STU 3 Ballot

This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). 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

11.1 Resource Medication - Content

Pharmacy Work GroupMaturity Level: 1Compartments: Not linked to any defined compartments

This resource is primarily used for the identification and definition of a medication. It covers the ingredients and the packaging for a medication.

11.1.1 Scope and Usage

Representing medications in the majority of healthcare settings is a matter of identifying an item from a list and then conveying a reference for the item selected either into a patient related resource or to other applications. Additional information about the medication is frequently provided for human verification, but a full representation of the details of composition and efficacy of the medicine is conveyed by referring to drug dictionaries by means of the codes they define. There are some occasions where it is necessary to identify slightly more detail, such as when dispensing a package containing a particular medicine requires identification both of the medicine and the package at once. There are also some occasions (e.g. custom formulations) where the composition of a medicine must be represented. In these cases the ingredients of the medicine have to be specified together with the amount contained, though the medication resource does not provide full details.

The Medication resource allows for medications to be characterized as either a product or a package or both. The product will include the ingredient(s) and their strength(s) and the package can include the amount (for example, number of tablets, volume, etc) that is contained in a particular container (for example, 100 capsules of Amoxicillin 500mg per bottle).

Depending on whether the medication is a product or a package, further details about the composition can be provided. A product has a form (tablet, suspension, etc.) and a list of ingredients with quantities. The ingredients may be other medications or substances. A package has a container (vacuum packed box, jar, etc.) and a list of the products or other packages that are in the package.

This resource is referenced by ActivityDefinition, CarePlan, Flag, Group, MedicationAdministration, MedicationDispense, MedicationOrder, MedicationStatement, Procedure, SupplyDelivery and SupplyRequest

11.1.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication DomainResourceDefinition of a Medication
... code Σ0..1CodeableConceptCodes that identify this medication
SNOMED CT Medication Codes (Example)
... isBrand Σ0..1booleanTrue if a brand
... manufacturer Σ0..1Reference(Organization)Manufacturer of the item
... product 0..1BackboneElementAdministrable medication details
.... form 0..1CodeableConceptpowder | tablets | carton +
SNOMED CT Form Codes (Example)
.... ingredient 0..*BackboneElementActive or inactive ingredient
..... item[x] 1..1The product contained
...... itemCodeableConceptCodeableConcept
...... itemReferenceReference(Substance | Medication)
..... amount 0..1RatioQuantity of ingredient present
.... batch 0..*BackboneElement
..... lotNumber 0..1string
..... expirationDate 0..1dateTime
... package 0..1BackboneElementDetails about packaged medications
.... container 0..1CodeableConceptE.g. box, vial, blister-pack
SNOMED CT Form Codes (Example)
.... content 0..*BackboneElementWhat is in the package
..... item[x] 1..1The item in the package
...... itemCodeableConceptCodeableConcept
...... itemReferenceReference(Medication)
..... amount 0..1SimpleQuantityQuantity present in the package

doco Documentation for this format

UML Diagram (Legend)

Medication (DomainResource)A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systemscode : CodeableConcept [0..1] « A coded concept that defines the type of a medication (Strength=Example)SNOMED CT Medication ?? »Set to true if the item is attributable to a specific manufacturerisBrand : boolean [0..1]Describes the details of the manufacturermanufacturer : Reference [0..1] « Organization »ProductDescribes the form of the item. Powder; tablets; cartonform : CodeableConcept [0..1] « A coded concept defining the form of a medication (Strength=Example)SNOMED CT Form ?? »IngredientThe actual ingredient - either a substance (simple ingredient) or another medicationitem[x] : Type [1..1] « CodeableConcept|Reference(Substance| Medication) »Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tabletamount : Ratio [0..1]BatchThe assigned lot number of a batch of the specified productlotNumber : string [0..1]When this specific batch of product will expireexpirationDate : dateTime [0..1]PackageThe kind of container that this package comes ascontainer : CodeableConcept [0..1] « A coded concept defining the kind of container a medication package is packaged in (Strength=Example)SNOMED CT Form ?? »ContentIdentifies one of the items in the packageitem[x] : Type [1..1] « CodeableConcept|Reference(Medication) »The amount of the product that is in the packageamount : Quantity(SimpleQuantity) [0..1]Identifies a particular constituent of interest in the productingredient[0..*]Information about a group of medication produced or packaged from one production runbatch[0..*]Information that only applies to products (not packages)product[0..1]A set of components that go to make up the described itemcontent[0..*]Information that only applies to packages (not products)package[0..1]

XML Template

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <isBrand value="[boolean]"/><!-- 0..1 True if a brand -->
 <manufacturer><!-- 0..1 Reference(Organization) Manufacturer of the item --></manufacturer>
 <product>  <!-- 0..1 Administrable medication details -->
  <form><!-- 0..1 CodeableConcept powder | tablets | carton + --></form>
  <ingredient>  <!-- 0..* Active or inactive ingredient -->
   <item[x]><!-- 1..1 CodeableConcept|Reference(Substance|Medication) The product contained --></item[x]>
   <amount><!-- 0..1 Ratio Quantity of ingredient present --></amount>
  </ingredient>
  <batch>  <!-- 0..* -->
   <lotNumber value="[string]"/><!-- 0..1  -->
   <expirationDate value="[dateTime]"/><!-- 0..1  -->
  </batch>
 </product>
 <package>  <!-- 0..1 Details about packaged medications -->
  <container><!-- 0..1 CodeableConcept E.g. box, vial, blister-pack --></container>
  <content>  <!-- 0..* What is  in the package -->
   <item[x]><!-- 1..1 CodeableConcept|Reference(Medication) The item in the package --></item[x]>
   <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity present in the package --></amount>
  </content>
 </package>
</Medication>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:Medication.isBrand [ boolean ]; # 0..1 True if a brand
  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Manufacturer of the item
  fhir:Medication.product [ # 0..1 Administrable medication details
    fhir:Medication.product.form [ CodeableConcept ]; # 0..1 powder | tablets | carton +
    fhir:Medication.product.ingredient [ # 0..* Active or inactive ingredient
      # Medication.product.ingredient.item[x] : 1..1 The product contained. One of these 2
        fhir:Medication.product.ingredient.itemCodeableConcept [ CodeableConcept ]
        fhir:Medication.product.ingredient.itemReference [ Reference(Substance|Medication) ]
      fhir:Medication.product.ingredient.amount [ Ratio ]; # 0..1 Quantity of ingredient present
    ], ...;
    fhir:Medication.product.batch [ # 0..* 
      fhir:Medication.product.batch.lotNumber [ string ]; # 0..1 
      fhir:Medication.product.batch.expirationDate [ dateTime ]; # 0..1 
    ], ...;
  ];
  fhir:Medication.package [ # 0..1 Details about packaged medications
    fhir:Medication.package.container [ CodeableConcept ]; # 0..1 E.g. box, vial, blister-pack
    fhir:Medication.package.content [ # 0..* What is  in the package
      # Medication.package.content.item[x] : 1..1 The item in the package. One of these 2
        fhir:Medication.package.content.itemCodeableConcept [ CodeableConcept ]
        fhir:Medication.package.content.itemReference [ Reference(Medication) ]
      fhir:Medication.package.content.amount [ Quantity(SimpleQuantity) ]; # 0..1 Quantity present in the package
    ], ...;
  ];
]

Changes since DSTU2

Medication
Medication.product.ingredient.item[x] Renamed from item to item[x]
Add CodeableConcept
Medication.package.content.item[x] Renamed from item to item[x]
Add CodeableConcept

See the Full Difference for further information

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication DomainResourceDefinition of a Medication
... code Σ0..1CodeableConceptCodes that identify this medication
SNOMED CT Medication Codes (Example)
... isBrand Σ0..1booleanTrue if a brand
... manufacturer Σ0..1Reference(Organization)Manufacturer of the item
... product 0..1BackboneElementAdministrable medication details
.... form 0..1CodeableConceptpowder | tablets | carton +
SNOMED CT Form Codes (Example)
.... ingredient 0..*BackboneElementActive or inactive ingredient
..... item[x] 1..1The product contained
...... itemCodeableConceptCodeableConcept
...... itemReferenceReference(Substance | Medication)
..... amount 0..1RatioQuantity of ingredient present
.... batch 0..*BackboneElement
..... lotNumber 0..1string
..... expirationDate 0..1dateTime
... package 0..1BackboneElementDetails about packaged medications
.... container 0..1CodeableConceptE.g. box, vial, blister-pack
SNOMED CT Form Codes (Example)
.... content 0..*BackboneElementWhat is in the package
..... item[x] 1..1The item in the package
...... itemCodeableConceptCodeableConcept
...... itemReferenceReference(Medication)
..... amount 0..1SimpleQuantityQuantity present in the package

doco Documentation for this format

UML Diagram (Legend)

Medication (DomainResource)A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systemscode : CodeableConcept [0..1] « A coded concept that defines the type of a medication (Strength=Example)SNOMED CT Medication ?? »Set to true if the item is attributable to a specific manufacturerisBrand : boolean [0..1]Describes the details of the manufacturermanufacturer : Reference [0..1] « Organization »ProductDescribes the form of the item. Powder; tablets; cartonform : CodeableConcept [0..1] « A coded concept defining the form of a medication (Strength=Example)SNOMED CT Form ?? »IngredientThe actual ingredient - either a substance (simple ingredient) or another medicationitem[x] : Type [1..1] « CodeableConcept|Reference(Substance| Medication) »Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tabletamount : Ratio [0..1]BatchThe assigned lot number of a batch of the specified productlotNumber : string [0..1]When this specific batch of product will expireexpirationDate : dateTime [0..1]PackageThe kind of container that this package comes ascontainer : CodeableConcept [0..1] « A coded concept defining the kind of container a medication package is packaged in (Strength=Example)SNOMED CT Form ?? »ContentIdentifies one of the items in the packageitem[x] : Type [1..1] « CodeableConcept|Reference(Medication) »The amount of the product that is in the packageamount : Quantity(SimpleQuantity) [0..1]Identifies a particular constituent of interest in the productingredient[0..*]Information about a group of medication produced or packaged from one production runbatch[0..*]Information that only applies to products (not packages)product[0..1]A set of components that go to make up the described itemcontent[0..*]Information that only applies to packages (not products)package[0..1]

XML Template

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <isBrand value="[boolean]"/><!-- 0..1 True if a brand -->
 <manufacturer><!-- 0..1 Reference(Organization) Manufacturer of the item --></manufacturer>
 <product>  <!-- 0..1 Administrable medication details -->
  <form><!-- 0..1 CodeableConcept powder | tablets | carton + --></form>
  <ingredient>  <!-- 0..* Active or inactive ingredient -->
   <item[x]><!-- 1..1 CodeableConcept|Reference(Substance|Medication) The product contained --></item[x]>
   <amount><!-- 0..1 Ratio Quantity of ingredient present --></amount>
  </ingredient>
  <batch>  <!-- 0..* -->
   <lotNumber value="[string]"/><!-- 0..1  -->
   <expirationDate value="[dateTime]"/><!-- 0..1  -->
  </batch>
 </product>
 <package>  <!-- 0..1 Details about packaged medications -->
  <container><!-- 0..1 CodeableConcept E.g. box, vial, blister-pack --></container>
  <content>  <!-- 0..* What is  in the package -->
   <item[x]><!-- 1..1 CodeableConcept|Reference(Medication) The item in the package --></item[x]>
   <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity present in the package --></amount>
  </content>
 </package>
</Medication>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:Medication.isBrand [ boolean ]; # 0..1 True if a brand
  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Manufacturer of the item
  fhir:Medication.product [ # 0..1 Administrable medication details
    fhir:Medication.product.form [ CodeableConcept ]; # 0..1 powder | tablets | carton +
    fhir:Medication.product.ingredient [ # 0..* Active or inactive ingredient
      # Medication.product.ingredient.item[x] : 1..1 The product contained. One of these 2
        fhir:Medication.product.ingredient.itemCodeableConcept [ CodeableConcept ]
        fhir:Medication.product.ingredient.itemReference [ Reference(Substance|Medication) ]
      fhir:Medication.product.ingredient.amount [ Ratio ]; # 0..1 Quantity of ingredient present
    ], ...;
    fhir:Medication.product.batch [ # 0..* 
      fhir:Medication.product.batch.lotNumber [ string ]; # 0..1 
      fhir:Medication.product.batch.expirationDate [ dateTime ]; # 0..1 
    ], ...;
  ];
  fhir:Medication.package [ # 0..1 Details about packaged medications
    fhir:Medication.package.container [ CodeableConcept ]; # 0..1 E.g. box, vial, blister-pack
    fhir:Medication.package.content [ # 0..* What is  in the package
      # Medication.package.content.item[x] : 1..1 The item in the package. One of these 2
        fhir:Medication.package.content.itemCodeableConcept [ CodeableConcept ]
        fhir:Medication.package.content.itemReference [ Reference(Medication) ]
      fhir:Medication.package.content.amount [ Quantity(SimpleQuantity) ]; # 0..1 Quantity present in the package
    ], ...;
  ];
]

Changes since DSTU2

Medication
Medication.product.ingredient.item[x] Renamed from item to item[x]
Add CodeableConcept
Medication.package.content.item[x] Renamed from item to item[x]
Add CodeableConcept

See the Full Difference for further information

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

11.1.2.1 Terminology Bindings

PathDefinitionTypeReference
Medication.code A coded concept that defines the type of a medicationExampleSNOMED CT Medication Codes
Medication.product.form A coded concept defining the form of a medicationExampleSNOMED CT Form Codes
Medication.package.container A coded concept defining the kind of container a medication package is packaged inExampleSNOMED CT Form Codes

11.1.3 Best practices for using 'Medication'

Medication does not have a status. Pharmacy is evaluating formulary use cases. Feedback is encouraged to the Pharmacy working group committee.

11.1.4 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
codetokenCodes that identify this medicationMedication.code
containertokenE.g. box, vial, blister-packMedication.package.container
formtokenpowder | tablets | carton +Medication.product.form
ingredientreferenceThe product containedMedication.product.ingredient.itemReference
(Medication, Substance)
ingredient-codetokenThe product containedMedication.product.ingredient.itemCodeableConcept
manufacturerreferenceManufacturer of the itemMedication.manufacturer
(Organization)
package-itemreferenceThe item in the packageMedication.package.content.itemReference
(Medication)
package-item-codetokenThe item in the packageMedication.package.content.itemCodeableConcept