Release 4B Snapshot #1

This page is part of the FHIR Specification v4.3.0-snapshot1: R4B Snapshot to support the Jan 2022 Connectathon. About the R4B version of FHIR. The current officially released version is 4.3.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Pharmacy Work GroupMaturity Level: 0 Trial UseSecurity Category: Business Compartments: Not linked to any defined compartments

Detailed Descriptions for the elements in the MedicationKnowledge resource.

MedicationKnowledge
Element IdMedicationKnowledge
Definition

Information about a medication that is used to support knowledge.

Cardinality0..*
TypeDomainResource
Summaryfalse
MedicationKnowledge.code
Element IdMedicationKnowledge.code
Definition

A code that specifies 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 systems.

Cardinality0..1
Terminology BindingSNOMED CT Medication Codes (Example)
TypeCodeableConcept
Summarytrue
Comments

Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

MedicationKnowledge.status
Element IdMedicationKnowledge.status
Definition

A code to indicate if the medication is in active use. The status refers to the validity about the information of the medication and not to its medicinal properties.

Cardinality0..1
Terminology BindingMedicationKnowledge Status Codes (Required)
Typecode
Is Modifiertrue (Reason: This element changes the interpretation of all descriptive attributes.)
Summarytrue
Comments

This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

MedicationKnowledge.manufacturer
Element IdMedicationKnowledge.manufacturer
Definition

Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.

Cardinality0..1
TypeReference(Organization)
Summarytrue
MedicationKnowledge.doseForm
Element IdMedicationKnowledge.doseForm
Definition

Describes the form of the item. Powder; tablets; capsule.

Cardinality0..1
Terminology BindingSNOMED CT Form Codes (Example)
TypeCodeableConcept
Summaryfalse
Comments

When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

MedicationKnowledge.amount
Element IdMedicationKnowledge.amount
Definition

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.).

Cardinality0..1
TypeSimpleQuantity
Summarytrue
Comments

This is the quantity of medication in a package. To specify the strength of the medication, the Ingredient.strength attribute is used.

MedicationKnowledge.synonym
Element IdMedicationKnowledge.synonym
Definition

Additional names for a medication, for example, the name(s) given to a medication in different countries. For example, acetaminophen and paracetamol or salbutamol and albuterol.

Cardinality0..*
Typestring
Summarytrue
MedicationKnowledge.relatedMedicationKnowledge
Element IdMedicationKnowledge.relatedMedicationKnowledge
Definition

Associated or related knowledge about a medication.

Cardinality0..*
Summaryfalse
MedicationKnowledge.relatedMedicationKnowledge.type
Element IdMedicationKnowledge.relatedMedicationKnowledge.type
Definition

The category of the associated medication knowledge reference.

Cardinality1..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.relatedMedicationKnowledge.reference
Element IdMedicationKnowledge.relatedMedicationKnowledge.reference
Definition

Associated documentation about the associated medication knowledge.

Cardinality1..*
TypeReference(MedicationKnowledge)
Summaryfalse
MedicationKnowledge.associatedMedication
Element IdMedicationKnowledge.associatedMedication
Definition

Associated or related medications. For example, if the medication is a branded product (e.g. Crestor), this is the Therapeutic Moeity (e.g. Rosuvastatin) or if this is a generic medication (e.g. Rosuvastatin), this would link to a branded product (e.g. Crestor).

Cardinality0..*
TypeReference(Medication)
Summaryfalse
MedicationKnowledge.productType
Element IdMedicationKnowledge.productType
Definition

Category of the medication or product (e.g. branded product, therapeutic moeity, generic product, innovator product, etc.).

Cardinality0..*
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.monograph
Element IdMedicationKnowledge.monograph
Definition

Associated documentation about the medication.

Cardinality0..*
Summaryfalse
MedicationKnowledge.monograph.type
Element IdMedicationKnowledge.monograph.type
Definition

The category of documentation about the medication. (e.g. professional monograph, patient education monograph).

Cardinality0..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.monograph.source
Element IdMedicationKnowledge.monograph.source
Definition

Associated documentation about the medication.

Cardinality0..1
TypeReference(DocumentReference | Media)
Summaryfalse
MedicationKnowledge.ingredient
Element IdMedicationKnowledge.ingredient
Definition

Identifies a particular constituent of interest in the product.

Cardinality0..*
Summaryfalse
MedicationKnowledge.ingredient.item[x]
Element IdMedicationKnowledge.ingredient.item[x]
Definition

The actual ingredient - either a substance (simple ingredient) or another medication.

Cardinality1..1
TypeCodeableConcept|Reference(Substance)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
MedicationKnowledge.ingredient.isActive
Element IdMedicationKnowledge.ingredient.isActive
Definition

Indication of whether this ingredient affects the therapeutic action of the drug.

Cardinality0..1
Typeboolean
Requirements

True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

Summaryfalse
MedicationKnowledge.ingredient.strength
Element IdMedicationKnowledge.ingredient.strength
Definition

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.

Cardinality0..1
TypeRatio
Summaryfalse
MedicationKnowledge.preparationInstruction
Element IdMedicationKnowledge.preparationInstruction
Definition

The instructions for preparing the medication.

Cardinality0..1
Typemarkdown
Summaryfalse
MedicationKnowledge.intendedRoute
Element IdMedicationKnowledge.intendedRoute
Definition

The intended or approved route of administration.

Cardinality0..*
Terminology BindingSNOMED CT Route Codes (Example)
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.cost
Element IdMedicationKnowledge.cost
Definition

The price of the medication.

Cardinality0..*
Summaryfalse
MedicationKnowledge.cost.type
Element IdMedicationKnowledge.cost.type
Definition

The category of the cost information. For example, manufacturers' cost, patient cost, claim reimbursement cost, actual acquisition cost.

Cardinality1..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.cost.source
Element IdMedicationKnowledge.cost.source
Definition

The source or owner that assigns the price to the medication.

Cardinality0..1
Typestring
Summaryfalse
MedicationKnowledge.cost.cost
Element IdMedicationKnowledge.cost.cost
Definition

The price of the medication.

Cardinality1..1
TypeMoney
Summaryfalse
MedicationKnowledge.monitoringProgram
Element IdMedicationKnowledge.monitoringProgram
Definition

The program under which the medication is reviewed.

Cardinality0..*
Summaryfalse
MedicationKnowledge.monitoringProgram.type
Element IdMedicationKnowledge.monitoringProgram.type
Definition

Type of program under which the medication is monitored.

Cardinality0..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.monitoringProgram.name
Element IdMedicationKnowledge.monitoringProgram.name
Definition

Name of the reviewing program.

Cardinality0..1
Typestring
Summaryfalse
MedicationKnowledge.administrationGuidelines
Element IdMedicationKnowledge.administrationGuidelines
Definition

Guidelines for the administration of the medication.

Cardinality0..*
Summaryfalse
MedicationKnowledge.administrationGuidelines.dosage
Element IdMedicationKnowledge.administrationGuidelines.dosage
Definition

Dosage for the medication for the specific guidelines.

Cardinality0..*
Summaryfalse
MedicationKnowledge.administrationGuidelines.dosage.type
Element IdMedicationKnowledge.administrationGuidelines.dosage.type
Definition

The type of dosage (for example, prophylaxis, maintenance, therapeutic, etc.).

Cardinality1..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.administrationGuidelines.dosage.dosage
Element IdMedicationKnowledge.administrationGuidelines.dosage.dosage
Definition

Dosage for the medication for the specific guidelines.

Cardinality1..*
TypeDosage
Summaryfalse
MedicationKnowledge.administrationGuidelines.indication[x]
Element IdMedicationKnowledge.administrationGuidelines.indication[x]
Definition

Indication for use that apply to the specific administration guidelines.

Cardinality0..1
TypeCodeableConcept|Reference(ObservationDefinition)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
MedicationKnowledge.administrationGuidelines.patientCharacteristics
Element IdMedicationKnowledge.administrationGuidelines.patientCharacteristics
Definition

Characteristics of the patient that are relevant to the administration guidelines (for example, height, weight, gender, etc.).

Cardinality0..*
Summaryfalse
MedicationKnowledge.administrationGuidelines.patientCharacteristics.characteristic[x]
Element IdMedicationKnowledge.administrationGuidelines.patientCharacteristics.characteristic[x]
Definition

Specific characteristic that is relevant to the administration guideline (e.g. height, weight, gender).

Cardinality1..1
TypeCodeableConcept|SimpleQuantity
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
MedicationKnowledge.administrationGuidelines.patientCharacteristics.value
Element IdMedicationKnowledge.administrationGuidelines.patientCharacteristics.value
Definition

The specific characteristic (e.g. height, weight, gender, etc.).

Cardinality0..*
Typestring
Summaryfalse
MedicationKnowledge.medicineClassification
Element IdMedicationKnowledge.medicineClassification
Definition

Categorization of the medication within a formulary or classification system.

Cardinality0..*
Summaryfalse
MedicationKnowledge.medicineClassification.type
Element IdMedicationKnowledge.medicineClassification.type
Definition

The type of category for the medication (for example, therapeutic classification, therapeutic sub-classification).

Cardinality1..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.medicineClassification.classification
Element IdMedicationKnowledge.medicineClassification.classification
Definition

Specific category assigned to the medication (e.g. anti-infective, anti-hypertensive, antibiotic, etc.).

Cardinality0..*
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.packaging
Element IdMedicationKnowledge.packaging
Definition

Information that only applies to packages (not products).

Cardinality0..1
Summaryfalse
MedicationKnowledge.packaging.type
Element IdMedicationKnowledge.packaging.type
Definition

A code that defines the specific type of packaging that the medication can be found in (e.g. blister sleeve, tube, bottle).

Cardinality0..1
Terminology BindingmedicationKnowledge Package Type Codes (Example)
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.packaging.quantity
Element IdMedicationKnowledge.packaging.quantity
Definition

The number of product units the package would contain if fully loaded.

Cardinality0..1
TypeSimpleQuantity
Summaryfalse
MedicationKnowledge.drugCharacteristic
Element IdMedicationKnowledge.drugCharacteristic
Definition

Specifies descriptive properties of the medicine, such as color, shape, imprints, etc.

Cardinality0..*
Summaryfalse
MedicationKnowledge.drugCharacteristic.type
Element IdMedicationKnowledge.drugCharacteristic.type
Definition

A code specifying which characteristic of the medicine is being described (for example, colour, shape, imprint).

Cardinality0..1
Terminology BindingmedicationKnowledge Characteristic Codes (Example)
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.drugCharacteristic.value[x]
Element IdMedicationKnowledge.drugCharacteristic.value[x]
Definition

Description of the characteristic.

Cardinality0..1
TypeCodeableConcept|string|SimpleQuantity|base64Binary
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Comments

The description should be provided as a CodeableConcept, SimpleQuantity or an image. The description can be a string only when these others are not available.

MedicationKnowledge.contraindication
Element IdMedicationKnowledge.contraindication
Definition

Potential clinical issue with or between medication(s) (for example, drug-drug interaction, drug-disease contraindication, drug-allergy interaction, etc.).

Cardinality0..*
TypeReference(DetectedIssue)
Summaryfalse
MedicationKnowledge.regulatory
Element IdMedicationKnowledge.regulatory
Definition

Regulatory information about a medication.

Cardinality0..*
Summaryfalse
MedicationKnowledge.regulatory.regulatoryAuthority
Element IdMedicationKnowledge.regulatory.regulatoryAuthority
Definition

The authority that is specifying the regulations.

Cardinality1..1
TypeReference(Organization)
Summaryfalse
MedicationKnowledge.regulatory.substitution
Element IdMedicationKnowledge.regulatory.substitution
Definition

Specifies if changes are allowed when dispensing a medication from a regulatory perspective.

Cardinality0..*
Summaryfalse
MedicationKnowledge.regulatory.substitution.type
Element IdMedicationKnowledge.regulatory.substitution.type
Definition

Specifies the type of substitution allowed.

Cardinality1..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.regulatory.substitution.allowed
Element IdMedicationKnowledge.regulatory.substitution.allowed
Definition

Specifies if regulation allows for changes in the medication when dispensing.

Cardinality1..1
Typeboolean
Summaryfalse
MedicationKnowledge.regulatory.schedule
Element IdMedicationKnowledge.regulatory.schedule
Definition

Specifies the schedule of a medication in jurisdiction.

Cardinality0..*
Summaryfalse
MedicationKnowledge.regulatory.schedule.schedule
Element IdMedicationKnowledge.regulatory.schedule.schedule
Definition

Specifies the specific drug schedule.

Cardinality1..1
TypeCodeableConcept
Summaryfalse
MedicationKnowledge.regulatory.maxDispense
Element IdMedicationKnowledge.regulatory.maxDispense
Definition

The maximum number of units of the medication that can be dispensed in a period.

Cardinality0..1
Summaryfalse
MedicationKnowledge.regulatory.maxDispense.quantity
Element IdMedicationKnowledge.regulatory.maxDispense.quantity
Definition

The maximum number of units of the medication that can be dispensed.

Cardinality1..1
TypeSimpleQuantity
Summaryfalse
MedicationKnowledge.regulatory.maxDispense.period
Element IdMedicationKnowledge.regulatory.maxDispense.period
Definition

The period that applies to the maximum number of units.

Cardinality0..1
TypeDuration
Summaryfalse
MedicationKnowledge.kinetics
Element IdMedicationKnowledge.kinetics
Definition

The time course of drug absorption, distribution, metabolism and excretion of a medication from the body.

Cardinality0..*
Summaryfalse
MedicationKnowledge.kinetics.areaUnderCurve
Element IdMedicationKnowledge.kinetics.areaUnderCurve
Definition

The drug concentration measured at certain discrete points in time.

Cardinality0..*
TypeSimpleQuantity
Summaryfalse
MedicationKnowledge.kinetics.lethalDose50
Element IdMedicationKnowledge.kinetics.lethalDose50
Definition

The median lethal dose of a drug.

Cardinality0..*
TypeSimpleQuantity
Summaryfalse
MedicationKnowledge.kinetics.halfLifePeriod
Element IdMedicationKnowledge.kinetics.halfLifePeriod
Definition

The time required for any specified property (e.g., the concentration of a substance in the body) to decrease by half.

Cardinality0..1
TypeDuration
Summaryfalse