Release 5 Draft Ballot

This page is part of the FHIR Specification (v4.6.0: R5 Draft Ballot - see ballot notes). 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

11.5 Resource Medication - Content

Pharmacy Work GroupMaturity Level: 3 Trial UseSecurity Category: Business Compartments: Not linked to any defined compartments

This resource has been identified by it's owning workgroup as a normative candidate for R5. Ballot comment is requested on this.

This resource is primarily used for the identification and definition of a medication, including ingredients, for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

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 medication 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 by the form of the drug and the ingredient (or ingredients), as well as how it is packaged. The medication 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).

The Medication resource can be used to describe a compounded (aka extemporaneous or magistral) product that is manufactured by the pharmacy at the time of dispensing. In this case there will be multiple ingredients which are typically base chemicals (for example, hydrocortisone powder) and there may be other ingredients that are manufactured products (for example, Glaxal Base).

When a medication includes a package, further details about the composition can be provided. 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, AdverseEvent, CarePlan, ChargeItem, ChargeItemDefinition, ClinicalUseIssue, DiagnosticReport, Flag, Group, MedicationKnowledge, Observation, ResearchSubject and SupplyDelivery.

This resource does not implement any patterns.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication TUDomainResourceDefinition of a Medication
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier for this medication
... code Σ0..1CodeableConceptCodes that identify this medication
SNOMED CT Medication Codes (Example)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Medication Status Codes (Required)
... doseForm 0..1CodeableConceptpowder | tablets | capsule +
SNOMED CT Form Codes (Example)
... amount Σ0..1RatioAmount of drug in package
... ingredient 0..*BackboneElementActive or inactive ingredient
.... item 1..1CodeableReference(Substance | Medication)The ingredient (substance or medication) that the ingredient.strength relates to
.... isActive 0..1booleanActive ingredient indicator
.... strength[x] 0..1Quantity of ingredient present
Medication Ingredient Strength Codes (Example)
..... strengthRatioRatio
..... strengthCodeableConceptCodeableConcept
..... strengthQuantityQuantity
... batch 0..1BackboneElementDetails about packaged medications
.... lotNumber 0..1stringIdentifier assigned to batch
.... expirationDate 0..1dateTimeWhen batch will expire

doco Documentation for this format

UML Diagram (Legend)

Medication (DomainResource)Business identifier for this medicationidentifier : Identifier [0..*]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] « null (Strength=Example)SNOMEDCTMedicationCodes?? »A code to indicate if the medication is in active use (this element modifies the meaning of other elements)status : code [0..1] « null (Strength=Required)Medication Status ! »Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.  Describes the organization that is responsible for the manufacturing of the item and holds the registration to market the product in a jurisdiction.. This might not be the company that physically manufactures the product.  May be known as Market Authorization Holdersponsor : Reference [0..1] « Organization »Describes the form of the item. Powder; tablets; capsuledoseForm : CodeableConcept [0..1] « null (Strength=Example)SNOMEDCTFormCodes?? »Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)amount : Ratio [0..1]IngredientThe ingredient (substance or medication) that the ingredient.strength relates to. This is represented as a concept from a code system or described in another resource (Substance or Medication)item : DataType [1..1] « Substance|Medication »Indication of whether this ingredient affects the therapeutic action of the drugisActive : boolean [0..1]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 tablet but can also be expressed a quantity when the denominator is assumed to be 1 tabletstrength[x] : DataType [0..1] « Ratio|CodeableConcept|Quantity; null (Strength=Example) Medication Ingredient Strengt...?? »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]Identifies a particular constituent of interest in the productingredient[0..*]Information that only applies to packages (not products)batch[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 -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <sponsor><!-- 0..1 Reference(Organization) Organization responsible for manufacturing the item --></sponsor>
 <doseForm><!-- 0..1 CodeableConcept powder | tablets | capsule + --></doseForm>
 <amount><!-- 0..1 Ratio Amount of drug in package --></amount>
 <ingredient>  <!-- 0..* Active or inactive ingredient -->
  <item><!-- 1..1 CodeableReference(Medication|Substance) The ingredient (substance or medication) that the ingredient.strength relates to --></item>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <strength[x]><!-- 0..1 Ratio|CodeableConcept|Quantity Quantity of ingredient present --></strength[x]>
 </ingredient>
 <batch>  <!-- 0..1 Details about packaged medications -->
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
 </batch>
</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.identifier [ Identifier ], ... ; # 0..* Business identifier for this medication
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error
  fhir:Medication.sponsor [ Reference(Organization) ]; # 0..1 Organization responsible for manufacturing the item
  fhir:Medication.doseForm [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.amount [ Ratio ]; # 0..1 Amount of drug in package
  fhir:Medication.ingredient [ # 0..* Active or inactive ingredient
    fhir:Medication.ingredient.item [ CodeableReference(Medication|Substance) ]; # 1..1 The ingredient (substance or medication) that the ingredient.strength relates to
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    # Medication.ingredient.strength[x] : 0..1 Quantity of ingredient present. One of these 3
      fhir:Medication.ingredient.strengthRatio [ Ratio ]
      fhir:Medication.ingredient.strengthCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.strengthQuantity [ Quantity ]
  ], ...;
  fhir:Medication.batch [ # 0..1 Details about packaged medications
    fhir:Medication.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
    fhir:Medication.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
  ];
]

Changes since R3

Medication
Medication.status
  • Change value set from http://hl7.org/fhir/ValueSet/medication-status|4.0.0 to http://hl7.org/fhir/ValueSet/medication-status|4.6.0
Medication.sponsor
  • Added Element
Medication.doseForm
  • Added Element
Medication.ingredient.item
  • Added Mandatory Element
Medication.ingredient.strength[x]
  • Added Element
Medication.manufacturer
  • deleted
Medication.form
  • deleted
Medication.ingredient.item[x]
  • deleted
Medication.ingredient.strength
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 22 fail round-trip testing and 22 r3 resources are invalid (0 errors).)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication TUDomainResourceDefinition of a Medication
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier for this medication
... code Σ0..1CodeableConceptCodes that identify this medication
SNOMED CT Medication Codes (Example)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Medication Status Codes (Required)
... doseForm 0..1CodeableConceptpowder | tablets | capsule +
SNOMED CT Form Codes (Example)
... amount Σ0..1RatioAmount of drug in package
... ingredient 0..*BackboneElementActive or inactive ingredient
.... item 1..1CodeableReference(Substance | Medication)The ingredient (substance or medication) that the ingredient.strength relates to
.... isActive 0..1booleanActive ingredient indicator
.... strength[x] 0..1Quantity of ingredient present
Medication Ingredient Strength Codes (Example)
..... strengthRatioRatio
..... strengthCodeableConceptCodeableConcept
..... strengthQuantityQuantity
... batch 0..1BackboneElementDetails about packaged medications
.... lotNumber 0..1stringIdentifier assigned to batch
.... expirationDate 0..1dateTimeWhen batch will expire

doco Documentation for this format

UML Diagram (Legend)

Medication (DomainResource)Business identifier for this medicationidentifier : Identifier [0..*]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] « null (Strength=Example)SNOMEDCTMedicationCodes?? »A code to indicate if the medication is in active use (this element modifies the meaning of other elements)status : code [0..1] « null (Strength=Required)Medication Status ! »Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.  Describes the organization that is responsible for the manufacturing of the item and holds the registration to market the product in a jurisdiction.. This might not be the company that physically manufactures the product.  May be known as Market Authorization Holdersponsor : Reference [0..1] « Organization »Describes the form of the item. Powder; tablets; capsuledoseForm : CodeableConcept [0..1] « null (Strength=Example)SNOMEDCTFormCodes?? »Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)amount : Ratio [0..1]IngredientThe ingredient (substance or medication) that the ingredient.strength relates to. This is represented as a concept from a code system or described in another resource (Substance or Medication)item : DataType [1..1] « Substance|Medication »Indication of whether this ingredient affects the therapeutic action of the drugisActive : boolean [0..1]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 tablet but can also be expressed a quantity when the denominator is assumed to be 1 tabletstrength[x] : DataType [0..1] « Ratio|CodeableConcept|Quantity; null (Strength=Example) Medication Ingredient Strengt...?? »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]Identifies a particular constituent of interest in the productingredient[0..*]Information that only applies to packages (not products)batch[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 -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <sponsor><!-- 0..1 Reference(Organization) Organization responsible for manufacturing the item --></sponsor>
 <doseForm><!-- 0..1 CodeableConcept powder | tablets | capsule + --></doseForm>
 <amount><!-- 0..1 Ratio Amount of drug in package --></amount>
 <ingredient>  <!-- 0..* Active or inactive ingredient -->
  <item><!-- 1..1 CodeableReference(Medication|Substance) The ingredient (substance or medication) that the ingredient.strength relates to --></item>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <strength[x]><!-- 0..1 Ratio|CodeableConcept|Quantity Quantity of ingredient present --></strength[x]>
 </ingredient>
 <batch>  <!-- 0..1 Details about packaged medications -->
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
 </batch>
</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.identifier [ Identifier ], ... ; # 0..* Business identifier for this medication
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error
  fhir:Medication.sponsor [ Reference(Organization) ]; # 0..1 Organization responsible for manufacturing the item
  fhir:Medication.doseForm [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.amount [ Ratio ]; # 0..1 Amount of drug in package
  fhir:Medication.ingredient [ # 0..* Active or inactive ingredient
    fhir:Medication.ingredient.item [ CodeableReference(Medication|Substance) ]; # 1..1 The ingredient (substance or medication) that the ingredient.strength relates to
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    # Medication.ingredient.strength[x] : 0..1 Quantity of ingredient present. One of these 3
      fhir:Medication.ingredient.strengthRatio [ Ratio ]
      fhir:Medication.ingredient.strengthCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.strengthQuantity [ Quantity ]
  ], ...;
  fhir:Medication.batch [ # 0..1 Details about packaged medications
    fhir:Medication.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
    fhir:Medication.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
  ];
]

Changes since Release 3

Medication
Medication.status
  • Change value set from http://hl7.org/fhir/ValueSet/medication-status|4.0.0 to http://hl7.org/fhir/ValueSet/medication-status|4.6.0
Medication.sponsor
  • Added Element
Medication.doseForm
  • Added Element
Medication.ingredient.item
  • Added Mandatory Element
Medication.ingredient.strength[x]
  • Added Element
Medication.manufacturer
  • deleted
Medication.form
  • deleted
Medication.ingredient.item[x]
  • deleted
Medication.ingredient.strength
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 22 fail round-trip testing and 22 r3 resources are invalid (0 errors).)

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis a

PathDefinitionTypeReference
Medication.code ExampleSNOMEDCTMedicationCodes
Medication.status RequiredMedication Status Codes
Medication.doseForm ExampleSNOMEDCTFormCodes
Medication.ingredient.strength[x] ExampleMedication Ingredient Strength Codes

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

NameTypeDescriptionExpressionIn Common
codetokenReturns medications for a specific codeMedication.code
expiration-date NdateReturns medications in a batch with this expiration dateMedication.batch.expirationDate
formtokenReturns medications for a specific dose form
identifiertokenReturns medications with this external identifierMedication.identifier
ingredient DreferenceReturns medications for this ingredient referenceMedication.ingredient.item.reference
ingredient-code DtokenReturns medications for this ingredient codeMedication.ingredient.item.concept
lot-number NtokenReturns medications in a batch with this lot numberMedication.batch.lotNumber
sponsorreferenceReturns medications made or sold for this manufacturerMedication.sponsor
(Organization)
status NtokenReturns medications for this statusMedication.status