STU3 Candidate

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11.1 Resource Medication - Content

Pharmacy

Work Group

Maturity Level: 1

Compartments: 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, MedicationRequest, MedicationStatement, Procedure, SupplyDelivery and SupplyRequest

Structure

Name	Flags	Card.	Type	Description & Constraints
Medication			DomainResource	Definition of a Medication
code	Σ	0..1	CodeableConcept	Codes that identify this medication SNOMED CT Medication Codes (Example)
isBrand	Σ	0..1	boolean	True if a brand
manufacturer	Σ	0..1	Reference(Organization)	Manufacturer of the item
product		0..1	BackboneElement	Administrable medication details
form		0..1	CodeableConcept	powder \| tablets \| capsule + SNOMED CT Form Codes (Example)
ingredient		0..*	BackboneElement	Active or inactive ingredient
item[x]		1..1		The product contained
itemCodeableConcept			CodeableConcept
itemReference			Reference(Substance \| Medication)
amount		0..1	Ratio	Quantity of ingredient present
batch		0..*	BackboneElement	Identifies a single production run
lotNumber		0..1	string	Identifier assigned to batch
expirationDate		0..1	dateTime	When batch will expire
package		0..1	BackboneElement	Details about packaged medications
container		0..1	CodeableConcept	E.g. box, vial, blister-pack SNOMED CT Form Codes (Example)
content		0..*	BackboneElement	What is in the package
item[x]		1..1		The item in the package
itemCodeableConcept			CodeableConcept
itemReference			Reference(Medication)
amount		0..1	SimpleQuantity	Quantity present in the package
Documentation for this format

UML Diagram (Legend)

XML Template

<Medication xmlns="http://hl7.org/fhir"> 
 <!-- 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 | capsule + --></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..* Identifies a single production run -->
   <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
   <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
  </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>

JSON Template

{
  "resourceType" : "Medication",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "code" : { CodeableConcept }, // Codes that identify this medication
  "isBrand" : <boolean>, // True if a brand
  "manufacturer" : { Reference(Organization) }, // Manufacturer of the item
  "product" : { // Administrable medication details
    "form" : { CodeableConcept }, // powder | tablets | capsule +
    "ingredient" : [{ // Active or inactive ingredient
      // item[x]: The product contained. One of these 2:
      "itemCodeableConcept" : { CodeableConcept },
      "itemReference" : { Reference(Substance|Medication) },
      "amount" : { Ratio } // Quantity of ingredient present
    }],
    "batch" : [{ // Identifies a single production run
      "lotNumber" : "<string>", // Identifier assigned to batch
      "expirationDate" : "<dateTime>" // When batch will expire
    }]
  },
  "package" : { // Details about packaged medications
    "container" : { CodeableConcept }, // E.g. box, vial, blister-pack
    "content" : [{ // What is  in the package
      // item[x]: The item in the package. One of these 2:
      "itemCodeableConcept" : { CodeableConcept },
      "itemReference" : { Reference(Medication) },
      "amount" : { Quantity(SimpleQuantity) } // Quantity present in the package
    }]
  }
}

Turtle Template

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


[ 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 | capsule +
    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..* Identifies a single production run
      fhir:Medication.product.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
      fhir:Medication.product.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
    ], ...;
  ];
  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

Name	Flags	Card.	Type	Description & Constraints
Medication			DomainResource	Definition of a Medication
code	Σ	0..1	CodeableConcept	Codes that identify this medication SNOMED CT Medication Codes (Example)
isBrand	Σ	0..1	boolean	True if a brand
manufacturer	Σ	0..1	Reference(Organization)	Manufacturer of the item
product		0..1	BackboneElement	Administrable medication details
form		0..1	CodeableConcept	powder \| tablets \| capsule + SNOMED CT Form Codes (Example)
ingredient		0..*	BackboneElement	Active or inactive ingredient
item[x]		1..1		The product contained
itemCodeableConcept			CodeableConcept
itemReference			Reference(Substance \| Medication)
amount		0..1	Ratio	Quantity of ingredient present
batch		0..*	BackboneElement	Identifies a single production run
lotNumber		0..1	string	Identifier assigned to batch
expirationDate		0..1	dateTime	When batch will expire
package		0..1	BackboneElement	Details about packaged medications
container		0..1	CodeableConcept	E.g. box, vial, blister-pack SNOMED CT Form Codes (Example)
content		0..*	BackboneElement	What is in the package
item[x]		1..1		The item in the package
itemCodeableConcept			CodeableConcept
itemReference			Reference(Medication)
amount		0..1	SimpleQuantity	Quantity present in the package
Documentation for this format

UML Diagram (Legend)

XML Template

<Medication xmlns="http://hl7.org/fhir"> 
 <!-- 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 | capsule + --></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..* Identifies a single production run -->
   <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
   <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
  </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>

JSON Template

{
  "resourceType" : "Medication",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "code" : { CodeableConcept }, // Codes that identify this medication
  "isBrand" : <boolean>, // True if a brand
  "manufacturer" : { Reference(Organization) }, // Manufacturer of the item
  "product" : { // Administrable medication details
    "form" : { CodeableConcept }, // powder | tablets | capsule +
    "ingredient" : [{ // Active or inactive ingredient
      // item[x]: The product contained. One of these 2:
      "itemCodeableConcept" : { CodeableConcept },
      "itemReference" : { Reference(Substance|Medication) },
      "amount" : { Ratio } // Quantity of ingredient present
    }],
    "batch" : [{ // Identifies a single production run
      "lotNumber" : "<string>", // Identifier assigned to batch
      "expirationDate" : "<dateTime>" // When batch will expire
    }]
  },
  "package" : { // Details about packaged medications
    "container" : { CodeableConcept }, // E.g. box, vial, blister-pack
    "content" : [{ // What is  in the package
      // item[x]: The item in the package. One of these 2:
      "itemCodeableConcept" : { CodeableConcept },
      "itemReference" : { Reference(Medication) },
      "amount" : { Quantity(SimpleQuantity) } // Quantity present in the package
    }]
  }
}

Turtle Template

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


[ 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 | capsule +
    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..* Identifies a single production run
      fhir:Medication.product.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
      fhir:Medication.product.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
    ], ...;
  ];
  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), JSON-LD (for RDF as JSON-LD),

11.1.2.1 Terminology Bindings

Path	Definition	Type	Reference
Medication.code	A coded concept that defines the type of a medication	Example	SNOMED CT Medication Codes
Medication.product.form	A coded concept defining the form of a medication	Example	SNOMED CT Form Codes
Medication.package.container	A coded concept defining the kind of container a medication package is packaged in	Example	SNOMED CT Form Codes

Path

Definition

Type

Reference

Medication.code

A coded concept that defines the type of a medication

Example

SNOMED CT Medication Codes

Medication.product.form

A coded concept defining the form of a medication

Example

SNOMED CT Form Codes

Medication.package.container

A coded concept defining the kind of container a medication package is packaged in

Example

SNOMED 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.

Name	Type	Description	Paths	In Common
code	token	Codes that identify this medication	Medication.code	4 Resources
container	token	E.g. box, vial, blister-pack	Medication.package.container
form	token	powder \| tablets \| capsule +	Medication.product.form
ingredient	reference	The product contained	Medication.product.ingredient.itemReference (Medication, Substance)
ingredient-code	token	The product contained	Medication.product.ingredient.itemCodeableConcept
manufacturer	reference	Manufacturer of the item	Medication.manufacturer (Organization)
package-item	reference	The item in the package	Medication.package.content.itemReference (Medication)
package-item-code	token	The item in the package	Medication.package.content.itemCodeableConcept