MedicationAdministration

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4.10.7 Resource MedicationAdministration - Formal Definitions

Formal definitions for the elements in the MedicationAdministration resource.

MedicationAdministration
Definition	Describes the event of a patient being given a dose of 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.
Control	1..1
Invariants	Defined on this element Inv-2: Reason not given is only permitted if wasNotGiven is true (xpath: not(exists(f:reasonNotGiven)) or f:wasNotGiven='true')
MedicationAdministration.identifier
Definition	External identifier - FHIR will generate its own internal IDs (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.
Control	0..*
Type	Identifier
Is Modifier	true
MedicationAdministration.status
Definition	Will generally be set to show that the administration has been completed. For some long running administrations such as infusions it is possible for an administration to be started but not completed or it may be paused while some other process is under way.
Control	1..1
Binding	MedicationAdministrationStatus: A set of codes indicating the current status of a MedicationAdministration (see http://hl7.org/fhir/medication-admin-status for values)
Type	code
Is Modifier	true
MedicationAdministration.patient
Definition	The person or animal to whom the medication was given.
Control	1..1
Type	Resource(Patient)
MedicationAdministration.practitioner
Definition	The individual who was responsible for giving the medication to the patient.
Control	1..1
Type	Resource(Practitioner)
MedicationAdministration.encounter
Definition	The visit or admission the or other contact between patient and health care provider the medication administration was performed as part of.
Control	0..1
Type	Resource(Encounter)
MedicationAdministration.prescription
Definition	The original request, instruction or authority to perform the administration.
Control	1..1
Type	Resource(MedicationPrescription)
MedicationAdministration.wasNotGiven
Definition	Set this to true if the record is saying that the medication was NOT administered.
Control	0..1
Type	boolean
Is Modifier	true
MedicationAdministration.reasonNotGiven
Definition	A code indicating why the administration was not performed.
Control	0..*
Binding	MedicationAdministrationNegationReason: (See http://hl7.org/fhir/vs/reason-medication-not-given-codes)
Type	CodeableConcept
Invariants	Affect this element Inv-2: Reason not given is only permitted if wasNotGiven is true (xpath: not(exists(f:reasonNotGiven)) or f:wasNotGiven='true')
MedicationAdministration.whenGiven
Definition	An interval of time during which the administration took place. For many administrations, such as swallowing a tablet the lower and upper values of the interval will be the same.
Control	1..1
Type	Period
MedicationAdministration.medication
Definition	Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
Control	0..1
Type	Resource(Medication)
Comments	Note: do not use Medication.name to describe the administered medication. When the only available information is a text description of the medication, Medication.code.text should be used.
MedicationAdministration.device
Definition	The device used in administering the medication to the patient. E.g. a particular infusion pump.
Control	0..*
Type	Resource(Device)
MedicationAdministration.dosage
Definition	Provides details of how much of the medication was administered.
Control	0..*
Invariants	Defined on this element Inv-1: SHALL have at least one of dosage.quantity and dosage.rate (xpath: exists(f:quantity) or exists(f:rate))
To Do	The RMIM has priority code on the act relationship. How do we handle this?.
MedicationAdministration.dosage.timing[x]
Definition	The timing schedule for giving the medication to the patient. This may be a single time point (using dateTime) or it may be a start and end dateTime (Period).
Control	0..1
Type	dateTime\|Period
Comments	This is generally only relevant if the administration record represents a summary of multiple administrations.
To Do	Is this in the 80% for an administration record? If so, need to explain how. 2014/01/22 HG: Changed data type.
MedicationAdministration.dosage.asNeeded[x]
Definition	If set to true or if specified as a CodeableConcept, indicates that the medication is only taken when needed within the specified schedule rather than at every scheduled dose. If a CodeableConcept is present, it indicates the pre-condition for taking the Medication.
Control	0..1
Binding	MedicationAsNeededReason: A coded concept identifying the pre-condition that should hold prior to consuming a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up", etc.
Type	boolean\|CodeableConcept
MedicationAdministration.dosage.site
Definition	A coded specification of the anatomic site where the medication first entered the body. E.g. "left arm".
Control	0..1
Binding	MedicationAdministrationSite: (See http://hl7.org/fhir/vs/approach-site-codes)
Type	CodeableConcept
MedicationAdministration.dosage.route
Definition	A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. E.g. topical, intravenous, etc.
Control	0..1
Binding	RouteOfAdministration: (See http://hl7.org/fhir/vs/route-codes)
Type	CodeableConcept
MedicationAdministration.dosage.method
Definition	A coded value indicating the method by which the medication was introduced into or onto the body. Most commonly used for injections. Examples: Slow Push; Deep IV. Terminologies used often pre-coordinate this term with the route and or form of administration.
Control	0..1
Binding	MedicationAdministrationMethod: (See http://hl7.org/fhir/vs/administration-method-codes)
Type	CodeableConcept
MedicationAdministration.dosage.quantity
Definition	The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.
Control	0..1
Type	Quantity
Comments	If the administration is not instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount administered over period of time of a single administration (as indicated by schedule).
MedicationAdministration.dosage.rate
Definition	Identifies the speed with which the medication was introduced into the patient. Typically the rate for an infusion e.g. 200ml in 2 hours. May also expressed as a rate per unit of time such as 100ml per hour - the duration is then not specified, or is specified in the quantity.
Control	0..1
Type	Ratio
Comments	If the rate changes over time, each change should be captured as a distinct "dosage" repetition. This element should not be used to convey an average rate.
MedicationAdministration.dosage.maxDosePerPeriod
Definition	The maximum total quantity of a therapeutic substance that was administered to the patient over the specified period of time. E.g. 1000mg in 24 hours.
Control	0..1
Type	Ratio
To Do	How is this relevant when capturing an administration already performed? Is it in the 80%?.