UKCoreMedicationAdministration (MedicationAdministration) | C | | MedicationAdministration | There are no (further) constraints on this element Element idMedicationAdministration Short descriptionAdministration of medication to a patient DefinitionDescribes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.
Data typeMedicationAdministration Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-3: 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 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(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - dom-6: A resource should have narrative for robust management
text.`div`.exists() Mappings- rim: Entity. Role, or Act
- workflow: Event
- rim: SubstanceAdministration
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.id Short descriptionLogical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
CommentsThe only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Data typestring |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationAdministration.meta Short descriptionMetadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Data typeMeta Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationAdministration.implicitRules Short descriptionA set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
CommentsAsserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.language Short descriptionLanguage of the resource content DefinitionThe base language in which the resource is written.
CommentsLanguage is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Data typecode BindingCommonLanguages (preferred) Binding extensionsConstraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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text | | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationAdministration.text Short descriptionText summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
CommentsContained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Data typeNarrative Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
contained | | 0..* | Resource | There are no (further) constraints on this element Element idMedicationAdministration.contained Short descriptionContained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
CommentsThis should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Data typeResource Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. 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.
CommentsThere 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.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
CommentsThere 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.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
identifier | S | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.identifier Short descriptionExternal identifier DefinitionIdentifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
CommentsThis is a business identifier, not a resource identifier.
Data typeIdentifier Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.identifier
- w5: FiveWs.identifier
- rim: .id
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instantiates | Σ | 0..* | uri | There are no (further) constraints on this element Element idMedicationAdministration.instantiates Short descriptionInstantiates protocol or definition DefinitionA protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.
Data typeuri Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.instantiates
- rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]
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partOf | Σ | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element idMedicationAdministration.partOf Short descriptionPart of referenced event DefinitionA larger event of which this particular event is a component or step.
Data typeReference(MedicationAdministration | Procedure) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.partOf
- rim: .outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.status Short descriptionin-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown DefinitionWill generally be set to show that the administration has been completed. For some long running administrations such as infusions, it is possible for an administration to be started but not completed or it may be paused while some other process is under way.
CommentsThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Data typecode BindingA set of codes indicating the current status of a MedicationAdministration.
MedicationAdministration Status Codes (required) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.status
- w5: FiveWs.status
- v2: RXA-20-Completion Status
- rim: .statusCode
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statusReason | | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.statusReason Short descriptionReason administration not performed DefinitionA code indicating why the administration was not performed.
Data typeCodeableConcept BindingA set of codes indicating the reason why the MedicationAdministration is negated.
SNOMEDCTReasonMedicationNotGivenCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.statusReason
- v2: RXA-9-Administration Notes / RXA-18 Substance/Treatment Refusal Reason
- rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason not given"].value
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category | | 0..1 | CodeableConceptBinding | Element idMedicationAdministration.category Short descriptionType of medication usage DefinitionIndicates where the medication is expected to be consumed or administered.
Data typeCodeableConcept BindingA coded concept describing where the medication administered is expected to occur.
UKCoreMedicationAdministrationCategory (extensible) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
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medication[x] | S Σ | 1..1 | Binding | Element idMedicationAdministration.medication[x] Short descriptionWhat was administered DefinitionIdentifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
CommentsIf only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
BindingCodes identifying substance or product that can be administered.
UKCoreMedicationCode (preferred) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.code
- w5: FiveWs.what[x]
- v2: RXA-5-Administered Code
- rim: .participation[typeCode=CSM].role[classCode=ADMM]
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medicationCodeableConcept | | | CodeableConcept | There are no (further) constraints on this element Data typeCodeableConcept |
medicationReference | | | Reference(Medication) | There are no (further) constraints on this element Data typeReference(Medication) |
subject | S Σ | 1..1 | Reference(Patient | Group) | There are no (further) constraints on this element Element idMedicationAdministration.subject Short descriptionWho received medication DefinitionThe person or animal or group receiving the medication.
Data typeReference(Patient | Group) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.subject
- w5: FiveWs.subject[x]
- v2: PID-3-Patient ID List
- rim: .participation[typeCode=SBJ].role[classCode=PAT]
- w5: FiveWs.subject
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context | | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationAdministration.context Short descriptionEncounter or Episode of Care administered as part of DefinitionThe visit, admission, or other contact between patient and health care provider during which the medication administration was performed.
Data typeReference(Encounter | EpisodeOfCare) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.context
- w5: FiveWs.context
- v2: PV1-19-Visit Number
- rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
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supportingInformation | | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationAdministration.supportingInformation Short descriptionAdditional information to support administration DefinitionAdditional information (for example, patient height and weight) that supports the administration of the medication.
Data typeReference(Resource) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- w5: FiveWs.context
- rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
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effective[x] | S Σ | 1..1 | | There are no (further) constraints on this element Element idMedicationAdministration.effective[x] Short descriptionStart and end time of administration DefinitionA specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.
Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.occurrence[x]
- w5: FiveWs.done[x]
- v2: RXA-3-Date/Time Start of Administration / RXA-4-Date/Time End of Administration
- rim: .effectiveTime
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effectiveDateTime | | | dateTime | There are no (further) constraints on this element Data typedateTime |
effectivePeriod | | | Period | There are no (further) constraints on this element Data typePeriod |
performer | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.performer Short descriptionWho performed the medication administration and what they did DefinitionIndicates who or what performed the medication administration and how they were involved.
Data typeBackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.performer
- w5: FiveWs.actor
- v2: RXA-10-Administering Provider / PRT-5-Participation Person: PRT-4-Participation='AP' (RXA-10 is deprecated)
- rim: .participation[typeCode=PRF]
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay 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.
CommentsThere 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.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
CommentsThere 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.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
function | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.performer.function Short descriptionType of performance DefinitionDistinguishes the type of involvement of the performer in the medication administration.
Data typeCodeableConcept BindingA code describing the role an individual played in administering the medication.
MedicationAdministration Performer Function Codes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.performer.function
- rim: participation[typeCode=PRF].functionCode
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actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor Short descriptionWho performed the medication administration DefinitionIndicates who or what performed the medication administration.
Data typeReference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.performer.actor
- rim: .role
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reasonCode | | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonCode Short descriptionReason administration performed DefinitionA code indicating why the medication was given.
Data typeCodeableConcept BindingA set of codes indicating the reason why the MedicationAdministration was made.
ReasonMedicationGivenCodes (example) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.reasonCode
- v2: RXE-27 Give Indication
- rim: .reasonCode
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reasonReference | | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element idMedicationAdministration.reasonReference Short descriptionCondition or observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered.
CommentsThis is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.
Data typeReference(Condition | Observation | DiagnosticReport) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.reasonReference
- w5: FiveWs.why[x]
- rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use ASSERTION"].value
- w3c.prov: no mapping
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request | | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationAdministration.request Short descriptionRequest administration performed against DefinitionThe original request, instruction or authority to perform the administration.
CommentsThis is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.
Data typeReference(MedicationRequest) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.basedOn
- v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
- rim: InFullfillmentOf->SubstanceAdministration
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device | | 0..* | Reference(Device) | There are no (further) constraints on this element Element idMedicationAdministration.device Short descriptionDevice used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump.
Data typeReference(Device) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: PRT-10 Participation Device / RXR-3 Administrative Device
- rim: device->Access OR device->AssignedDevice
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note | | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationAdministration.note Short descriptionInformation about the administration DefinitionExtra information about the medication administration that is not conveyed by the other attributes.
Data typeAnnotation Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- workflow: Event.note
- rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
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dosage | S C | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.dosage Short descriptionDetails of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
Data typeBackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
dose.exists() or rate.exists() Mappings- rim: component->SubstanceAdministrationEvent
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id | | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.id Short descriptionUnique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Data typestring Mappings |
extension | C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.extension Short descriptionAdditional content defined by implementations Alternate namesextensions, user content DefinitionMay 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.
CommentsThere 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.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.modifierExtension Short descriptionExtensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
RequirementsModifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
CommentsThere 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.
Data typeExtension Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists() Mappings |
text | | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.text Short descriptionFree text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.
The dosage instructions should reflect the dosage of the medication that was administered.
Data typestring Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings |
site | | 0..1 | CodeableConceptBinding | Element idMedicationAdministration.dosage.site Short descriptionBody site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm".
CommentsIf the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.
Data typeCodeableConcept BindingA coded concept describing the site location the medicine enters into or onto the body.
UKCoreBodySite (preferred) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier
- rim: .approachSiteCode
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route | | 0..1 | CodeableConceptBinding | Element idMedicationAdministration.dosage.route Short descriptionPath of substance into body DefinitionA code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.
Data typeCodeableConcept BindingA coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
UKCoreSubstanceOrProductAdministrationRoute (preferred) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXR-1-Route
- rim: .routeCode
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method | | 0..1 | CodeableConceptBinding | Element idMedicationAdministration.dosage.method Short descriptionHow drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.
CommentsOne of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.
Data typeCodeableConcept BindingA coded concept describing the technique by which the medicine is administered.
UKCoreMedicationDosageMethod (preferred) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXR-4-Administration Method
- rim: .methodCode
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dose | | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationAdministration.dosage.dose Short descriptionAmount of medication per dose DefinitionThe amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.
CommentsIf the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.
Data typeSimpleQuantity Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXA-6 Administered Amount / RXA-7 Administered Units
- rim: .doseQuantity
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rate[x] | | 0..1 | | There are no (further) constraints on this element Element idMedicationAdministration.dosage.rate[x] Short descriptionDose quantity per unit of time DefinitionIdentifies the speed with which the medication was or will be introduced into the patient. Typically, the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time, e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.
CommentsIf the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.
Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- v2: RXA-12-Administered Per (Time Unit)
- rim: .rateQuantity
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rateRatio | | | Ratio | There are no (further) constraints on this element Data typeRatio |
rateQuantity | | | SimpleQuantity | There are no (further) constraints on this element Data typeSimpleQuantity |
eventHistory | | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationAdministration.eventHistory Short descriptionA list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified.
CommentsThis might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
Data typeReference(Provenance) Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) Mappings- rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
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