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

Extension: ExtensionDosage_DoseAndRate - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the ext-R4B-Dosage.doseAndRate extension.

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

0. Extension
Definition

R4B: Dosage.doseAndRate (new:Element)


Optional Extension Element - found in all resources.

ShortR4B: Amount of medication administered (new)Optional Extensions Element
Comments

Element Dosage.doseAndRate has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

Control0..*
This element is affected by the following invariants: ele-1
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (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() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
2. Extension.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Extension.extension:type
    Slice Nametype
    Definition

    R4B: Dosage.doseAndRate.type (new:CodeableConcept)

    ShortR4B: The kind of dose or rate specified (new)Additional Content defined by implementations
    Comments

    Element Dosage.doseAndRate.type is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.type has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..1*
    TypeExtension
    Requirements

    If the type is not populated, assume to be "ordered". Element Dosage.doseAndRate.type is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.type has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    6. Extension.extension:type.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuetype
    8. Extension.extension:type.value[x]
    Definition

    The kind of dose or rate specified, for example, ordered or calculated.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortThe kind of dose or rate specifiedValue of extension
    Control0..1
    BindingFor example codes, see For codes, see R4BDoseRateTypeForR3 (0.1.0)
    (example to http://hl7.org/fhir/uv/xver/ValueSet/R4B-dose-rate-type-for-R3|0.1.0)
    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    10. Extension.extension:dose
    Slice Namedose
    Definition

    R4B: Dosage.doseAndRate.dose[x]

    ShortR4B: doseAdditional Content defined by implementations
    Comments

    Element Dosage.doseAndRate.dose[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.dose[x] is mapped to FHIR STU3 element Dosage.dose[x] as SourceIsBroaderThanTarget. The target context Dosage.dose[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

    Control0..1*
    TypeExtension
    Requirements

    The amount of therapeutic or other substance given at one administration event. Element Dosage.doseAndRate.dose[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.dose[x] is mapped to FHIR STU3 element Dosage.dose[x] as SourceIsBroaderThanTarget. The target context Dosage.dose[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage.

    12. Extension.extension:dose.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuedose
    14. Extension.extension:dose.value[x]
    Definition

    Amount of medication per dose.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortAmount of medication per doseValue of extension
    Comments

    Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

    Control0..1
    TypeChoice of: Range, Quantity(SimpleQuantity), date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Duration, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    16. Extension.extension:rate
    Slice Namerate
    Definition

    R4B: Dosage.doseAndRate.rate[x] additional types (Ratio, Range)

    ShortR4B: rate additional typesAdditional Content defined by implementations
    Comments

    Element Dosage.doseAndRate.rate[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.rate[x] is mapped to FHIR STU3 element Dosage.rate[x] as SourceIsBroaderThanTarget. The mappings for Dosage.doseAndRate.rate[x] do not cover the following types: Range, Ratio. The target context Dosage.rate[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

    Control0..1*
    TypeExtension
    Requirements

    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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Element Dosage.doseAndRate.rate[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.rate[x] is mapped to FHIR STU3 element Dosage.rate[x] as SourceIsBroaderThanTarget. The mappings for Dosage.doseAndRate.rate[x] do not cover the following types: Range, Ratio. The target context Dosage.rate[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage.

    18. Extension.extension:rate.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuerate
    20. Extension.extension:rate.value[x]
    Definition

    Amount of medication per unit of time.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortAmount of medication per unit of timeValue of extension
    Comments

    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

    Control0..1
    TypeChoice of: Ratio, Range, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    22. Extension.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://hl7.org/fhir/4.3/StructureDefinition/extension-Dosage.doseAndRate
    24. Extension.value[x]
    Definition

    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortValue of extension
    Control0..01
    TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

    0. Extension
    Definition

    R4B: Dosage.doseAndRate (new:Element)

    ShortR4B: Amount of medication administered (new)
    Comments

    Element Dosage.doseAndRate has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..*
    Is Modifierfalse
    2. Extension.extension
    Control0..*
    SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 4. Extension.extension:type
      Slice Nametype
      Definition

      R4B: Dosage.doseAndRate.type (new:CodeableConcept)

      ShortR4B: The kind of dose or rate specified (new)
      Comments

      Element Dosage.doseAndRate.type is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.type has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      Control0..1
      Requirements

      If the type is not populated, assume to be "ordered". Element Dosage.doseAndRate.type is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.type has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      6. Extension.extension:type.url
      Control1..1
      Fixed Valuetype
      8. Extension.extension:type.value[x]
      Definition

      The kind of dose or rate specified, for example, ordered or calculated.

      ShortThe kind of dose or rate specified
      Control0..1
      BindingFor example codes, see R4BDoseRateTypeForR3 (0.1.0)
      (example to http://hl7.org/fhir/uv/xver/ValueSet/R4B-dose-rate-type-for-R3|0.1.0)
      TypeCodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      10. Extension.extension:dose
      Slice Namedose
      Definition

      R4B: Dosage.doseAndRate.dose[x]

      ShortR4B: dose
      Comments

      Element Dosage.doseAndRate.dose[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.dose[x] is mapped to FHIR STU3 element Dosage.dose[x] as SourceIsBroaderThanTarget. The target context Dosage.dose[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

      Control0..1
      Requirements

      The amount of therapeutic or other substance given at one administration event. Element Dosage.doseAndRate.dose[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.dose[x] is mapped to FHIR STU3 element Dosage.dose[x] as SourceIsBroaderThanTarget. The target context Dosage.dose[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage.

      12. Extension.extension:dose.url
      Control1..1
      Fixed Valuedose
      14. Extension.extension:dose.value[x]
      Definition

      Amount of medication per dose.

      ShortAmount of medication per dose
      Comments

      Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

      Control0..1
      TypeChoice of: Range, Quantity(SimpleQuantity)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      16. Extension.extension:rate
      Slice Namerate
      Definition

      R4B: Dosage.doseAndRate.rate[x] additional types (Ratio, Range)

      ShortR4B: rate additional types
      Comments

      Element Dosage.doseAndRate.rate[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.rate[x] is mapped to FHIR STU3 element Dosage.rate[x] as SourceIsBroaderThanTarget. The mappings for Dosage.doseAndRate.rate[x] do not cover the following types: Range, Ratio. The target context Dosage.rate[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

      It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

      Control0..1
      Requirements

      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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Element Dosage.doseAndRate.rate[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.rate[x] is mapped to FHIR STU3 element Dosage.rate[x] as SourceIsBroaderThanTarget. The mappings for Dosage.doseAndRate.rate[x] do not cover the following types: Range, Ratio. The target context Dosage.rate[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage.

      18. Extension.extension:rate.url
      Control1..1
      Fixed Valuerate
      20. Extension.extension:rate.value[x]
      Definition

      Amount of medication per unit of time.

      ShortAmount of medication per unit of time
      Comments

      It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

      It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

      Control0..1
      TypeChoice of: Ratio, Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      22. Extension.url
      Control1..1
      Fixed Valuehttp://hl7.org/fhir/4.3/StructureDefinition/extension-Dosage.doseAndRate
      24. Extension.value[x]
      Control0..0

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

      0. Extension
      Definition

      R4B: Dosage.doseAndRate (new:Element)

      ShortR4B: Amount of medication administered (new)
      Comments

      Element Dosage.doseAndRate has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      Control0..*
      This element is affected by the following invariants: ele-1
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      2. Extension.id
      Definition

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

      Shortxml:id (or equivalent in JSON)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      4. Extension.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Extension.extension:type
        Slice Nametype
        Definition

        R4B: Dosage.doseAndRate.type (new:CodeableConcept)

        ShortR4B: The kind of dose or rate specified (new)
        Comments

        Element Dosage.doseAndRate.type is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.type has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

        Control0..1
        TypeExtension
        Requirements

        If the type is not populated, assume to be "ordered". Element Dosage.doseAndRate.type is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.type has a context of Dosage based on following the parent source element upwards and mapping to Dosage. Element Dosage.doseAndRate.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

        8. Extension.extension:type.id
        Definition

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

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        10. Extension.extension:type.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        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
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 12. Extension.extension:type.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuetype
          14. Extension.extension:type.value[x]
          Definition

          The kind of dose or rate specified, for example, ordered or calculated.

          ShortThe kind of dose or rate specified
          Control0..1
          BindingFor example codes, see R4BDoseRateTypeForR3 (0.1.0)
          (example to http://hl7.org/fhir/uv/xver/ValueSet/R4B-dose-rate-type-for-R3|0.1.0)
          TypeCodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          16. Extension.extension:dose
          Slice Namedose
          Definition

          R4B: Dosage.doseAndRate.dose[x]

          ShortR4B: dose
          Comments

          Element Dosage.doseAndRate.dose[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.dose[x] is mapped to FHIR STU3 element Dosage.dose[x] as SourceIsBroaderThanTarget. The target context Dosage.dose[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

          Control0..1
          TypeExtension
          Requirements

          The amount of therapeutic or other substance given at one administration event. Element Dosage.doseAndRate.dose[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.dose[x] is mapped to FHIR STU3 element Dosage.dose[x] as SourceIsBroaderThanTarget. The target context Dosage.dose[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage.

          18. Extension.extension:dose.id
          Definition

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

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          20. Extension.extension:dose.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          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
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 22. Extension.extension:dose.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuedose
            24. Extension.extension:dose.value[x]
            Definition

            Amount of medication per dose.

            ShortAmount of medication per dose
            Comments

            Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

            Control0..1
            TypeChoice of: Range, Quantity(SimpleQuantity)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            26. Extension.extension:rate
            Slice Namerate
            Definition

            R4B: Dosage.doseAndRate.rate[x] additional types (Ratio, Range)

            ShortR4B: rate additional types
            Comments

            Element Dosage.doseAndRate.rate[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.rate[x] is mapped to FHIR STU3 element Dosage.rate[x] as SourceIsBroaderThanTarget. The mappings for Dosage.doseAndRate.rate[x] do not cover the following types: Range, Ratio. The target context Dosage.rate[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

            It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

            Control0..1
            TypeExtension
            Requirements

            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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Element Dosage.doseAndRate.rate[x] is part of an existing definition because parent element Dosage.doseAndRate requires a cross-version extension. Element Dosage.doseAndRate.rate[x] is mapped to FHIR STU3 element Dosage.rate[x] as SourceIsBroaderThanTarget. The mappings for Dosage.doseAndRate.rate[x] do not cover the following types: Range, Ratio. The target context Dosage.rate[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Dosage.

            28. Extension.extension:rate.id
            Definition

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

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            30. Extension.extension:rate.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            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
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. Extension.extension:rate.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuerate
              34. Extension.extension:rate.value[x]
              Definition

              Amount of medication per unit of time.

              ShortAmount of medication per unit of time
              Comments

              It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

              It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

              Control0..1
              TypeChoice of: Ratio, Range
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              36. Extension.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://hl7.org/fhir/4.3/StructureDefinition/extension-Dosage.doseAndRate
              38. Extension.value[x]
              Definition

              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

              ShortValue of extension
              Control0..0
              TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension