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4.14 Resource MedicationAdministration - Content

Pharmacy Work GroupMaturity Level: 0Compartments: 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.

4.14.1 Scope and Usage

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.

4.14.2 Boundaries and Relationships

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.

4.14.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration ΣDomainResourceAdministration of medication to a patient
... identifier Σ0..*IdentifierExternal identifier
... status ?! Σ1..1codein-progress | on-hold | completed | entered-in-error | stopped
MedicationAdministrationStatus (Required)
... patient Σ1..1Reference(Patient)Who received medication?
... practitioner Σ0..1Reference(Practitioner | Patient | RelatedPerson)Who administered substance?
... encounter Σ0..1Reference(Encounter)Encounter administered as part of
... prescription Σ0..1Reference(MedicationOrder)Order administration performed against
... wasNotGiven ?! Σ0..1booleanTrue if medication not administered
... reasonNotGiven Σ I0..*CodeableConceptReason administration not performed
Reason Medication Not Given Codes (Example)
Reason not given is only permitted if wasNotGiven is true
... reasonGiven Σ I0..*CodeableConceptReason administration performed
Reason Medication Given Codes (Example)
Reason given is only permitted if wasNotGiven is false
... effectiveTime[x] Σ1..1Start and end time of administration
.... effectiveTimeDateTimedateTime
.... effectiveTimePeriodPeriod
... medication[x] Σ1..1What was administered?
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... device Σ0..*Reference(Device)Device used to administer
... note Σ0..1stringInformation about the administration
... dosage Σ I0..1BackboneElementDetails of how medication was taken
SHALL have at least one of dosage.quantity and dosage.rate
.... text Σ0..1stringDosage Instructions
.... site[x] Σ0..1Body site administered to
SNOMED CT Anatomical Structure for Administration Site Codes (Example)
..... siteCodeableConceptCodeableConcept
..... siteReferenceReference(BodySite)
.... route Σ0..1CodeableConceptPath of substance into body
SNOMED CT Route Codes (Example)
.... method Σ0..1CodeableConceptHow drug was administered
.... quantity Σ0..1SimpleQuantityAmount administered in one dose
.... rate[x] Σ0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateRangeRange

doco Documentation for this format

UML Diagram

MedicationAdministration (DomainResource)External identifier - FHIR will generate its own internal IDs (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updatedidentifier : Identifier [0..*]Will 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 (this element modifies the meaning of other elements)status : code [1..1] « A set of codes indicating the current status of a MedicationAdministration (Strength=Required)MedicationAdministrationStatus! »The person or animal to whom the medication was givenpatient : Reference [1..1] « Patient »The individual who was responsible for giving the medication to the patientpractitioner : Reference [0..1] « Practitioner|Patient|RelatedPerson »The visit or admission the or other contact between patient and health care provider the medication administration was performed as part ofencounter : Reference [0..1] « Encounter »The original request, instruction or authority to perform the administrationprescription : Reference [0..1] « MedicationOrder »Set this to true if the record is saying that the medication was NOT administered (this element modifies the meaning of other elements)wasNotGiven : boolean [0..1]A code indicating why the administration was not performedreasonNotGiven : CodeableConcept [0..*] « A set of codes indicating the reason why the MedicationAdministration is negated. (Strength=Example)Reason Medication Not Given ?? »A code indicating why the medication was givenreasonGiven : CodeableConcept [0..*] « A set of codes indicating the reason why the MedicationAdministration was made. (Strength=Example)Reason Medication Given ?? »A 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 appropriateeffectiveTime[x] : Type [1..1] « dateTime|Period »Identifies 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 medicationsmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication) »The device used in administering the medication to the patient. E.g. a particular infusion pumpdevice : Reference [0..*] « Device »Extra information about the medication administration that is not conveyed by the other attributesnote : string [0..1]DosageFree text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medicationtext : string [0..1]A coded specification of the anatomic site where the medication first entered the body. E.g. "left arm"site[x] : Type [0..1] « CodeableConcept|Reference(BodySite); A coded concept describing the site location the medicine enters into or onto the body (Strength=Example)SNOMED CT Anatomical Structur...?? »A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. E.g. topical, intravenous, etcroute : CodeableConcept [0..1] « A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject (Strength=Example)SNOMED CT Route ?? »A 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. Examples: Slow Push, Deep IV. One 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 frequentlymethod : CodeableConcept [0..1]The 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 injectionquantity : Quantity(SimpleQuantity) [0..1]Identifies 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. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hoursrate[x] : Type [0..1] « Ratio|Range »Describes the medication dosage information details e.g. dose, rate, site, route, etcdosage[0..1]

XML Template

<MedicationAdministration xmlns="http://hl7.org/fhir"> doco
 <!-- 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

{doco
  "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

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration ΣDomainResourceAdministration of medication to a patient
... identifier Σ0..*IdentifierExternal identifier
... status ?! Σ1..1codein-progress | on-hold | completed | entered-in-error | stopped
MedicationAdministrationStatus (Required)
... patient Σ1..1Reference(Patient)Who received medication?
... practitioner Σ0..1Reference(Practitioner | Patient | RelatedPerson)Who administered substance?
... encounter Σ0..1Reference(Encounter)Encounter administered as part of
... prescription Σ0..1Reference(MedicationOrder)Order administration performed against
... wasNotGiven ?! Σ0..1booleanTrue if medication not administered
... reasonNotGiven Σ I0..*CodeableConceptReason administration not performed
Reason Medication Not Given Codes (Example)
Reason not given is only permitted if wasNotGiven is true
... reasonGiven Σ I0..*CodeableConceptReason administration performed
Reason Medication Given Codes (Example)
Reason given is only permitted if wasNotGiven is false
... effectiveTime[x] Σ1..1Start and end time of administration
.... effectiveTimeDateTimedateTime
.... effectiveTimePeriodPeriod
... medication[x] Σ1..1What was administered?
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... device Σ0..*Reference(Device)Device used to administer
... note Σ0..1stringInformation about the administration
... dosage Σ I0..1BackboneElementDetails of how medication was taken
SHALL have at least one of dosage.quantity and dosage.rate
.... text Σ0..1stringDosage Instructions
.... site[x] Σ0..1Body site administered to
SNOMED CT Anatomical Structure for Administration Site Codes (Example)
..... siteCodeableConceptCodeableConcept
..... siteReferenceReference(BodySite)
.... route Σ0..1CodeableConceptPath of substance into body
SNOMED CT Route Codes (Example)
.... method Σ0..1CodeableConceptHow drug was administered
.... quantity Σ0..1SimpleQuantityAmount administered in one dose
.... rate[x] Σ0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateRangeRange

doco Documentation for this format

UML Diagram

MedicationAdministration (DomainResource)External identifier - FHIR will generate its own internal IDs (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updatedidentifier : Identifier [0..*]Will 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 (this element modifies the meaning of other elements)status : code [1..1] « A set of codes indicating the current status of a MedicationAdministration (Strength=Required)MedicationAdministrationStatus! »The person or animal to whom the medication was givenpatient : Reference [1..1] « Patient »The individual who was responsible for giving the medication to the patientpractitioner : Reference [0..1] « Practitioner|Patient|RelatedPerson »The visit or admission the or other contact between patient and health care provider the medication administration was performed as part ofencounter : Reference [0..1] « Encounter »The original request, instruction or authority to perform the administrationprescription : Reference [0..1] « MedicationOrder »Set this to true if the record is saying that the medication was NOT administered (this element modifies the meaning of other elements)wasNotGiven : boolean [0..1]A code indicating why the administration was not performedreasonNotGiven : CodeableConcept [0..*] « A set of codes indicating the reason why the MedicationAdministration is negated. (Strength=Example)Reason Medication Not Given ?? »A code indicating why the medication was givenreasonGiven : CodeableConcept [0..*] « A set of codes indicating the reason why the MedicationAdministration was made. (Strength=Example)Reason Medication Given ?? »A 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 appropriateeffectiveTime[x] : Type [1..1] « dateTime|Period »Identifies 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 medicationsmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication) »The device used in administering the medication to the patient. E.g. a particular infusion pumpdevice : Reference [0..*] « Device »Extra information about the medication administration that is not conveyed by the other attributesnote : string [0..1]DosageFree text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medicationtext : string [0..1]A coded specification of the anatomic site where the medication first entered the body. E.g. "left arm"site[x] : Type [0..1] « CodeableConcept|Reference(BodySite); A coded concept describing the site location the medicine enters into or onto the body (Strength=Example)SNOMED CT Anatomical Structur...?? »A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. E.g. topical, intravenous, etcroute : CodeableConcept [0..1] « A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject (Strength=Example)SNOMED CT Route ?? »A 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. Examples: Slow Push, Deep IV. One 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 frequentlymethod : CodeableConcept [0..1]The 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 injectionquantity : Quantity(SimpleQuantity) [0..1]Identifies 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. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hoursrate[x] : Type [0..1] « Ratio|Range »Describes the medication dosage information details e.g. dose, rate, site, route, etcdosage[0..1]

XML Template

<MedicationAdministration xmlns="http://hl7.org/fhir"> doco
 <!-- 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

{doco
  "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

4.14.3.1 Terminology Bindings

PathDefinitionTypeReference
MedicationAdministration.status A set of codes indicating the current status of a MedicationAdministrationRequiredMedicationAdministrationStatus
MedicationAdministration.reasonNotGiven A set of codes indicating the reason why the MedicationAdministration is negated.ExampleReason Medication Not Given Codes
MedicationAdministration.reasonGiven A set of codes indicating the reason why the MedicationAdministration was made.ExampleReason Medication Given Codes
MedicationAdministration.dosage.site[x] A coded concept describing the site location the medicine enters into or onto the bodyExampleSNOMED 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 subjectExampleSNOMED CT Route Codes
MedicationAdministration.dosage.method A coded concept describing the technique by which the medicine is administeredUnknownNo details provided yet

4.14.3.2 Constraints

  • mad-1: On MedicationAdministration.dosage: SHALL have at least one of dosage.quantity and dosage.rate (xpath on f:MedicationAdministration/f:dosage: exists(f:quantity) or exists(f:rate))
  • mad-2: On MedicationAdministration.reasonNotGiven: Reason not given is only permitted if wasNotGiven is true (xpath on f:MedicationAdministration/f:reasonNotGiven: not(exists(f:reasonNotGiven) and f:wasNotGiven/@value='false'))
  • mad-3: On MedicationAdministration.reasonGiven: Reason given is only permitted if wasNotGiven is false (xpath on f:MedicationAdministration/f:reasonGiven: not(exists(f:reasonGiven) and f:wasNotGiven/@value='true'))

4.14.4 Known Issues

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.

4.14.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
codetokenReturn administrations of this medication codeMedicationAdministration.medicationCodeableConcept
devicereferenceReturn administrations with this administration device identityMedicationAdministration.device
(Device)
effectivetimedateDate administration happened (or did not happen)MedicationAdministration.effectiveTime[x]
encounterreferenceReturn administrations that share this encounterMedicationAdministration.encounter
(Encounter)
identifiertokenReturn administrations with this external identityMedicationAdministration.identifier
medicationreferenceReturn administrations of this medication resourceMedicationAdministration.medicationReference
(Medication)
notgiventokenAdministrations that were not madeMedicationAdministration.wasNotGiven
patientreferenceThe identity of a patient to list administrations forMedicationAdministration.patient
(Patient)
practitionerreferenceWho administered substance?MedicationAdministration.practitioner
(Patient, Practitioner, RelatedPerson)
prescriptionreferenceThe identity of a prescription to list administrations fromMedicationAdministration.prescription
(MedicationOrder)
statustokenMedicationAdministration event status (for example one of active/paused/completed/nullified)MedicationAdministration.status