
        ],
        "identifier": [
          {
            "use": "official",
            "value": "I607_p_64533_3"
          }
        ],
        "patient": {
          "reference": "Patient/JacksonHerman324567"
        },
        "status": "active",
        "_status": {
          "extension": [
            {
              "url": "http://cerner.hs.fhir.com/StructureDefinition/additional-status",
              "valueString": "modified"
            }
          ]
        },
        "wasNotTaken": false,
        "medicationReference": {
          "reference": "#1",
          "display": "Medication/I607_p_64533_3"
        }
      }
    },
    {
      "resource": {
        "resourceType": "MedicationStatement",
        "text": {
          "status": "additional",
          "div": "<div>diltiazem HCl 180 mg Tablet Extended Release 24 hr, Held By: Admin  Admin<br/>Directions: 1 tablet oral twice a day</div>"
        },
        "contained": [
          {
            "resourceType": "Medication",
            "id": "1",
            "code": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "code": "830877",
                  "display": "diltiazem HCl 180 mg Tablet Extended Release 24 hr"
                }
              ]
            }
          }
        ],
        "identifier": [
          {
            "use": "official",
            "value": "I607_p_73019_0"
          }
        ],
        "patient": {
          "reference": "Patient/JacksonHerman324567"
        },
        "status": "intended",
        "wasNotTaken": true,
        "medicationReference": {
          "reference": "#1",
          "display": "Medication/I607_p_73019_0"
        }
      }
    },
    {
      "resource": {
        "resourceType": "MedicationStatement",
        "text": {
          "status": "additional",
          "div": "<div>atorvastatin 40 mg Tablet<br/>Directions: 1 tablet oral once</div>"
        },
        "contained": [
          {
            "resourceType": "Medication",
            "id": "1",
            "code": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "display": "atorvastatin 40 mg Tablet"
                }
              ]
            }
          }
        ],
        "identifier": [
          {
            "use": "official",
            "value": "I607_p_73020_0"
          }
        ],
        "patient": {
          "reference": "Patient/JacksonHerman324567"
        },
        "status": "completed",
        "wasNotTaken": true,
        "medicationReference": {
          "reference": "#1",
          "display": "Medication/I607_p_73020_0"
        }
      }
    }
  ]
}

Errors and Informational messages

The common errors and informational messages can be returned.

These additional informational messages may be returned within the bundle extension:

Code Message
papi023 No relevant clinical data exists.
papi024 Medication reconciliation has not been performed.