Profile Comparison between http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity vs http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
copyright
date	2023-12-21T01:13:10+10:00	2024-05-18T00:42:57-05:00	Values Differ
description	A Medication Activity describes substance administrations that have actually occurred (e.g., pills ingested or injections given) or are intended to occur (e.g., "take 2 tablets twice a day for the next 10 days"). Medication activities in "INT" mood are reflections of what a clinician intends a patient to be taking. For example, a clinician may intend that a patient be administered Lisinopril 20 mg PO for blood pressure control. If what was actually administered was Lisinopril 10 mg., then the Medication activities in the "EVN" mood would reflect actual use. A moodCode of INT is allowed, but it is recommended that the Planned Medication Activity template be used for moodCodes other than EVN if the document type contains a section that includes Planned Medication Activity (for example a Care Plan document with Plan of Treatment, Intervention, or Goal sections). At a minimum, a Medication Activity shall include an effectiveTime indicating the duration of the administration (or single-administration timestamp). Ambulatory medication lists generally provide a summary of use for a given medication over time - a medication activity in event mood with the duration reflecting when the medication started and stopped. Ongoing medications will not have a stop date (or will have a stop date with a suitable NULL value). Ambulatory medication lists will generally also have a frequency (e.g., a medication is being taken twice a day). Inpatient medications generally record each administration as a separate act. The dose (doseQuantity) represents how many of the consumables are to be administered at each administration event. As a result, the dose is always relative to the consumable and the interval of administration. Thus, a patient consuming a single "metoprolol 25mg tablet " per administration will have a doseQuantity of "1 ", whereas a patient consuming "metoprolol Oral Product " (RxCUI 1163523) will have a dose of "25 mg ".	A Medication Activity describes substance administrations that have actually occurred (e.g., pills ingested or injections given) or are intended to occur (e.g., "take 2 tablets twice a day for the next 10 days"). Medication activities in "INT" mood are reflections of what a clinician intends a patient to be taking. For example, a clinician may intend that a patient be administered Lisinopril 20 mg PO for blood pressure control. If what was actually administered was Lisinopril 10 mg., then the Medication activities in the "EVN" mood would reflect actual use. A moodCode of INT is allowed, but it is recommended that the Planned Medication Activity template be used for moodCodes other than EVN if the document type contains a section that includes Planned Medication Activity (for example a Care Plan document with Plan of Treatment, Intervention, or Goal sections). At a minimum, a Medication Activity shall include an effectiveTime indicating the duration of the administration (or single-administration timestamp). Ambulatory medication lists generally provide a summary of use for a given medication over time - a medication activity in event mood with the duration reflecting when the medication started and stopped. Ongoing medications will not have a stop date (or will have a stop date with a suitable NULL value). Ambulatory medication lists will generally also have a frequency (e.g., a medication is being taken twice a day). Inpatient medications generally record each administration as a separate act. The dose (doseQuantity) represents how many of the consumables are to be administered at each administration event. As a result, the dose is always relative to the consumable and the interval of administration. Thus, a patient consuming a single "metoprolol 25mg tablet" per administration will have a doseQuantity of "1", whereas a patient consuming "metoprolol Oral Product" (RxCUI 1163523) will have a dose of "25 mg".	Values Differ
experimental
fhirVersion	5.0.0
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	logical
name	MedicationActivity
publisher	Health Level Seven
purpose
status	draft
title	Medication Activity
type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
url	http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity
version	3.0.0-ballot	3.0.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
SubstanceAdministration	C	1..1	SubstanceAdministration	Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author	C	1..1	SubstanceAdministration	Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
realmCode		0..*	CS			0..*	CS
typeId		0..1	II			0..1	II
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
assigningAuthorityName		0..1	??			0..1	??
displayable		0..1	??			0..1	??
root		1..1	??, ??, ??	Fixed Value: 2.16.840.1.113883.1.3		1..1	??, ??, ??	Fixed Value: 2.16.840.1.113883.1.3
st-simple		1..1	string	Primitive Type string URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple		1..1	string	Primitive Type string URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension		1..*	II	Slice: Unordered, Open by value:root, value:extension
classCode		1..1	??	Binding: ?? (required) Fixed Value: SBADM		1..1	??	Binding: ?? (required) Fixed Value: SBADM
moodCode		1..1	??	Binding: ?? (required)		1..1	??	Binding: ?? (required)
id		1..*	II			1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set. Binding: ?? (example)		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set. Binding: ?? (example)
negationInd		0..1	??			0..1	??
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
compression		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
integrityCheck		0..1	??			0..1	??
integrityCheckAlgorithm		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
language		0..1	??			0..1	??
mediaType		0..1	??	Binding: ?? (example)		0..1	??	Binding: ?? (example)
representation		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
xmlText		0..1	??	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.		0..1	??	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED			0..1	ED
statusCode		1..1	CS	Binding: ?? (required)		1..1	CS	Binding: ?? (required)
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
code		1..1	??	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: ?? (required)		1..1	??	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: ?? (required)
codeSystem		0..0				0..0
codeSystemName		0..0				0..0
codeSystemVersion		0..0				0..0
displayName		0..0				0..0
sdtcValueSet		0..1	??	XML: valueSet (urn:hl7-org:sdtc)		0..1	??	XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion		0..1	??	XML: valueSetVersion (urn:hl7-org:sdtc)		0..1	??	XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..0				0..0
qualifier		0..0				0..0
translation		0..0				0..0
Slices for effectiveTime		1..*	SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS	Slice: Unordered, Open by type:$this		1..*	SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS	Slice: Unordered, Open by type:$this
priorityCode		0..1	CE	Binding: ?? (example)		0..1	CE	Binding: ?? (example)
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: ?? (required) should-translation: SHOULD contain translation	C	0..1	CE	Binding: ?? (required) should-translation: SHOULD contain translation
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
code		0..1	??			0..1	??
codeSystem		0..1	??, ??, ??			0..1	??, ??, ??
codeSystemName		0..1	??			0..1	??
codeSystemVersion		0..1	??			0..1	??
displayName		0..1	??			0..1	??
sdtcValueSet		0..1	??	XML: valueSet (urn:hl7-org:sdtc)		0..1	??	XML: valueSet (urn:hl7-org:sdtc)
sdtcValueSetVersion		0..1	??	XML: valueSetVersion (urn:hl7-org:sdtc)		0..1	??	XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED			0..1	ED
qualifier		0..0				0..0
translation		0..*	CD	Binding: ?? (required)		0..*	CD	Binding: ?? (preferred)
approachSiteCode		0..1	CD	Binding: ?? (required)		0..1	CD	Binding: ?? (required)
doseQuantity	C	1..1	IVL_PQ	(USCDI) Dose Unit of Measure should-unit: SHOULD contain @unit	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
unit		0..1	??	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: ?? (required)		0..1	??	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: ?? (preferred)
value		0..1	??			0..1	??
translation		0..*	PQR			0..*	PQR
operator		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
low		0..1	IVXB_PQ			0..1	IVXB_PQ
center		0..1	PQ			0..1	PQ
width		0..1	PQ			0..1	PQ
high		0..1	IVXB_PQ			0..1	IVXB_PQ
rateQuantity		0..1	IVL_PQ			0..1	IVL_PQ
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
unit		1..1	??	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: ?? (required)		1..1	??	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: ?? (required)
value		0..1	??			0..1	??
translation		0..*	PQR			0..*	PQR
operator		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
low		0..1	IVXB_PQ			0..1	IVXB_PQ
center		0..1	PQ			0..1	PQ
width		0..1	PQ			0..1	PQ
high		0..1	IVXB_PQ			0..1	IVXB_PQ
maxDoseQuantity		0..1	RTO_PQ_PQ			0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: ?? (required)		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: ?? (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications		1..1	InfrastructureRoot	(USCDI) Medications
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
realmCode		0..*	CS			0..*	CS
typeId		0..1	II			0..1	II
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
assigningAuthorityName		0..1	??			0..1	??
displayable		0..1	??			0..1	??
root		1..1	??, ??, ??	Fixed Value: 2.16.840.1.113883.1.3		1..1	??, ??, ??	Fixed Value: 2.16.840.1.113883.1.3
st-simple		1..1	string	Primitive Type string URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple		1..1	string	Primitive Type string URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
templateId		0..*	II			0..*	II
typeCode		0..1	??	Binding: ?? (required) Fixed Value: CSM		0..1	??	Binding: ?? (required) Fixed Value: CSM
manufacturedProduct	C	1..1	??	Base for all types and resources product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)	C	1..1	??	Base for all types and resources product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
subject		0..1	Subject			0..1	Subject
specimen		0..*	Specimen			0..*	Specimen
performer		0..1	Performer2			0..1	Performer2
author		0..*	??	Base for all types and resources		0..*	??	Base for all types and resources
informant		0..*	Informant			0..*	Informant
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode		0..*	Participant2	Slice: Unordered, Open by value:typeCode
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
reference		0..*	Reference			0..*	Reference
precondition		0..*	Precondition			0..*	Precondition
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
realmCode		0..*	CS			0..*	CS
typeId		0..1	II			0..1	II
nullFlavor		0..1	??	Binding: ?? (required)		0..1	??	Binding: ?? (required)
assigningAuthorityName		0..1	??			0..1	??
displayable		0..1	??			0..1	??
root		1..1	??, ??, ??	Fixed Value: 2.16.840.1.113883.1.3		1..1	??, ??, ??	Fixed Value: 2.16.840.1.113883.1.3
st-simple		1..1	string	Primitive Type string URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple		1..1	string	Primitive Type string URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
templateId		0..*	II			0..*	II
typeCode		1..1	??	Binding: ?? (required) Fixed Value: PRCN		1..1	??	Binding: ?? (required) Fixed Value: PRCN
criterion		1..1	??	Base for all types and resources		1..1	??	Base for all types and resources
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML: inFulfillmentOf1 (urn:hl7-org:sdtc)		0..*	InFulfillmentOf1	XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
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