Data Exchange For Quality Measures STU3 for FHIR R4
3.0.0 - STU 3

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v3.0.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: DEQM MedicationAdministration Profile

Defining URL:http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/medicationadministration-deqm
Version:3.0.0
Name:DEQMMedicationAdministrationProfile
Title:DEQM MedicationAdministration Profile
Status:Active as of 2018-06-19T00:00:00-07:00
Definition:

The DEQM MedicationAdministration Profile describes the event of a patient consuming or otherwise being administered a medication

Publisher:HL7 International - Clinical Quality Information Work Group
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/medicationadministration-deqm

We seek comment on which of the two methods below is appropriate, and when, based on your experience. For the evaluateMeasure operation, you can manage what data to evaluate the measure in one of two ways: 1) Define the CQL rules to only look at a resource that has certain elements or elements of a certain value. This scenario puts the burden on the measure developer to add the specific needs into the CQL statements 2) Specify that a specific profile of a Resource should be used to calculate the measure. This would require the generator of the FHIR data to insure that a Resource meets the conditions of the profile Most of the examples and profiles in the DEQM assume the first (1) approach above. However DEQM MedicationAdministration profile is created here to represent how measure requirements could be handled by profiling a resource, (2) above.

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each MedicationAdministration must have:

  1. A medication code that identifies the medication that was administered
  2. The period of time during which the administration took place

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from QICoreMedicationAdministration

Summary

Must-Support: 2 elements

This structure is derived from QICoreMedicationAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... instantiates Σ0..*uriInstantiates protocol or definition
... partOf Σ0..*Reference(MedicationAdministration | Procedure)Part of referenced event
... status ?!SΣ1..1codein-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.

... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.


... category 0..1CodeableConceptType of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.

... medication[x] SΣ1..1CodeableConceptWhat was administered
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

... subject SΣ1..1Reference(QICorePatient)Who received medication
... context S0..1Reference(QICoreEncounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... supportingInformation 0..*Reference(Resource)Additional information to support administration
... effective[x] SΣ1..1PeriodStart and end time of administration
... performer Σ0..*BackboneElementWho performed the medication administration and what they did
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptType of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.

.... actor Σ1..1Reference(QICorePractitioner | QICorePatient | QICoreRelatedPerson | QICoreDevice)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.


... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication was administered
... request 0..1Reference(QICoreMedicationRequest)Request administration performed against
... device 0..*Reference(QICoreDevice)Device used to administer
... note 0..*AnnotationInformation about the administration
... dosage I0..1BackboneElementDetails of how medication was taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity(SimpleQuantity)
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... status ?!Σ1..1codein-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.

... statusReason 0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.


... medication[x] Σ1..1CodeableConceptWhat was administered
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

... subject Σ1..1Reference(QICorePatient)Who received medication
... context 0..1Reference(QICoreEncounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... effective[x] Σ1..1PeriodStart and end time of administration
... reasonCode 0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.


... dosage I0..1BackboneElementDetails of how medication was taken
.... route 0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... dose 0..1SimpleQuantityAmount of medication per dose

doco Documentation for this format

This structure is derived from QICoreMedicationAdministration

Summary

Must-Support: 2 elements

Differential View

This structure is derived from QICoreMedicationAdministration

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... instantiates Σ0..*uriInstantiates protocol or definition
... partOf Σ0..*Reference(MedicationAdministration | Procedure)Part of referenced event
... status ?!SΣ1..1codein-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.

... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.


... category 0..1CodeableConceptType of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.

... medication[x] SΣ1..1CodeableConceptWhat was administered
Binding: US Core Medication Codes (RxNorm) (preferred): The set of RxNorm codes to represent medications

... subject SΣ1..1Reference(QICorePatient)Who received medication
... context S0..1Reference(QICoreEncounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... supportingInformation 0..*Reference(Resource)Additional information to support administration
... effective[x] SΣ1..1PeriodStart and end time of administration
... performer Σ0..*BackboneElementWho performed the medication administration and what they did
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptType of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.

.... actor Σ1..1Reference(QICorePractitioner | QICorePatient | QICoreRelatedPerson | QICoreDevice)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.


... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication was administered
... request 0..1Reference(QICoreMedicationRequest)Request administration performed against
... device 0..*Reference(QICoreDevice)Device used to administer
... note 0..*AnnotationInformation about the administration
... dosage I0..1BackboneElementDetails of how medication was taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity(SimpleQuantity)
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
MedicationAdministration.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationAdministration.statusrequiredMedicationAdministration Status Codes
MedicationAdministration.statusReasonexampleSNOMEDCTReasonMedicationNotGivenCodes
MedicationAdministration.categorypreferredMedicationAdministration Category Codes
MedicationAdministration.medication[x]preferredUSCoreMedicationCodes
MedicationAdministration.performer.functionexampleMedicationAdministration Performer Function Codes
MedicationAdministration.reasonCodeexampleReasonMedicationGivenCodes
MedicationAdministration.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationAdministration.dosage.routeexampleSNOMEDCTRouteCodes
MedicationAdministration.dosage.methodexampleSNOMEDCTAdministrationMethodCodes

Notes:

This profile is used in the following transactions: