HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG, published by New Zealand Medicines Formulary LP. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7NZ/nzf/ and changes regularly. See the Directory of published versions

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Resource Profile: Interaction Clincial Use Definition resource for NZ Formulary

Interaction Clincial Use Definition resource for NZ Formulary

Usage:

• This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from ClinicalUseDefinition

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition		0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
category		0..0
subject		1..1	Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance)	The medication or procedure for which this is an indication
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
contraindication		0..0
indication		0..0
interaction		1..1	BackboneElement	Specifics for when this is an interaction
Slices for extension		6..*	Extension	Extension Slice: Unordered, Open by value:url
severity		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-severity-code/vs (required)
warning		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-warning-code/vs (required)
evidence		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-evidence-code/vs (required)
modificationDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
reviewDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
textLink		1..1	string	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link
interactant		1..1	BackboneElement	The specific medication, food, substance or laboratory test that interacts
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
type		0..0
incidence		0..0
undesirableEffect		0..0
warning		0..0
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.
subject	Σ	1..1	Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance)	The medication or procedure for which this is an indication
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
interaction	Σ	1..1	BackboneElement	Specifics for when this is an interaction
Slices for extension		6..*	Extension	Extension Slice: Unordered, Open by value:url
severity		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-severity-code/vs (required)
warning		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-warning-code/vs (required)
evidence		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-evidence-code/vs (required)
modificationDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
reviewDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
textLink		1..1	string	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
interactant	Σ	1..1	BackboneElement	The specific medication, food, substance or laboratory test that interacts
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	Σ	1..1		The specific medication, food or laboratory test that interacts Binding: Interactant (example): An interactant - a substance that may have an clinically significant effect on another.
itemReference			Reference(MedicinalProductDefinition | Medication | Substance | ObservationDefinition)
itemCodeableConcept			CodeableConcept
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ClinicalUseDefinition.type	required	ClinicalUseDefinitionType http://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0 from the FHIR Standard
ClinicalUseDefinition.interaction.interactant.item[x]	example	Interactant http://hl7.org/fhir/ValueSet/interactant from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier for this issue
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.
subject	Σ	1..1	Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance)	The medication or procedure for which this is an indication
id		0..1	id	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
status	Σ	0..1	CodeableConcept	Whether this is a current issue or one that has been retired etc Binding: PublicationStatus (preferred): The lifecycle status of an artifact.
interaction	Σ	1..1	BackboneElement	Specifics for when this is an interaction
id		0..1	string	Unique id for inter-element referencing
Slices for extension		6..*	Extension	Extension Slice: Unordered, Open by value:url
severity		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-severity-code/vs (required)
warning		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-warning-code/vs (required)
evidence		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-evidence-code/vs (required)
modificationDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
reviewDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
textLink		1..1	string	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
interactant	Σ	1..1	BackboneElement	The specific medication, food, substance or laboratory test that interacts
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	Σ	1..1		The specific medication, food or laboratory test that interacts Binding: Interactant (example): An interactant - a substance that may have an clinically significant effect on another.
itemReference			Reference(MedicinalProductDefinition | Medication | Substance | ObservationDefinition)
itemCodeableConcept			CodeableConcept
effect	Σ	0..1	CodeableReference(ObservationDefinition)	The effect of the interaction, for example "reduced gastric absorption of primary medication" Binding: InteractionEffect (example): A interaction effect of clinical use of a medication or other substance.
management	Σ	0..*	CodeableConcept	Actions for managing the interaction Binding: InteractionManagement (example): A type of management for an interaction of a medication or other substance.
population	Σ	0..*	Reference(Group)	The population group to which this applies
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ClinicalUseDefinition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
ClinicalUseDefinition.type	required	ClinicalUseDefinitionType http://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0 from the FHIR Standard
ClinicalUseDefinition.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
ClinicalUseDefinition.status	preferred	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.contraindication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.relationshipType	preferred	TherapyRelationshipType http://hl7.org/fhir/ValueSet/therapy-relationship-type from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.therapy	example	Therapy http://hl7.org/fhir/ValueSet/therapy from the FHIR Standard
ClinicalUseDefinition.indication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.indication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.intendedEffect	preferred	ProductIntendedUse http://hl7.org/fhir/ValueSet/product-intended-use from the FHIR Standard
ClinicalUseDefinition.interaction.interactant.item[x]	example	Interactant http://hl7.org/fhir/ValueSet/interactant from the FHIR Standard
ClinicalUseDefinition.interaction.effect	example	InteractionEffect http://hl7.org/fhir/ValueSet/interaction-effect from the FHIR Standard
ClinicalUseDefinition.interaction.management	example	InteractionManagement http://hl7.org/fhir/ValueSet/interaction-management from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.symptomConditionEffect	example	UndesirableEffectSymptom http://hl7.org/fhir/ValueSet/undesirable-effect-symptom from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.classification	example	UndesirableEffectClassification http://hl7.org/fhir/ValueSet/undesirable-effect-classification from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrence	example	UndesirablEffectFrequency http://hl7.org/fhir/ValueSet/undesirable-effect-frequency from the FHIR Standard
ClinicalUseDefinition.warning.code	example	WarningType http://hl7.org/fhir/ValueSet/warning-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
dom-r4b	warning	ClinicalUseDefinition.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems : ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 13 elements
Prohibited: 7 elements

Extensions

This structure refers to these extensions:

• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link

Differential View

This structure is derived from ClinicalUseDefinition

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition		0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
category		0..0
subject		1..1	Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance)	The medication or procedure for which this is an indication
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
contraindication		0..0
indication		0..0
interaction		1..1	BackboneElement	Specifics for when this is an interaction
Slices for extension		6..*	Extension	Extension Slice: Unordered, Open by value:url
severity		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-severity-code/vs (required)
warning		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-warning-code/vs (required)
evidence		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-evidence-code/vs (required)
modificationDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
reviewDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
textLink		1..1	string	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link
interactant		1..1	BackboneElement	The specific medication, food, substance or laboratory test that interacts
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
type		0..0
incidence		0..0
undesirableEffect		0..0
warning		0..0
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.
subject	Σ	1..1	Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance)	The medication or procedure for which this is an indication
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
interaction	Σ	1..1	BackboneElement	Specifics for when this is an interaction
Slices for extension		6..*	Extension	Extension Slice: Unordered, Open by value:url
severity		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-severity-code/vs (required)
warning		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-warning-code/vs (required)
evidence		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-evidence-code/vs (required)
modificationDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
reviewDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
textLink		1..1	string	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
interactant	Σ	1..1	BackboneElement	The specific medication, food, substance or laboratory test that interacts
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	Σ	1..1		The specific medication, food or laboratory test that interacts Binding: Interactant (example): An interactant - a substance that may have an clinically significant effect on another.
itemReference			Reference(MedicinalProductDefinition | Medication | Substance | ObservationDefinition)
itemCodeableConcept			CodeableConcept
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ClinicalUseDefinition.type	required	ClinicalUseDefinitionType http://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0 from the FHIR Standard
ClinicalUseDefinition.interaction.interactant.item[x]	example	Interactant http://hl7.org/fhir/ValueSet/interactant from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ClinicalUseDefinition	C	0..*	ClinicalUseDefinition	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure cud-1: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier for this issue
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.
subject	Σ	1..1	Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance)	The medication or procedure for which this is an indication
id		0..1	id	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible)
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
status	Σ	0..1	CodeableConcept	Whether this is a current issue or one that has been retired etc Binding: PublicationStatus (preferred): The lifecycle status of an artifact.
interaction	Σ	1..1	BackboneElement	Specifics for when this is an interaction
id		0..1	string	Unique id for inter-element referencing
Slices for extension		6..*	Extension	Extension Slice: Unordered, Open by value:url
severity		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-severity-code/vs (required)
warning		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-warning-code/vs (required)
evidence		1..1	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code Binding: https://pharmaceuticalpress.com/ns/stockleys-interaction-evidence-code/vs (required)
modificationDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
reviewDate		1..1	date	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
textLink		1..1	string	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
interactant	Σ	1..1	BackboneElement	The specific medication, food, substance or laboratory test that interacts
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
route		1..*	CodeableConcept	Optional Extensions Element URL: http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
item[x]	Σ	1..1		The specific medication, food or laboratory test that interacts Binding: Interactant (example): An interactant - a substance that may have an clinically significant effect on another.
itemReference			Reference(MedicinalProductDefinition | Medication | Substance | ObservationDefinition)
itemCodeableConcept			CodeableConcept
effect	Σ	0..1	CodeableReference(ObservationDefinition)	The effect of the interaction, for example "reduced gastric absorption of primary medication" Binding: InteractionEffect (example): A interaction effect of clinical use of a medication or other substance.
management	Σ	0..*	CodeableConcept	Actions for managing the interaction Binding: InteractionManagement (example): A type of management for an interaction of a medication or other substance.
population	Σ	0..*	Reference(Group)	The population group to which this applies
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ClinicalUseDefinition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
ClinicalUseDefinition.type	required	ClinicalUseDefinitionType http://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0 from the FHIR Standard
ClinicalUseDefinition.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
ClinicalUseDefinition.status	preferred	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.contraindication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.relationshipType	preferred	TherapyRelationshipType http://hl7.org/fhir/ValueSet/therapy-relationship-type from the FHIR Standard
ClinicalUseDefinition.contraindication.otherTherapy.therapy	example	Therapy http://hl7.org/fhir/ValueSet/therapy from the FHIR Standard
ClinicalUseDefinition.indication.diseaseSymptomProcedure	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.diseaseStatus	example	DiseaseStatus http://hl7.org/fhir/ValueSet/disease-status from the FHIR Standard
ClinicalUseDefinition.indication.comorbidity	example	DiseaseSymptomProcedure http://hl7.org/fhir/ValueSet/disease-symptom-procedure from the FHIR Standard
ClinicalUseDefinition.indication.intendedEffect	preferred	ProductIntendedUse http://hl7.org/fhir/ValueSet/product-intended-use from the FHIR Standard
ClinicalUseDefinition.interaction.interactant.item[x]	example	Interactant http://hl7.org/fhir/ValueSet/interactant from the FHIR Standard
ClinicalUseDefinition.interaction.effect	example	InteractionEffect http://hl7.org/fhir/ValueSet/interaction-effect from the FHIR Standard
ClinicalUseDefinition.interaction.management	example	InteractionManagement http://hl7.org/fhir/ValueSet/interaction-management from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.symptomConditionEffect	example	UndesirableEffectSymptom http://hl7.org/fhir/ValueSet/undesirable-effect-symptom from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.classification	example	UndesirableEffectClassification http://hl7.org/fhir/ValueSet/undesirable-effect-classification from the FHIR Standard
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrence	example	UndesirablEffectFrequency http://hl7.org/fhir/ValueSet/undesirable-effect-frequency from the FHIR Standard
ClinicalUseDefinition.warning.code	example	WarningType http://hl7.org/fhir/ValueSet/warning-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cud-1	error	ClinicalUseDefinition	Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance : (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ClinicalUseDefinition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ClinicalUseDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ClinicalUseDefinition	A resource should have narrative for robust management : text.`div`.exists()
dom-r4b	warning	ClinicalUseDefinition.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems : ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 13 elements
Prohibited: 7 elements

Extensions

This structure refers to these extensions:

• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-route
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-severity-code
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-warning-code
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-evidence-code
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-modification-date
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-review-date
• http://hl7.org.nz/fhir/StructureDefinition/stockleys-interaction-text-link

Other representations of profile: CSV, Excel, Schematron