This page is part of the US-Medication FHIR IG (v0.0.1: STU 1 Ballot 1) based on FHIR v1.8.0. The current version which supercedes this version is 1.2.0. For a full list of available versions, see the Directory of published versions
Definitions for the StructureDefinition-medicationadministration Profile.
MedicationAdministration(US CoreMedicationAdministration) | |
Definition | Administration that a medication is/was actively taken by a patient. |
Control | 0..* |
Comments | The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html). |
Invariants | Defined on this element dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (xpath: not(parent::f:contained and f:text)) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (xpath: not(parent::f:contained and f:contained)) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (xpath: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (xpath: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))) mad-2: Reason not given is only permitted if NotGiven is true (xpath: not(exists(f:reasonNotGiven) and f:notGiven/@value=false())) mad-3: Reason given is only permitted if NotGiven is false (xpath: not(exists(f:reasonGiven) and f:notGiven/@value=true())) |
MedicationAdministration.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Control | 0..1 |
Type | id |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
MedicationAdministration.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. |
Control | 0..1 |
Type | Meta |
MedicationAdministration.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. |
Control | 0..1 |
Type | uri |
Is Modifier | true |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible. |
MedicationAdministration.language | |
Definition | The base language in which the resource is written. |
Control | 0..1 |
Binding | A human language. The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable |
Type | code |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
MedicationAdministration.text | |
Definition | A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Control | 0..1 This element is affected by the following invariants: dom-1 |
Type | Narrative |
Alternate Names | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. |
MedicationAdministration.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Control | 0..* |
Type | Resource |
Alternate Names | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. |
MedicationAdministration.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
MedicationAdministration.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
MedicationAdministration.identifier | |
Definition | External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated. |
Note | This is a business identifer, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
MedicationAdministration.status | |
Definition | Will generally be set to show that the administration has been completed. For some long running administrations such as infusions it is possible for an administration to be started but not completed or it may be paused while some other process is under way. |
Control | 1..1 |
Binding | A set of codes indicating the current status of a MedicationAdministration. The codes SHALL be taken from http://hl7.org/fhir/ValueSet/medication-Administration-status |
Type | code |
Is Modifier | true |
Must Support | true |
MedicationAdministration.medication[x] | |
Definition | Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. |
Control | 1..1 |
Binding | Prescribable medications The codes SHALL be taken from Medication Clinical Drug (RxNorm); other codes may be used where these codes are not suitable |
Type | Choice of: CodeableConcept, Reference(US Core Medication Profile) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | true |
Comments | If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. Note: do not use Medication.name to describe the administered medication. When the only available information is a text description of the medication, Medication.code.text should be used. |
MedicationAdministration.patient | |
Definition | The person or animal receiving the medication. |
Control | 1..1 |
Type | Reference(US Core Patient Profile) |
Must Support | true |
MedicationAdministration.encounter | |
Definition | The visit, admission or other contact between patient and health care provider the medication administration was performed as part of. |
Control | 0..1 |
Type | Reference(Encounter) |
MedicationAdministration.supportingInformation | |
Definition | Additional information (for example, patient height and weight) that supports the administration of the medication. |
Control | 0..* |
Type | Reference(Resource) |
MedicationAdministration.effective[x] | |
Definition | A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. |
Control | 1..1 |
Type | Choice of: dateTime, Period |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | true |
MedicationAdministration.performer | |
Definition | The individual who was responsible for giving the medication to the patient. |
Control | 0..1 |
Type | Choice of: Reference(US Core Practitioner), Reference(US Core Patient Profile), Reference(RelatedPerson) |
Must Support | true |
MedicationAdministration.reasonReference | |
Definition | Condition or observation that supports why the medication was administered. |
Control | 0..* |
Type | Choice of: Reference(Condition), Reference(Observation) |
Comments | This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. |
MedicationAdministration.prescription | |
Definition | The original request, instruction or authority to perform the administration. |
Control | 0..1 |
Type | Reference(MedicationRequest) |
MedicationAdministration.notGiven | |
Definition | Set this to true if the record is saying that the medication was NOT administered. |
Control | 0..1 |
Type | boolean |
Is Modifier | true |
Meaning if Missing | If this is missing, then the medication was administered |
MedicationAdministration.reasonNotGiven | |
Definition | A code indicating why the administration was not performed. |
Control | 0..* This element is affected by the following invariants: mad-2 |
Binding | A set of codes indicating the reason why the MedicationAdministration is negated. For example codes, see SNOMED CT Reason Medication Not Given Codes |
Type | CodeableConcept |
MedicationAdministration.reasonGiven | |
Definition | A code indicating why the medication was given. |
Control | 0..* This element is affected by the following invariants: mad-3 |
Binding | A set of codes indicating the reason why the MedicationAdministration was made. For example codes, see Reason Medication Given Codes |
Type | CodeableConcept |
MedicationAdministration.device | |
Definition | The device used in administering the medication to the patient. For example, a particular infusion pump. |
Control | 0..* |
Type | Reference(Device) |
MedicationAdministration.note | |
Definition | Extra information about the medication administration that is not conveyed by the other attributes. |
Control | 0..* |
Type | Annotation |
MedicationAdministration.dosage | |
Definition | Describes the medication dosage information details e.g. dose, rate, site, route, etc. |
Control | 0..1 |
Type | BackboneElement |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div) mad-1: SHALL have at least one of dosage.dose and dosage.rate[x] (xpath: exists(f:dose) or exists(f:rateRatio) or exists(f:rateRange)) |
MedicationAdministration.dosage.id | |
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
MedicationAdministration.dosage.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
MedicationAdministration.dosage.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Alternate Names | extensions, user content, modifiers |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
MedicationAdministration.dosage.text | |
Definition | Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. |
Control | 0..1 |
Type | string |
MedicationAdministration.dosage.site | |
Definition | A coded specification of the anatomic site where the medication first entered the body. For example, "left arm". |
Control | 0..1 |
Binding | A coded concept describing the site location the medicine enters into or onto the body. For example codes, see SNOMED CT Anatomical Structure for Administration Site Codes |
Type | CodeableConcept |
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. |
MedicationAdministration.dosage.route | |
Definition | A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc. |
Control | 0..1 |
Binding | A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. For example codes, see SNOMED CT Route Codes |
Type | CodeableConcept |
MedicationAdministration.dosage.method | |
Definition | A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. |
Control | 0..1 |
Binding | A coded concept describing the technique by which the medicine is administered. For example codes, see SNOMED CT Administration Method Codes |
Type | CodeableConcept |
Comments | One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. |
MedicationAdministration.dosage.dose | |
Definition | The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection. |
Control | 0..1 |
Type | Quantity(SimpleQuantity) |
Comments | If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration. |
MedicationAdministration.dosage.rate[x] | |
Definition | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. |
Control | 0..1 |
Type | Choice of: Ratio, Quantity(SimpleQuantity) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Comments | If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate. |
MedicationAdministration.eventHistory | |
Definition | A summary of the events of interest that have occurred, such as when the administration was verified. |
Control | 0..* |
Type | Reference(Provenance) |
Comments | See usage notes in Request pattern in request history. |