This page is part of the FHIR Specification (v1.0.0: DSTU 2 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
Pharmacy Work Group | Maturity Level: 0 | Compartments: Device, Encounter, Patient, Practitioner |
Describes 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.
This resource covers the administration of all medications and vaccines. Please refer to the Immunization Resource/Profile for the treatment of vaccines. It will principally be used within care settings (including inpatient) to record the capture of medication administrations including self-administrations of oral medications, injections, intra-venous adjustments, etc. It can also be used in out-patient settings to record allergy shots and other non-immunization administrations. In some cases it might be used for home-health reporting, such as recording self-administered or even device-administered insulin.
The Medication domain includes a number of related resources
MedicationOrder | An order for both supply of the medication and the instructions for administration of the medicine to a patient. |
MedicationDispense | Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription). |
MedicationAdministration | When a patient actually consumes a medicine, or it is otherwise administered to them |
MedicationStatement | This is a record of medication being taken by a patient, or that the medication has been given to a patient where the record is the result of a report from the patient, or another clinician. A medication statement is not a part of the prescribe->dispense->administer sequence but is a report that such a sequence (or at least a part of it) did take place resulting in a belief that the patient has received a particular medication. |
MedicationAdministration is intended for tracking the administration of non-vaccine medications. Administration of vaccines is intended to be handled using the Immunization resource. Some systems treat immunizations in the same way as any other medication administration. Such systems SHOULD use an immunization resource to represent these. If systems need to use a MedicationAdministration resource to capture vaccinations for workflow or other reasons, they SHOULD also create and expose an equivalent Immunization instance.
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MedicationAdministration | Σ | DomainResource | Administration of medication to a patient | |
identifier | Σ | 0..* | Identifier | External identifier |
status | ?! Σ | 1..1 | code | in-progress | on-hold | completed | entered-in-error | stopped MedicationAdministrationStatus (Required) |
patient | Σ | 1..1 | Reference(Patient) | Who received medication? |
practitioner | Σ | 0..1 | Reference(Practitioner | Patient | RelatedPerson) | Who administered substance? |
encounter | Σ | 0..1 | Reference(Encounter) | Encounter administered as part of |
prescription | Σ | 0..1 | Reference(MedicationOrder) | Order administration performed against |
wasNotGiven | ?! Σ | 0..1 | boolean | True if medication not administered |
reasonNotGiven | Σ I | 0..* | CodeableConcept | Reason administration not performed Reason Medication Not Given Codes (Example) Reason not given is only permitted if wasNotGiven is true |
reasonGiven | Σ I | 0..* | CodeableConcept | Reason administration performed Reason Medication Given Codes (Example) Reason given is only permitted if wasNotGiven is false |
effectiveTime[x] | Σ | 1..1 | Start and end time of administration | |
effectiveTimeDateTime | dateTime | |||
effectiveTimePeriod | Period | |||
medication[x] | Σ | 1..1 | What was administered? | |
medicationCodeableConcept | CodeableConcept | |||
medicationReference | Reference(Medication) | |||
device | Σ | 0..* | Reference(Device) | Device used to administer |
note | Σ | 0..1 | string | Information about the administration |
dosage | Σ I | 0..1 | BackboneElement | Details of how medication was taken SHALL have at least one of dosage.quantity and dosage.rate |
text | Σ | 0..1 | string | Dosage Instructions |
site[x] | Σ | 0..1 | Body site administered to SNOMED CT Anatomical Structure for Administration Site Codes (Example) | |
siteCodeableConcept | CodeableConcept | |||
siteReference | Reference(BodySite) | |||
route | Σ | 0..1 | CodeableConcept | Path of substance into body SNOMED CT Route Codes (Example) |
method | Σ | 0..1 | CodeableConcept | How drug was administered |
quantity | Σ | 0..1 | SimpleQuantity | Amount administered in one dose |
rate[x] | Σ | 0..1 | Dose quantity per unit of time | |
rateRatio | Ratio | |||
rateRange | Range | |||
Documentation for this format |
UML Diagram
XML Template
<MedicationAdministration xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier External identifier --></identifier> <status value="[code]"/><!-- 1..1 in-progress | on-hold | completed | entered-in-error | stopped --> <patient><!-- 1..1 Reference(Patient) Who received medication? --></patient> <practitioner><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson) Who administered substance? --></practitioner> <encounter><!-- 0..1 Reference(Encounter) Encounter administered as part of --></encounter> <prescription><!-- 0..1 Reference(MedicationOrder) Order administration performed against --></prescription> <wasNotGiven value="[boolean]"/><!-- 0..1 True if medication not administered --> <reasonNotGiven><!-- 0..* CodeableConcept Reason administration not performed --></reasonNotGiven> <reasonGiven><!-- 0..* CodeableConcept Reason administration performed --></reasonGiven> <effectiveTime[x]><!-- 1..1 dateTime|Period Start and end time of administration --></effectiveTime[x]> <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What was administered? --></medication[x]> <device><!-- 0..* Reference(Device) Device used to administer --></device> <note value="[string]"/><!-- 0..1 Information about the administration --> <dosage> <!-- 0..1 Details of how medication was taken --> <text value="[string]"/><!-- 0..1 Dosage Instructions --> <site[x]><!-- 0..1 CodeableConcept|Reference(BodySite) Body site administered to --></site[x]> <route><!-- 0..1 CodeableConcept Path of substance into body --></route> <method><!-- 0..1 CodeableConcept How drug was administered --></method> <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount administered in one dose --></quantity> <rate[x]><!-- 0..1 Ratio|Range Dose quantity per unit of time --></rate[x]> </dosage> </MedicationAdministration>
JSON Template
{ "resourceType" : "MedicationAdministration", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // External identifier "status" : "<code>", // R! in-progress | on-hold | completed | entered-in-error | stopped "patient" : { Reference(Patient) }, // R! Who received medication? "practitioner" : { Reference(Practitioner|Patient|RelatedPerson) }, // Who administered substance? "encounter" : { Reference(Encounter) }, // Encounter administered as part of "prescription" : { Reference(MedicationOrder) }, // Order administration performed against "wasNotGiven" : <boolean>, // True if medication not administered "reasonNotGiven" : [{ CodeableConcept }], // C? Reason administration not performed "reasonGiven" : [{ CodeableConcept }], // C? Reason administration performed // effectiveTime[x]: Start and end time of administration. One of these 2: "effectiveTimeDateTime" : "<dateTime>", "effectiveTimePeriod" : { Period }, // medication[x]: What was administered?. One of these 2: "medicationCodeableConcept" : { CodeableConcept }, "medicationReference" : { Reference(Medication) }, "device" : [{ Reference(Device) }], // Device used to administer "note" : "<string>", // Information about the administration "dosage" : { // Details of how medication was taken "text" : "<string>", // Dosage Instructions // site[x]: Body site administered to. One of these 2: "siteCodeableConcept" : { CodeableConcept }, "siteReference" : { Reference(BodySite) }, "route" : { CodeableConcept }, // Path of substance into body "method" : { CodeableConcept }, // How drug was administered "quantity" : { Quantity(SimpleQuantity) }, // Amount administered in one dose // rate[x]: Dose quantity per unit of time. One of these 2: "rateRatio" : { Ratio } "rateRange" : { Range } } }
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MedicationAdministration | Σ | DomainResource | Administration of medication to a patient | |
identifier | Σ | 0..* | Identifier | External identifier |
status | ?! Σ | 1..1 | code | in-progress | on-hold | completed | entered-in-error | stopped MedicationAdministrationStatus (Required) |
patient | Σ | 1..1 | Reference(Patient) | Who received medication? |
practitioner | Σ | 0..1 | Reference(Practitioner | Patient | RelatedPerson) | Who administered substance? |
encounter | Σ | 0..1 | Reference(Encounter) | Encounter administered as part of |
prescription | Σ | 0..1 | Reference(MedicationOrder) | Order administration performed against |
wasNotGiven | ?! Σ | 0..1 | boolean | True if medication not administered |
reasonNotGiven | Σ I | 0..* | CodeableConcept | Reason administration not performed Reason Medication Not Given Codes (Example) Reason not given is only permitted if wasNotGiven is true |
reasonGiven | Σ I | 0..* | CodeableConcept | Reason administration performed Reason Medication Given Codes (Example) Reason given is only permitted if wasNotGiven is false |
effectiveTime[x] | Σ | 1..1 | Start and end time of administration | |
effectiveTimeDateTime | dateTime | |||
effectiveTimePeriod | Period | |||
medication[x] | Σ | 1..1 | What was administered? | |
medicationCodeableConcept | CodeableConcept | |||
medicationReference | Reference(Medication) | |||
device | Σ | 0..* | Reference(Device) | Device used to administer |
note | Σ | 0..1 | string | Information about the administration |
dosage | Σ I | 0..1 | BackboneElement | Details of how medication was taken SHALL have at least one of dosage.quantity and dosage.rate |
text | Σ | 0..1 | string | Dosage Instructions |
site[x] | Σ | 0..1 | Body site administered to SNOMED CT Anatomical Structure for Administration Site Codes (Example) | |
siteCodeableConcept | CodeableConcept | |||
siteReference | Reference(BodySite) | |||
route | Σ | 0..1 | CodeableConcept | Path of substance into body SNOMED CT Route Codes (Example) |
method | Σ | 0..1 | CodeableConcept | How drug was administered |
quantity | Σ | 0..1 | SimpleQuantity | Amount administered in one dose |
rate[x] | Σ | 0..1 | Dose quantity per unit of time | |
rateRatio | Ratio | |||
rateRange | Range | |||
Documentation for this format |
XML Template
<MedicationAdministration xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier External identifier --></identifier> <status value="[code]"/><!-- 1..1 in-progress | on-hold | completed | entered-in-error | stopped --> <patient><!-- 1..1 Reference(Patient) Who received medication? --></patient> <practitioner><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson) Who administered substance? --></practitioner> <encounter><!-- 0..1 Reference(Encounter) Encounter administered as part of --></encounter> <prescription><!-- 0..1 Reference(MedicationOrder) Order administration performed against --></prescription> <wasNotGiven value="[boolean]"/><!-- 0..1 True if medication not administered --> <reasonNotGiven><!-- 0..* CodeableConcept Reason administration not performed --></reasonNotGiven> <reasonGiven><!-- 0..* CodeableConcept Reason administration performed --></reasonGiven> <effectiveTime[x]><!-- 1..1 dateTime|Period Start and end time of administration --></effectiveTime[x]> <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What was administered? --></medication[x]> <device><!-- 0..* Reference(Device) Device used to administer --></device> <note value="[string]"/><!-- 0..1 Information about the administration --> <dosage> <!-- 0..1 Details of how medication was taken --> <text value="[string]"/><!-- 0..1 Dosage Instructions --> <site[x]><!-- 0..1 CodeableConcept|Reference(BodySite) Body site administered to --></site[x]> <route><!-- 0..1 CodeableConcept Path of substance into body --></route> <method><!-- 0..1 CodeableConcept How drug was administered --></method> <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount administered in one dose --></quantity> <rate[x]><!-- 0..1 Ratio|Range Dose quantity per unit of time --></rate[x]> </dosage> </MedicationAdministration>
JSON Template
{ "resourceType" : "MedicationAdministration", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // External identifier "status" : "<code>", // R! in-progress | on-hold | completed | entered-in-error | stopped "patient" : { Reference(Patient) }, // R! Who received medication? "practitioner" : { Reference(Practitioner|Patient|RelatedPerson) }, // Who administered substance? "encounter" : { Reference(Encounter) }, // Encounter administered as part of "prescription" : { Reference(MedicationOrder) }, // Order administration performed against "wasNotGiven" : <boolean>, // True if medication not administered "reasonNotGiven" : [{ CodeableConcept }], // C? Reason administration not performed "reasonGiven" : [{ CodeableConcept }], // C? Reason administration performed // effectiveTime[x]: Start and end time of administration. One of these 2: "effectiveTimeDateTime" : "<dateTime>", "effectiveTimePeriod" : { Period }, // medication[x]: What was administered?. One of these 2: "medicationCodeableConcept" : { CodeableConcept }, "medicationReference" : { Reference(Medication) }, "device" : [{ Reference(Device) }], // Device used to administer "note" : "<string>", // Information about the administration "dosage" : { // Details of how medication was taken "text" : "<string>", // Dosage Instructions // site[x]: Body site administered to. One of these 2: "siteCodeableConcept" : { CodeableConcept }, "siteReference" : { Reference(BodySite) }, "route" : { CodeableConcept }, // Path of substance into body "method" : { CodeableConcept }, // How drug was administered "quantity" : { Quantity(SimpleQuantity) }, // Amount administered in one dose // rate[x]: Dose quantity per unit of time. One of these 2: "rateRatio" : { Ratio } "rateRange" : { Range } } }
Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire
Path | Definition | Type | Reference |
---|---|---|---|
MedicationAdministration.status | A set of codes indicating the current status of a MedicationAdministration | Required | MedicationAdministrationStatus |
MedicationAdministration.reasonNotGiven | A set of codes indicating the reason why the MedicationAdministration is negated. | Example | Reason Medication Not Given Codes |
MedicationAdministration.reasonGiven | A set of codes indicating the reason why the MedicationAdministration was made. | Example | Reason Medication Given Codes |
MedicationAdministration.dosage.site[x] | A coded concept describing the site location the medicine enters into or onto the body | Example | SNOMED CT Anatomical Structure for Administration Site Codes |
MedicationAdministration.dosage.route | A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject | Example | SNOMED CT Route Codes |
MedicationAdministration.dosage.method | A coded concept describing the technique by which the medicine is administered | Unknown | No details provided yet |
Issue | Comments |
---|---|
Medication Resource | A medication will typically be referred to by means of a code drawn from a suitable Medicines Terminology. However on occasion a product will be required for which the "recipe" must be specified. This implies a requirement to deal with a choice of either a code or a much more complete resource. Currently that resource has not been created. |
Encounter | Administration records are usually tied to some wider grouping of care records. Encounter or Episode of Care is a common name for this. The present MedicationAdministration resource (and the other three yet to be built) link to an Encounter as an identifier, but it may be more appropriate for it to be a full resource. |
Contrast Media | Is this resource adequate for administering contrast media to a patient? |
Author (accountability) | Authorship (and any other accountability) is assumed to be dealt with by the standard FHIR methods. |
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
Name | Type | Description | Paths |
code | token | Return administrations of this medication code | MedicationAdministration.medicationCodeableConcept |
device | reference | Return administrations with this administration device identity | MedicationAdministration.device (Device) |
effectivetime | date | Date administration happened (or did not happen) | MedicationAdministration.effectiveTime[x] |
encounter | reference | Return administrations that share this encounter | MedicationAdministration.encounter (Encounter) |
identifier | token | Return administrations with this external identity | MedicationAdministration.identifier |
medication | reference | Return administrations of this medication resource | MedicationAdministration.medicationReference (Medication) |
notgiven | token | Administrations that were not made | MedicationAdministration.wasNotGiven |
patient | reference | The identity of a patient to list administrations for | MedicationAdministration.patient (Patient) |
practitioner | reference | Who administered substance? | MedicationAdministration.practitioner (Patient, Practitioner, RelatedPerson) |
prescription | reference | The identity of a prescription to list administrations from | MedicationAdministration.prescription (MedicationOrder) |
status | token | MedicationAdministration event status (for example one of active/paused/completed/nullified) | MedicationAdministration.status |