Extensions for Using Data Elements from FHIR STU3 in FHIR R4B
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Extensions for Using Data Elements from FHIR STU3 in FHIR R4B - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R3_MedicationAdministration_R4B - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-MedicationAdministration resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationAdministration
Definition

Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.

ShortAdministration of medication to a patient
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationAdministration.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationAdministration.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. MedicationAdministration.extension:definition
    Slice Namedefinition
    Definition

    STU3: MedicationAdministration.definition (new:Reference(PlanDefinition,ActivityDefinition))

    ShortSTU3: Instantiates protocol or definition (new)
    Comments

    Element MedicationAdministration.definition has a context of MedicationAdministration based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.definition has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(STU3: Instantiates protocol or definition (new)) (Extension Type: Reference(Cross-version Profile for STU3.PlanDefinition for use in FHIR R4B, PlanDefinition, Cross-version Profile for STU3.ActivityDefinition for use in FHIR R4B, ActivityDefinition))
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. MedicationAdministration.modifierExtension
    Definition

    An Extension


    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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensionExtensions that cannot be ignored
    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationAdministration.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. MedicationAdministration.modifierExtension:notGiven
      Slice NamenotGiven
      Definition

      STU3: MedicationAdministration.notGiven (new:boolean)

      ShortSTU3: True if medication not administered (new)
      Comments

      Element MedicationAdministration.notGiven has a context of MedicationAdministration based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.notGiven has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This element is labeled as a modifier because it indicates that a administration didn't happen.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(STU3: True if medication not administered (new)) (Extension Type: boolean)
      Is Modifiertrue because This extension is a modifier because the source element `MedicationAdministration.notGiven` is flagged as a modifier element.
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. 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.

      Shortin-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from MedicationAdministration Status Codeshttp://hl7.org/fhir/ValueSet/medication-admin-status|4.3.0
      (required to http://hl7.org/fhir/ValueSet/medication-admin-status|4.3.0)

      A set of codes indicating the current status of a MedicationAdministration.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. MedicationAdministration.status.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationAdministration.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. MedicationAdministration.status.extension:status
        Slice Namestatus
        Definition

        STU3: MedicationAdministration.status additional codes

        ShortSTU3: in-progress | on-hold | completed | entered-in-error | stopped | unknown additional codes
        Comments

        Element MedicationAdministration.status is mapped to FHIR R4B element MedicationAdministration.status as RelatedTo. The mappings for MedicationAdministration.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationAdministration.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(STU3: in-progress | on-hold | completed | entered-in-error | stopped | unknown additional codes) (Extension Type: code)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. 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.

        ShortWhat was administered
        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. For example, if you require form or lot number, then you must reference the Medication resource.

        Control1..1
        BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.3.0
        (example to http://hl7.org/fhir/ValueSet/medication-codes|4.3.0)

        Codes identifying substance or product that can be administered.

        TypeChoice of: CodeableConcept, Reference(Medication)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. MedicationAdministration.medication[x].extension:alternateReference
        Slice NamealternateReference
        Definition

        STU3: MedicationAdministration.medication[x] additional types from child elements (display, identifier, reference)

        ShortSTU3: medication additional types
        Comments

        Element MedicationAdministration.medication[x] is mapped to FHIR R4B element MedicationAdministration.medication[x] as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.medication[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.medication[x] with unmapped reference targets: Medication. Source element MedicationAdministration.medication[x] has unmapped reference types. While the target element MedicationAdministration.medication[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. 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.  For example if you require form or lot number, then you must reference the Medication resource. .

        Control0..1
        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. MedicationAdministration.subject
        Definition

        The person or animal or group receiving the medication.

        ShortWho received medication
        Control1..1
        TypeReference(Patient, Group)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationAdministration.subject.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MedicationAdministration.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 26. MedicationAdministration.subject.extension:subject
          Slice Namesubject
          Definition

          STU3: MedicationAdministration.subject additional types from child elements (display, identifier, reference)

          ShortSTU3: subject additional types
          Comments

          Element MedicationAdministration.subject is mapped to FHIR R4B element MedicationAdministration.subject as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.subject do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.subject with unmapped reference targets: Group, Patient.

          Control0..1
          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          28. 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.

          ShortStart and end time of administration
          Control1..1
          TypeChoice of: dateTime, Period
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be foundhere

          0. MedicationAdministration
          2. MedicationAdministration.meta
          4. MedicationAdministration.meta.extension
          Control0..*
          SlicingThis element introduces a set of slices on MedicationAdministration.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 6. MedicationAdministration.meta.extension:meta
            Slice Namemeta
            Definition

            STU3: MedicationAdministration.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

            ShortSTU3: meta additional types
            Comments

            Element MedicationAdministration.meta is mapped to FHIR R4B element MedicationAdministration.meta as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.meta do not cover the following types: Meta. The mappings for MedicationAdministration.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

            Control0..1
            TypeExtension(STU3: meta additional types) (Complex Extension)
            8. MedicationAdministration.text
            10. MedicationAdministration.text.extension
            Control0..*
            SlicingThis element introduces a set of slices on MedicationAdministration.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 12. MedicationAdministration.text.extension:text
              Slice Nametext
              Definition

              STU3: MedicationAdministration.text additional types (Narrative) additional types from child elements (div, status)

              ShortSTU3: text additional types
              Comments

              Element MedicationAdministration.text is mapped to FHIR R4B element MedicationAdministration.text as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.text do not cover the following types: Narrative. The mappings for MedicationAdministration.text do not cover the following types based on type expansion: div, status. 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.

              Control0..1
              TypeExtension(STU3: text additional types) (Complex Extension)
              14. MedicationAdministration.extension
              Control0..*
              SlicingThis element introduces a set of slices on MedicationAdministration.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 16. MedicationAdministration.extension:definition
                Slice Namedefinition
                Definition

                STU3: MedicationAdministration.definition (new:Reference(PlanDefinition,ActivityDefinition))

                ShortSTU3: Instantiates protocol or definition (new)
                Comments

                Element MedicationAdministration.definition has a context of MedicationAdministration based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.definition has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                Control0..*
                TypeExtension(STU3: Instantiates protocol or definition (new)) (Extension Type: Reference(Cross-version Profile for STU3.PlanDefinition for use in FHIR R4B, PlanDefinition, Cross-version Profile for STU3.ActivityDefinition for use in FHIR R4B, ActivityDefinition))
                18. MedicationAdministration.modifierExtension
                Control0..*
                SlicingThis element introduces a set of slices on MedicationAdministration.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 20. MedicationAdministration.modifierExtension:notGiven
                  Slice NamenotGiven
                  Definition

                  STU3: MedicationAdministration.notGiven (new:boolean)

                  ShortSTU3: True if medication not administered (new)
                  Comments

                  Element MedicationAdministration.notGiven has a context of MedicationAdministration based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.notGiven has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This element is labeled as a modifier because it indicates that a administration didn't happen.

                  Control0..1
                  TypeExtension(STU3: True if medication not administered (new)) (Extension Type: boolean)
                  22. MedicationAdministration.identifier
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  24. MedicationAdministration.identifier.extension
                  Control0..*
                  SlicingThis element introduces a set of slices on MedicationAdministration.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 26. MedicationAdministration.identifier.extension:identifier
                    Slice Nameidentifier
                    Definition

                    STU3: MedicationAdministration.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

                    ShortSTU3: identifier additional types
                    Comments

                    Element MedicationAdministration.identifier is mapped to FHIR R4B element MedicationAdministration.identifier as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.identifier do not cover the following types: Identifier. The mappings for MedicationAdministration.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

                    Control0..*
                    TypeExtension(STU3: identifier additional types) (Extension Type: Identifier)
                    28. MedicationAdministration.partOf
                    30. MedicationAdministration.partOf.extension
                    Control0..*
                    SlicingThis element introduces a set of slices on MedicationAdministration.partOf.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 32. MedicationAdministration.partOf.extension:partOf
                      Slice NamepartOf
                      Definition

                      STU3: MedicationAdministration.partOf additional types from child elements (display, identifier, reference)

                      ShortSTU3: partOf additional types
                      Comments

                      Element MedicationAdministration.partOf is mapped to FHIR R4B element MedicationAdministration.partOf as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.partOf do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.partOf with unmapped reference targets: MedicationAdministration, Procedure.

                      Control0..*
                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                      34. MedicationAdministration.status
                      36. MedicationAdministration.status.extension
                      Control0..*
                      SlicingThis element introduces a set of slices on MedicationAdministration.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 38. MedicationAdministration.status.extension:status
                        Slice Namestatus
                        Definition

                        STU3: MedicationAdministration.status additional codes

                        ShortSTU3: in-progress | on-hold | completed | entered-in-error | stopped | unknown additional codes
                        Comments

                        Element MedicationAdministration.status is mapped to FHIR R4B element MedicationAdministration.status as RelatedTo. The mappings for MedicationAdministration.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationAdministration.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                        Control0..1
                        TypeExtension(STU3: in-progress | on-hold | completed | entered-in-error | stopped | unknown additional codes) (Extension Type: code)
                        40. MedicationAdministration.medicationReference
                        42. MedicationAdministration.medicationReference.extension
                        Control0..*
                        SlicingThis element introduces a set of slices on MedicationAdministration.medicationReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 44. MedicationAdministration.medicationReference.extension:alternateReference
                          Slice NamealternateReference
                          Definition

                          STU3: MedicationAdministration.medication[x] additional types from child elements (display, identifier, reference)

                          ShortSTU3: medication additional types
                          Comments

                          Element MedicationAdministration.medication[x] is mapped to FHIR R4B element MedicationAdministration.medication[x] as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.medication[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.medication[x] with unmapped reference targets: Medication. Source element MedicationAdministration.medication[x] has unmapped reference types. While the target element MedicationAdministration.medication[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. 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.  For example if you require form or lot number, then you must reference the Medication resource. .

                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                          46. MedicationAdministration.subject
                          48. MedicationAdministration.subject.extension
                          Control0..*
                          SlicingThis element introduces a set of slices on MedicationAdministration.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 50. MedicationAdministration.subject.extension:subject
                            Slice Namesubject
                            Definition

                            STU3: MedicationAdministration.subject additional types from child elements (display, identifier, reference)

                            ShortSTU3: subject additional types
                            Comments

                            Element MedicationAdministration.subject is mapped to FHIR R4B element MedicationAdministration.subject as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.subject do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.subject with unmapped reference targets: Group, Patient.

                            Control0..1
                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                            52. MedicationAdministration.context
                            54. MedicationAdministration.context.extension
                            Control0..*
                            SlicingThis element introduces a set of slices on MedicationAdministration.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 56. MedicationAdministration.context.extension:context
                              Slice Namecontext
                              Definition

                              STU3: MedicationAdministration.context additional types from child elements (display, identifier, reference)

                              ShortSTU3: context additional types
                              Comments

                              Element MedicationAdministration.context is mapped to FHIR R4B element MedicationAdministration.context as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.context do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.context with unmapped reference targets: Encounter, EpisodeOfCare.

                              Control0..1
                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                              58. MedicationAdministration.supportingInformation
                              60. MedicationAdministration.supportingInformation.extension
                              Control0..*
                              SlicingThis element introduces a set of slices on MedicationAdministration.supportingInformation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 62. MedicationAdministration.supportingInformation.extension:supportingInformation
                                Slice NamesupportingInformation
                                Definition

                                STU3: MedicationAdministration.supportingInformation additional types from child elements (display, identifier, reference)

                                ShortSTU3: supportingInformation additional types
                                Comments

                                Element MedicationAdministration.supportingInformation is mapped to FHIR R4B element MedicationAdministration.supportingInformation as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.supportingInformation do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.supportingInformation with unmapped reference targets: Resource.

                                Control0..*
                                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                64. MedicationAdministration.performer
                                66. MedicationAdministration.performer.extension
                                Control0..*
                                SlicingThis element introduces a set of slices on MedicationAdministration.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 68. MedicationAdministration.performer.extension:onBehalfOf
                                  Slice NameonBehalfOf
                                  Definition

                                  STU3: MedicationAdministration.performer.onBehalfOf (new:Reference(Organization))

                                  ShortSTU3: Organization organization was acting for (new)
                                  Comments

                                  Element MedicationAdministration.performer.onBehalfOf has a context of MedicationAdministration.performer based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.performer.onBehalfOf has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                                  Control0..1
                                  TypeExtension(STU3: Organization organization was acting for (new)) (Extension Type: Reference(Cross-version Profile for STU3.Organization for use in FHIR R4B, Organization))
                                  70. MedicationAdministration.performer.actor
                                  72. MedicationAdministration.performer.actor.extension
                                  Control0..*
                                  SlicingThis element introduces a set of slices on MedicationAdministration.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 74. MedicationAdministration.performer.actor.extension:actor
                                    Slice Nameactor
                                    Definition

                                    STU3: MedicationAdministration.performer.actor

                                    ShortSTU3: Individual who was performing
                                    Comments

                                    Element MedicationAdministration.performer.actor is mapped to FHIR R4B element MedicationAdministration.performer.actor as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.performer.actor with unmapped reference targets: Device, Patient, Practitioner, RelatedPerson.

                                    Control0..1
                                    TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                    76. MedicationAdministration.reasonReference
                                    78. MedicationAdministration.reasonReference.extension
                                    Control0..*
                                    SlicingThis element introduces a set of slices on MedicationAdministration.reasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 80. MedicationAdministration.reasonReference.extension:reasonReference
                                      Slice NamereasonReference
                                      Definition

                                      STU3: MedicationAdministration.reasonReference additional types from child elements (display, identifier, reference)

                                      ShortSTU3: Condition or Observation that supports why the medication was administered additional types
                                      Comments

                                      Element MedicationAdministration.reasonReference is mapped to FHIR R4B element MedicationAdministration.reasonReference as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.reasonReference do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.reasonReference with unmapped reference targets: Condition, Observation. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

                                      Control0..*
                                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                      82. MedicationAdministration.request
                                      84. MedicationAdministration.request.extension
                                      Control0..*
                                      SlicingThis element introduces a set of slices on MedicationAdministration.request.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 86. MedicationAdministration.request.extension:prescription
                                        Slice Nameprescription
                                        Definition

                                        STU3: MedicationAdministration.prescription additional types from child elements (display, identifier, reference)

                                        ShortSTU3: prescription additional types
                                        Comments

                                        Element MedicationAdministration.prescription is mapped to FHIR R4B element MedicationAdministration.request as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.prescription do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.prescription with unmapped reference targets: MedicationRequest.

                                        Control0..1
                                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                        88. MedicationAdministration.device
                                        90. MedicationAdministration.device.extension
                                        Control0..*
                                        SlicingThis element introduces a set of slices on MedicationAdministration.device.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 92. MedicationAdministration.device.extension:device
                                          Slice Namedevice
                                          Definition

                                          STU3: MedicationAdministration.device additional types from child elements (display, identifier, reference)

                                          ShortSTU3: device additional types
                                          Comments

                                          Element MedicationAdministration.device is mapped to FHIR R4B element MedicationAdministration.device as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.device do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.device with unmapped reference targets: Device.

                                          Control0..*
                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                          94. MedicationAdministration.note
                                          96. MedicationAdministration.note.extension
                                          Control0..*
                                          SlicingThis element introduces a set of slices on MedicationAdministration.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 98. MedicationAdministration.note.extension:note
                                            Slice Namenote
                                            Definition

                                            STU3: MedicationAdministration.note additional types (Annotation) additional types from child elements (author[x], text, time)

                                            ShortSTU3: note additional types
                                            Comments

                                            Element MedicationAdministration.note is mapped to FHIR R4B element MedicationAdministration.note as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.note do not cover the following types: Annotation. The mappings for MedicationAdministration.note do not cover the following types based on type expansion: author[x], text, time.

                                            Control0..*
                                            TypeExtension(STU3: note additional types) (Extension Type: Annotation)
                                            100. MedicationAdministration.eventHistory
                                            102. MedicationAdministration.eventHistory.extension
                                            Control0..*
                                            SlicingThis element introduces a set of slices on MedicationAdministration.eventHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 104. MedicationAdministration.eventHistory.extension:eventHistory
                                              Slice NameeventHistory
                                              Definition

                                              STU3: MedicationAdministration.eventHistory additional types from child elements (display, identifier, reference)

                                              ShortSTU3: eventHistory additional types
                                              Comments

                                              Element MedicationAdministration.eventHistory is mapped to FHIR R4B element MedicationAdministration.eventHistory as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.eventHistory do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.eventHistory with unmapped reference targets: Provenance. This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                                              Control0..*
                                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))

                                              Guidance on how to interpret the contents of this table can be foundhere

                                              0. MedicationAdministration
                                              Definition

                                              Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.

                                              ShortAdministration of medication to a patient
                                              Control0..*
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
                                              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                              dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                              2. MedicationAdministration.id
                                              Definition

                                              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                              ShortLogical id of this artifact
                                              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.

                                              Control0..1
                                              Typeid
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summarytrue
                                              4. MedicationAdministration.meta
                                              Definition

                                              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                              ShortMetadata about the resource
                                              Control0..1
                                              TypeMeta
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              6. MedicationAdministration.meta.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typeid
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              8. MedicationAdministration.meta.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on MedicationAdministration.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 10. MedicationAdministration.meta.extension:meta
                                                Slice Namemeta
                                                Definition

                                                STU3: MedicationAdministration.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

                                                ShortSTU3: meta additional types
                                                Comments

                                                Element MedicationAdministration.meta is mapped to FHIR R4B element MedicationAdministration.meta as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.meta do not cover the following types: Meta. The mappings for MedicationAdministration.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

                                                Control0..1
                                                TypeExtension(STU3: meta additional types) (Complex Extension)
                                                Is Modifierfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                12. MedicationAdministration.meta.versionId
                                                Definition

                                                The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                                                ShortVersion specific identifier
                                                Comments

                                                The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                                                Control0..1
                                                Typeid
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                14. MedicationAdministration.meta.lastUpdated
                                                Definition

                                                When the resource last changed - e.g. when the version changed.

                                                ShortWhen the resource version last changed
                                                Comments

                                                This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                                                Control0..1
                                                Typeinstant
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                16. MedicationAdministration.meta.source
                                                Definition

                                                A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                                                ShortIdentifies where the resource comes from
                                                Comments

                                                In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                                                This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                                                Control0..1
                                                Typeuri
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                18. MedicationAdministration.meta.profile
                                                Definition

                                                A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                                                ShortProfiles this resource claims to conform to
                                                Comments

                                                It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                                                Control0..*
                                                Typecanonical(StructureDefinition)
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                20. MedicationAdministration.meta.security
                                                Definition

                                                Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                                                ShortSecurity Labels applied to this resource
                                                Comments

                                                The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                                                Control0..*
                                                BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                                                (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.3.0)
                                                TypeCoding
                                                Is Modifierfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                22. MedicationAdministration.meta.tag
                                                Definition

                                                Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                                                ShortTags applied to this resource
                                                Comments

                                                The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                                                Control0..*
                                                BindingFor example codes, see CommonTags
                                                (example to http://hl7.org/fhir/ValueSet/common-tags|4.3.0)
                                                TypeCoding
                                                Is Modifierfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                24. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                ShortA set of rules under which this content was created
                                                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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                Control0..1
                                                Typeuri
                                                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                26. MedicationAdministration.language
                                                Definition

                                                The base language in which the resource is written.

                                                ShortLanguage of the resource content
                                                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).

                                                Control0..1
                                                BindingThe codes SHOULD be taken from CommonLanguages
                                                (preferred to http://hl7.org/fhir/ValueSet/languages|4.3.0)

                                                IETF language tag

                                                Additional BindingsPurpose
                                                AllLanguagesMax Binding
                                                Typecode
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                28. MedicationAdministration.text
                                                Definition

                                                A human-readable narrative that contains a summary of the resource and can 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.

                                                ShortText summary of the resource, for human interpretation
                                                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 information is added later.

                                                Control0..1
                                                TypeNarrative
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Alternate Namesnarrative, html, xhtml, display
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                30. MedicationAdministration.text.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                32. MedicationAdministration.text.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on MedicationAdministration.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 34. MedicationAdministration.text.extension:text
                                                  Slice Nametext
                                                  Definition

                                                  STU3: MedicationAdministration.text additional types (Narrative) additional types from child elements (div, status)

                                                  ShortSTU3: text additional types
                                                  Comments

                                                  Element MedicationAdministration.text is mapped to FHIR R4B element MedicationAdministration.text as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.text do not cover the following types: Narrative. The mappings for MedicationAdministration.text do not cover the following types based on type expansion: div, status. 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.

                                                  Control0..1
                                                  TypeExtension(STU3: text additional types) (Complex Extension)
                                                  Is Modifierfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  36. MedicationAdministration.text.status
                                                  Definition

                                                  The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

                                                  Shortgenerated | extensions | additional | empty
                                                  Control1..1
                                                  BindingThe codes SHALL be taken from NarrativeStatus
                                                  (required to http://hl7.org/fhir/ValueSet/narrative-status|4.3.0)
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  38. MedicationAdministration.text.div
                                                  Definition

                                                  The actual narrative content, a stripped down version of XHTML.

                                                  ShortLimited xhtml content
                                                  Comments

                                                  The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

                                                  Control1..1
                                                  Typexhtml
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
                                                  txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
                                                  40. 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.

                                                  ShortContained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                  Control0..*
                                                  TypeResource
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Alternate Namesinline resources, anonymous resources, contained resources
                                                  Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
                                                  42. MedicationAdministration.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on MedicationAdministration.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 44. MedicationAdministration.extension:definition
                                                    Slice Namedefinition
                                                    Definition

                                                    STU3: MedicationAdministration.definition (new:Reference(PlanDefinition,ActivityDefinition))

                                                    ShortSTU3: Instantiates protocol or definition (new)
                                                    Comments

                                                    Element MedicationAdministration.definition has a context of MedicationAdministration based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.definition has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(STU3: Instantiates protocol or definition (new)) (Extension Type: Reference(Cross-version Profile for STU3.PlanDefinition for use in FHIR R4B, PlanDefinition, Cross-version Profile for STU3.ActivityDefinition for use in FHIR R4B, ActivityDefinition))
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    46. MedicationAdministration.modifierExtension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on MedicationAdministration.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 48. MedicationAdministration.modifierExtension:notGiven
                                                      Slice NamenotGiven
                                                      Definition

                                                      STU3: MedicationAdministration.notGiven (new:boolean)

                                                      ShortSTU3: True if medication not administered (new)
                                                      Comments

                                                      Element MedicationAdministration.notGiven has a context of MedicationAdministration based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.notGiven has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This element is labeled as a modifier because it indicates that a administration didn't happen.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(STU3: True if medication not administered (new)) (Extension Type: boolean)
                                                      Is Modifiertrue because This extension is a modifier because the source element `MedicationAdministration.notGiven` is flagged as a modifier element.
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      50. MedicationAdministration.identifier
                                                      Definition

                                                      Identifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                                                      ShortExternal identifier
                                                      Comments

                                                      This is a business identifier, not a resource identifier.

                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      52. MedicationAdministration.identifier.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typeid
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      54. MedicationAdministration.identifier.extension
                                                      Definition

                                                      An Extension

                                                      ShortExtension
                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on MedicationAdministration.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 56. MedicationAdministration.identifier.extension:identifier
                                                        Slice Nameidentifier
                                                        Definition

                                                        STU3: MedicationAdministration.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

                                                        ShortSTU3: identifier additional types
                                                        Comments

                                                        Element MedicationAdministration.identifier is mapped to FHIR R4B element MedicationAdministration.identifier as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.identifier do not cover the following types: Identifier. The mappings for MedicationAdministration.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

                                                        Control0..*
                                                        TypeExtension(STU3: identifier additional types) (Extension Type: Identifier)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        58. MedicationAdministration.identifier.use
                                                        Definition

                                                        The purpose of this identifier.

                                                        Shortusual | official | temp | secondary | old (If known)
                                                        Comments

                                                        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from IdentifierUse
                                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                                        Typecode
                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        60. MedicationAdministration.identifier.type
                                                        Definition

                                                        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                        ShortDescription of identifier
                                                        Comments

                                                        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                        Control0..1
                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

                                                        Allows users to make use of identifiers when the identifier system is not known.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        62. MedicationAdministration.identifier.system
                                                        Definition

                                                        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                        ShortThe namespace for the identifier value
                                                        Comments

                                                        Identifier.system is always case sensitive.

                                                        Control0..1
                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                        ExampleGeneral: http://www.acme.com/identifiers/patient
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        64. MedicationAdministration.identifier.value
                                                        Definition

                                                        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                        ShortThe value that is unique
                                                        Comments

                                                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        ExampleGeneral: 123456
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        66. MedicationAdministration.identifier.period
                                                        Definition

                                                        Time period during which identifier is/was valid for use.

                                                        ShortTime period when id is/was valid for use
                                                        Control0..1
                                                        TypePeriod
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        68. MedicationAdministration.identifier.assigner
                                                        Definition

                                                        Organization that issued/manages the identifier.

                                                        ShortOrganization that issued id (may be just text)
                                                        Comments

                                                        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                        Control0..1
                                                        TypeReference(Organization)
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        70. MedicationAdministration.instantiates
                                                        Definition

                                                        A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.

                                                        ShortInstantiates protocol or definition
                                                        Control0..*
                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        72. MedicationAdministration.partOf
                                                        Definition

                                                        A larger event of which this particular event is a component or step.

                                                        ShortPart of referenced event
                                                        Control0..*
                                                        TypeReference(MedicationAdministration, Procedure)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        74. MedicationAdministration.partOf.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typeid
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        76. MedicationAdministration.partOf.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on MedicationAdministration.partOf.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 78. MedicationAdministration.partOf.extension:partOf
                                                          Slice NamepartOf
                                                          Definition

                                                          STU3: MedicationAdministration.partOf additional types from child elements (display, identifier, reference)

                                                          ShortSTU3: partOf additional types
                                                          Comments

                                                          Element MedicationAdministration.partOf is mapped to FHIR R4B element MedicationAdministration.partOf as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.partOf do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.partOf with unmapped reference targets: MedicationAdministration, Procedure.

                                                          Control0..1
                                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          80. MedicationAdministration.partOf.reference
                                                          Definition

                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                          Comments

                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                          Control0..1
                                                          This element is affected by the following invariants: ref-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          82. MedicationAdministration.partOf.type
                                                          Definition

                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                          ShortType the reference refers to (e.g. "Patient")
                                                          Comments

                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                          Control0..1
                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                          Typeuri
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          84. MedicationAdministration.partOf.identifier
                                                          Definition

                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                          ShortLogical reference, when literal reference is not known
                                                          Comments

                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control0..1
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          86. MedicationAdministration.partOf.display
                                                          Definition

                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                          ShortText alternative for the resource
                                                          Comments

                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          88. 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.

                                                          Shortin-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
                                                          Comments

                                                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                          Control1..1
                                                          BindingThe codes SHALL be taken from MedicationAdministration Status Codes
                                                          (required to http://hl7.org/fhir/ValueSet/medication-admin-status|4.3.0)

                                                          A set of codes indicating the current status of a MedicationAdministration.

                                                          Typecode
                                                          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          90. MedicationAdministration.status.id
                                                          Definition

                                                          unique id for the element within a resource (for internal references)

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          92. MedicationAdministration.status.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on MedicationAdministration.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 94. MedicationAdministration.status.extension:status
                                                            Slice Namestatus
                                                            Definition

                                                            STU3: MedicationAdministration.status additional codes

                                                            ShortSTU3: in-progress | on-hold | completed | entered-in-error | stopped | unknown additional codes
                                                            Comments

                                                            Element MedicationAdministration.status is mapped to FHIR R4B element MedicationAdministration.status as RelatedTo. The mappings for MedicationAdministration.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationAdministration.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(STU3: in-progress | on-hold | completed | entered-in-error | stopped | unknown additional codes) (Extension Type: code)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            96. MedicationAdministration.status.value
                                                            Definition

                                                            Primitive value for code

                                                            ShortPrimitive value for code
                                                            Control0..1
                                                            Typecode
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            98. MedicationAdministration.statusReason
                                                            Definition

                                                            A code indicating why the administration was not performed.

                                                            ShortReason administration not performed
                                                            Control0..*
                                                            BindingFor example codes, see SNOMEDCTReasonMedicationNotGivenCodes
                                                            (example to http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes|4.3.0)

                                                            A set of codes indicating the reason why the MedicationAdministration is negated.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            100. MedicationAdministration.category
                                                            Definition

                                                            Indicates where the medication is expected to be consumed or administered.

                                                            ShortType of medication usage
                                                            Control0..1
                                                            BindingThe codes SHOULD be taken from MedicationAdministration Category Codes
                                                            (preferred to http://hl7.org/fhir/ValueSet/medication-admin-category|4.3.0)

                                                            A coded concept describing where the medication administered is expected to occur.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            102. 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.

                                                            ShortWhat was administered
                                                            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. For example, if you require form or lot number, then you must reference the Medication resource.

                                                            Control1..1
                                                            BindingFor example codes, see SNOMEDCTMedicationCodes
                                                            (example to http://hl7.org/fhir/ValueSet/medication-codes|4.3.0)

                                                            Codes identifying substance or product that can be administered.

                                                            TypeChoice of: CodeableConcept, Reference(Medication)
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            104. MedicationAdministration.medication[x].id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            106. MedicationAdministration.medication[x].extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on MedicationAdministration.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 108. MedicationAdministration.medication[x].extension:alternateReference
                                                              Slice NamealternateReference
                                                              Definition

                                                              STU3: MedicationAdministration.medication[x] additional types from child elements (display, identifier, reference)

                                                              ShortSTU3: medication additional types
                                                              Comments

                                                              Element MedicationAdministration.medication[x] is mapped to FHIR R4B element MedicationAdministration.medication[x] as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.medication[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.medication[x] with unmapped reference targets: Medication. Source element MedicationAdministration.medication[x] has unmapped reference types. While the target element MedicationAdministration.medication[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. 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.  For example if you require form or lot number, then you must reference the Medication resource. .

                                                              Control0..1
                                                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              110. MedicationAdministration.subject
                                                              Definition

                                                              The person or animal or group receiving the medication.

                                                              ShortWho received medication
                                                              Control1..1
                                                              TypeReference(Patient, Group)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              112. MedicationAdministration.subject.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typeid
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              114. MedicationAdministration.subject.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on MedicationAdministration.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 116. MedicationAdministration.subject.extension:subject
                                                                Slice Namesubject
                                                                Definition

                                                                STU3: MedicationAdministration.subject additional types from child elements (display, identifier, reference)

                                                                ShortSTU3: subject additional types
                                                                Comments

                                                                Element MedicationAdministration.subject is mapped to FHIR R4B element MedicationAdministration.subject as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.subject do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.subject with unmapped reference targets: Group, Patient.

                                                                Control0..1
                                                                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                118. MedicationAdministration.subject.reference
                                                                Definition

                                                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                ShortLiteral reference, Relative, internal or absolute URL
                                                                Comments

                                                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                Control0..1
                                                                This element is affected by the following invariants: ref-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                120. MedicationAdministration.subject.type
                                                                Definition

                                                                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                ShortType the reference refers to (e.g. "Patient")
                                                                Comments

                                                                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                Control0..1
                                                                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                Typeuri
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                122. MedicationAdministration.subject.identifier
                                                                Definition

                                                                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                ShortLogical reference, when literal reference is not known
                                                                Comments

                                                                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control0..1
                                                                TypeIdentifier
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                124. MedicationAdministration.subject.display
                                                                Definition

                                                                Plain text narrative that identifies the resource in addition to the resource reference.

                                                                ShortText alternative for the resource
                                                                Comments

                                                                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                126. MedicationAdministration.context
                                                                Definition

                                                                The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

                                                                ShortEncounter or Episode of Care administered as part of
                                                                Control0..1
                                                                TypeReference(Encounter, EpisodeOfCare)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                128. MedicationAdministration.context.id
                                                                Definition

                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typeid
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                130. MedicationAdministration.context.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on MedicationAdministration.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 132. MedicationAdministration.context.extension:context
                                                                  Slice Namecontext
                                                                  Definition

                                                                  STU3: MedicationAdministration.context additional types from child elements (display, identifier, reference)

                                                                  ShortSTU3: context additional types
                                                                  Comments

                                                                  Element MedicationAdministration.context is mapped to FHIR R4B element MedicationAdministration.context as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.context do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.context with unmapped reference targets: Encounter, EpisodeOfCare.

                                                                  Control0..1
                                                                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  134. MedicationAdministration.context.reference
                                                                  Definition

                                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                                  Comments

                                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ref-1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  136. MedicationAdministration.context.type
                                                                  Definition

                                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                  ShortType the reference refers to (e.g. "Patient")
                                                                  Comments

                                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                  Control0..1
                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  138. MedicationAdministration.context.identifier
                                                                  Definition

                                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                  ShortLogical reference, when literal reference is not known
                                                                  Comments

                                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                  Control0..1
                                                                  TypeIdentifier
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  140. MedicationAdministration.context.display
                                                                  Definition

                                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                                  ShortText alternative for the resource
                                                                  Comments

                                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  142. MedicationAdministration.supportingInformation
                                                                  Definition

                                                                  Additional information (for example, patient height and weight) that supports the administration of the medication.

                                                                  ShortAdditional information to support administration
                                                                  Control0..*
                                                                  TypeReference(Resource)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  144. MedicationAdministration.supportingInformation.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typeid
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  146. MedicationAdministration.supportingInformation.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on MedicationAdministration.supportingInformation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 148. MedicationAdministration.supportingInformation.extension:supportingInformation
                                                                    Slice NamesupportingInformation
                                                                    Definition

                                                                    STU3: MedicationAdministration.supportingInformation additional types from child elements (display, identifier, reference)

                                                                    ShortSTU3: supportingInformation additional types
                                                                    Comments

                                                                    Element MedicationAdministration.supportingInformation is mapped to FHIR R4B element MedicationAdministration.supportingInformation as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.supportingInformation do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.supportingInformation with unmapped reference targets: Resource.

                                                                    Control0..1
                                                                    TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    150. MedicationAdministration.supportingInformation.reference
                                                                    Definition

                                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                                    Comments

                                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ref-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    152. MedicationAdministration.supportingInformation.type
                                                                    Definition

                                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                    ShortType the reference refers to (e.g. "Patient")
                                                                    Comments

                                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                    Control0..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    154. MedicationAdministration.supportingInformation.identifier
                                                                    Definition

                                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                    ShortLogical reference, when literal reference is not known
                                                                    Comments

                                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control0..1
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    156. MedicationAdministration.supportingInformation.display
                                                                    Definition

                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                    ShortText alternative for the resource
                                                                    Comments

                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    158. 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.

                                                                    ShortStart and end time of administration
                                                                    Control1..1
                                                                    TypeChoice of: dateTime, Period
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    160. MedicationAdministration.performer
                                                                    Definition

                                                                    Indicates who or what performed the medication administration and how they were involved.

                                                                    ShortWho performed the medication administration and what they did
                                                                    Control0..*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                    162. MedicationAdministration.performer.id
                                                                    Definition

                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    164. MedicationAdministration.performer.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on MedicationAdministration.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 166. MedicationAdministration.performer.extension:onBehalfOf
                                                                      Slice NameonBehalfOf
                                                                      Definition

                                                                      STU3: MedicationAdministration.performer.onBehalfOf (new:Reference(Organization))

                                                                      ShortSTU3: Organization organization was acting for (new)
                                                                      Comments

                                                                      Element MedicationAdministration.performer.onBehalfOf has a context of MedicationAdministration.performer based on following the parent source element upwards and mapping to MedicationAdministration. Element MedicationAdministration.performer.onBehalfOf has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension(STU3: Organization organization was acting for (new)) (Extension Type: Reference(Cross-version Profile for STU3.Organization for use in FHIR R4B, Organization))
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      168. MedicationAdministration.performer.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                      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.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                      Summarytrue
                                                                      Requirements

                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                      Alternate Namesextensions, user content, modifiers
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      170. MedicationAdministration.performer.function
                                                                      Definition

                                                                      Distinguishes the type of involvement of the performer in the medication administration.

                                                                      ShortType of performance
                                                                      Control0..1
                                                                      BindingFor example codes, see MedicationAdministration Performer Function Codes
                                                                      (example to http://hl7.org/fhir/ValueSet/med-admin-perform-function|4.3.0)

                                                                      A code describing the role an individual played in administering the medication.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      172. MedicationAdministration.performer.actor
                                                                      Definition

                                                                      Indicates who or what performed the medication administration.

                                                                      ShortWho performed the medication administration
                                                                      Control1..1
                                                                      TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson, Device)
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      174. MedicationAdministration.performer.actor.id
                                                                      Definition

                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typeid
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      176. MedicationAdministration.performer.actor.extension
                                                                      Definition

                                                                      An Extension

                                                                      ShortExtension
                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on MedicationAdministration.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 178. MedicationAdministration.performer.actor.extension:actor
                                                                        Slice Nameactor
                                                                        Definition

                                                                        STU3: MedicationAdministration.performer.actor

                                                                        ShortSTU3: Individual who was performing
                                                                        Comments

                                                                        Element MedicationAdministration.performer.actor is mapped to FHIR R4B element MedicationAdministration.performer.actor as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.performer.actor with unmapped reference targets: Device, Patient, Practitioner, RelatedPerson.

                                                                        Control0..1
                                                                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        180. MedicationAdministration.performer.actor.reference
                                                                        Definition

                                                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                        ShortLiteral reference, Relative, internal or absolute URL
                                                                        Comments

                                                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ref-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        182. MedicationAdministration.performer.actor.type
                                                                        Definition

                                                                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                        ShortType the reference refers to (e.g. "Patient")
                                                                        Comments

                                                                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                        Control0..1
                                                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                        Typeuri
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        184. MedicationAdministration.performer.actor.identifier
                                                                        Definition

                                                                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                        ShortLogical reference, when literal reference is not known
                                                                        Comments

                                                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                        Control0..1
                                                                        TypeIdentifier
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        186. MedicationAdministration.performer.actor.display
                                                                        Definition

                                                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                                                        ShortText alternative for the resource
                                                                        Comments

                                                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        188. MedicationAdministration.reasonCode
                                                                        Definition

                                                                        A code indicating why the medication was given.

                                                                        ShortReason administration performed
                                                                        Control0..*
                                                                        BindingFor example codes, see ReasonMedicationGivenCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/reason-medication-given-codes|4.3.0)

                                                                        A set of codes indicating the reason why the MedicationAdministration was made.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        190. MedicationAdministration.reasonReference
                                                                        Definition

                                                                        Condition or observation that supports why the medication was administered.

                                                                        ShortCondition or observation that supports why the medication was administered
                                                                        Comments

                                                                        This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

                                                                        Control0..*
                                                                        TypeReference(Condition, Observation, DiagnosticReport)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        192. MedicationAdministration.reasonReference.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typeid
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        194. MedicationAdministration.reasonReference.extension
                                                                        Definition

                                                                        An Extension

                                                                        ShortExtension
                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on MedicationAdministration.reasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 196. MedicationAdministration.reasonReference.extension:reasonReference
                                                                          Slice NamereasonReference
                                                                          Definition

                                                                          STU3: MedicationAdministration.reasonReference additional types from child elements (display, identifier, reference)

                                                                          ShortSTU3: Condition or Observation that supports why the medication was administered additional types
                                                                          Comments

                                                                          Element MedicationAdministration.reasonReference is mapped to FHIR R4B element MedicationAdministration.reasonReference as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.reasonReference do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.reasonReference with unmapped reference targets: Condition, Observation. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

                                                                          Control0..1
                                                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          198. MedicationAdministration.reasonReference.reference
                                                                          Definition

                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                          Comments

                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ref-1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          200. MedicationAdministration.reasonReference.type
                                                                          Definition

                                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                          ShortType the reference refers to (e.g. "Patient")
                                                                          Comments

                                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                          Control0..1
                                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                          Typeuri
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          202. MedicationAdministration.reasonReference.identifier
                                                                          Definition

                                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                          ShortLogical reference, when literal reference is not known
                                                                          Comments

                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                          Control0..1
                                                                          TypeIdentifier
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          204. MedicationAdministration.reasonReference.display
                                                                          Definition

                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                          ShortText alternative for the resource
                                                                          Comments

                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          206. MedicationAdministration.request
                                                                          Definition

                                                                          The original request, instruction or authority to perform the administration.

                                                                          ShortRequest administration performed against
                                                                          Comments

                                                                          This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

                                                                          Control0..1
                                                                          TypeReference(MedicationRequest)
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          208. MedicationAdministration.request.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typeid
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          210. MedicationAdministration.request.extension
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on MedicationAdministration.request.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 212. MedicationAdministration.request.extension:prescription
                                                                            Slice Nameprescription
                                                                            Definition

                                                                            STU3: MedicationAdministration.prescription additional types from child elements (display, identifier, reference)

                                                                            ShortSTU3: prescription additional types
                                                                            Comments

                                                                            Element MedicationAdministration.prescription is mapped to FHIR R4B element MedicationAdministration.request as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.prescription do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.prescription with unmapped reference targets: MedicationRequest.

                                                                            Control0..1
                                                                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            214. MedicationAdministration.request.reference
                                                                            Definition

                                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                                            Comments

                                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ref-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            216. MedicationAdministration.request.type
                                                                            Definition

                                                                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                            ShortType the reference refers to (e.g. "Patient")
                                                                            Comments

                                                                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                            Control0..1
                                                                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                            (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                            Typeuri
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            218. MedicationAdministration.request.identifier
                                                                            Definition

                                                                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                            ShortLogical reference, when literal reference is not known
                                                                            Comments

                                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                            Control0..1
                                                                            TypeIdentifier
                                                                            Is Modifierfalse
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            220. MedicationAdministration.request.display
                                                                            Definition

                                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                                            ShortText alternative for the resource
                                                                            Comments

                                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            222. MedicationAdministration.device
                                                                            Definition

                                                                            The device used in administering the medication to the patient. For example, a particular infusion pump.

                                                                            ShortDevice used to administer
                                                                            Control0..*
                                                                            TypeReference(Device)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            224. MedicationAdministration.device.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typeid
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            226. MedicationAdministration.device.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on MedicationAdministration.device.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 228. MedicationAdministration.device.extension:device
                                                                              Slice Namedevice
                                                                              Definition

                                                                              STU3: MedicationAdministration.device additional types from child elements (display, identifier, reference)

                                                                              ShortSTU3: device additional types
                                                                              Comments

                                                                              Element MedicationAdministration.device is mapped to FHIR R4B element MedicationAdministration.device as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.device do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.device with unmapped reference targets: Device.

                                                                              Control0..1
                                                                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              230. MedicationAdministration.device.reference
                                                                              Definition

                                                                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                              ShortLiteral reference, Relative, internal or absolute URL
                                                                              Comments

                                                                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ref-1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              232. MedicationAdministration.device.type
                                                                              Definition

                                                                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                              ShortType the reference refers to (e.g. "Patient")
                                                                              Comments

                                                                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                              Control0..1
                                                                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                              Typeuri
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              234. MedicationAdministration.device.identifier
                                                                              Definition

                                                                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                              ShortLogical reference, when literal reference is not known
                                                                              Comments

                                                                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                              Control0..1
                                                                              TypeIdentifier
                                                                              Is Modifierfalse
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              236. MedicationAdministration.device.display
                                                                              Definition

                                                                              Plain text narrative that identifies the resource in addition to the resource reference.

                                                                              ShortText alternative for the resource
                                                                              Comments

                                                                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              238. MedicationAdministration.note
                                                                              Definition

                                                                              Extra information about the medication administration that is not conveyed by the other attributes.

                                                                              ShortInformation about the administration
                                                                              Control0..*
                                                                              TypeAnnotation
                                                                              Is Modifierfalse
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              240. MedicationAdministration.note.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typeid
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              242. MedicationAdministration.note.extension
                                                                              Definition

                                                                              An Extension

                                                                              ShortExtension
                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on MedicationAdministration.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 244. MedicationAdministration.note.extension:note
                                                                                Slice Namenote
                                                                                Definition

                                                                                STU3: MedicationAdministration.note additional types (Annotation) additional types from child elements (author[x], text, time)

                                                                                ShortSTU3: note additional types
                                                                                Comments

                                                                                Element MedicationAdministration.note is mapped to FHIR R4B element MedicationAdministration.note as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.note do not cover the following types: Annotation. The mappings for MedicationAdministration.note do not cover the following types based on type expansion: author[x], text, time.

                                                                                Control0..*
                                                                                TypeExtension(STU3: note additional types) (Extension Type: Annotation)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                246. MedicationAdministration.note.author[x]
                                                                                Definition

                                                                                The individual responsible for making the annotation.

                                                                                ShortIndividual responsible for the annotation
                                                                                Comments

                                                                                Organization is used when there's no need for specific attribution as to who made the comment.

                                                                                Control0..1
                                                                                TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                248. MedicationAdministration.note.time
                                                                                Definition

                                                                                Indicates when this particular annotation was made.

                                                                                ShortWhen the annotation was made
                                                                                Control0..1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                250. MedicationAdministration.note.text
                                                                                Definition

                                                                                The text of the annotation in markdown format.

                                                                                ShortThe annotation - text content (as markdown)
                                                                                Control1..1
                                                                                Typemarkdown
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                252. MedicationAdministration.dosage
                                                                                Definition

                                                                                Describes the medication dosage information details e.g. dose, rate, site, route, etc.

                                                                                ShortDetails of how medication was taken
                                                                                Control0..1
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                                mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (dose.exists() or rate.exists())
                                                                                254. 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.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                256. MedicationAdministration.dosage.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                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.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                258. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                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.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                260. 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.

                                                                                ShortFree text dosage instructions e.g. SIG
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                262. MedicationAdministration.dosage.site
                                                                                Definition

                                                                                A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

                                                                                ShortBody site administered to
                                                                                Comments

                                                                                If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                                                                Control0..1
                                                                                BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.3.0)

                                                                                A coded concept describing the site location the medicine enters into or onto the body.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                264. 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.

                                                                                ShortPath of substance into body
                                                                                Control0..1
                                                                                BindingFor example codes, see SNOMEDCTRouteCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/route-codes|4.3.0)

                                                                                A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                266. 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.

                                                                                ShortHow drug was administered
                                                                                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.

                                                                                Control0..1
                                                                                BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.3.0)

                                                                                A coded concept describing the technique by which the medicine is administered.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                268. 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.

                                                                                ShortAmount of medication per dose
                                                                                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.

                                                                                Control0..1
                                                                                TypeQuantity(SimpleQuantity)
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                270. 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.

                                                                                ShortDose quantity per unit of time
                                                                                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.

                                                                                Control0..1
                                                                                TypeChoice of: Ratio, Quantity(SimpleQuantity)
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                272. MedicationAdministration.eventHistory
                                                                                Definition

                                                                                A summary of the events of interest that have occurred, such as when the administration was verified.

                                                                                ShortA list of events of interest in the lifecycle
                                                                                Comments

                                                                                This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                                                                                Control0..*
                                                                                TypeReference(Provenance)
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                274. MedicationAdministration.eventHistory.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typeid
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                276. MedicationAdministration.eventHistory.extension
                                                                                Definition

                                                                                An Extension

                                                                                ShortExtension
                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on MedicationAdministration.eventHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 278. MedicationAdministration.eventHistory.extension:eventHistory
                                                                                  Slice NameeventHistory
                                                                                  Definition

                                                                                  STU3: MedicationAdministration.eventHistory additional types from child elements (display, identifier, reference)

                                                                                  ShortSTU3: eventHistory additional types
                                                                                  Comments

                                                                                  Element MedicationAdministration.eventHistory is mapped to FHIR R4B element MedicationAdministration.eventHistory as SourceIsBroaderThanTarget. The mappings for MedicationAdministration.eventHistory do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationAdministration.eventHistory with unmapped reference targets: Provenance. This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                                                                                  Control0..1
                                                                                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  280. MedicationAdministration.eventHistory.reference
                                                                                  Definition

                                                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                                                  Comments

                                                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ref-1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  282. MedicationAdministration.eventHistory.type
                                                                                  Definition

                                                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                  ShortType the reference refers to (e.g. "Patient")
                                                                                  Comments

                                                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                  Control0..1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                                  Typeuri
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  284. MedicationAdministration.eventHistory.identifier
                                                                                  Definition

                                                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                  ShortLogical reference, when literal reference is not known
                                                                                  Comments

                                                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                  Control0..1
                                                                                  TypeIdentifier
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  286. MedicationAdministration.eventHistory.display
                                                                                  Definition

                                                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                  ShortText alternative for the resource
                                                                                  Comments

                                                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))