DSTU2

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4.12 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.

4.12.1 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; this classification is important because it affects the interpretation of a prescribed amount. For instance, is the prescribed amount 20 tablets, or 20 packages of 50 tablets each?

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 CarePlan, Group, MedicationAdministration, MedicationDispense, MedicationOrder, 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 \| carton + SNOMED CT Form Codes (Example)
ingredient		0..*	BackboneElement	Active or inactive ingredient
item		1..1	Reference(Substance \| Medication)	The product contained
amount		0..1	Ratio	Quantity of ingredient present
batch		0..*	BackboneElement
lotNumber		0..1	string
expirationDate		0..1	dateTime
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		1..1	Reference(Medication)	A product in the package
amount		0..1	SimpleQuantity	Quantity present in the package
Documentation for this format

UML Diagram

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 | carton + --></form>
  <ingredient>  <!-- 0..* Active or inactive ingredient -->
   <item><!-- 1..1 Reference(Substance|Medication) The product contained --></item>
   <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><!-- 1..1 Reference(Medication) A product in the package --></item>
   <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 | carton +
    "ingredient" : [{ // Active or inactive ingredient
      "item" : { Reference(Substance|Medication) }, // R!  The product contained
      "amount" : { Ratio } // Quantity of ingredient present
    }],
    "batch" : [{ // 
      "lotNumber" : "<string>", // 
      "expirationDate" : "<dateTime>" // 
    }]
  },
  "package" : { // Details about packaged medications
    "container" : { CodeableConcept }, // E.g. box, vial, blister-pack
    "content" : [{ // What is  in the package
      "item" : { Reference(Medication) }, // R!  A product in the package
      "amount" : { Quantity(SimpleQuantity) } // Quantity present in the package
    }]
  }
}

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 \| carton + SNOMED CT Form Codes (Example)
ingredient		0..*	BackboneElement	Active or inactive ingredient
item		1..1	Reference(Substance \| Medication)	The product contained
amount		0..1	Ratio	Quantity of ingredient present
batch		0..*	BackboneElement
lotNumber		0..1	string
expirationDate		0..1	dateTime
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		1..1	Reference(Medication)	A product in the package
amount		0..1	SimpleQuantity	Quantity present in the package
Documentation for this format

UML Diagram

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 | carton + --></form>
  <ingredient>  <!-- 0..* Active or inactive ingredient -->
   <item><!-- 1..1 Reference(Substance|Medication) The product contained --></item>
   <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><!-- 1..1 Reference(Medication) A product in the package --></item>
   <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 | carton +
    "ingredient" : [{ // Active or inactive ingredient
      "item" : { Reference(Substance|Medication) }, // R!  The product contained
      "amount" : { Ratio } // Quantity of ingredient present
    }],
    "batch" : [{ // 
      "lotNumber" : "<string>", // 
      "expirationDate" : "<dateTime>" // 
    }]
  },
  "package" : { // Details about packaged medications
    "container" : { CodeableConcept }, // E.g. box, vial, blister-pack
    "content" : [{ // What is  in the package
      "item" : { Reference(Medication) }, // R!  A product in the package
      "amount" : { Quantity(SimpleQuantity) } // Quantity present in the package
    }]
  }
}

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

4.12.2.1 Terminology Bindings

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

Path

Definition

Type

Reference

Medication.code

A code that defines the type of a medication

Example

SNOMED CT Medication Codes

Medication.product.form

The form of a medication

Example

SNOMED CT Form Codes

Medication.package.container

Kind of container a medication package is packaged in

Example

SNOMED CT Form Codes

4.12.3 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
code	token	Codes that identify this medication	Medication.code
container	token	E.g. box, vial, blister-pack	Medication.package.container
content	reference	A product in the package	Medication.package.content.item (Medication)
form	token	powder \| tablets \| carton +	Medication.product.form
ingredient	reference	The product contained	Medication.product.ingredient.item (Medication, Substance)
manufacturer	reference	Manufacturer of the item	Medication.manufacturer (Organization)