<status value="draft" /> <date value="2022-10-17T09:09:13.9562003+00:00" /> <publisher value="Healthdata.be (Sciensano)" /> <contact> <name value="Service portal – healthdata.be" /> <telecom> <system value="url" /> <value value="https://sciensano.service-now.com/sp" /> <use value="work" /> </telecom> </contact> <description value="Instructions for the use or administration of the medication, e.g. dose and route of administration. In the event of medication use, this is the pattern of use established by the patient or which the patient followed." /> <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." /> <fhirVersion value="4.0.1" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <uri value="https://zibs.nl/wiki/InstructionsForUse-v1.2.1(2020EN)" /> <name value="zib InstructionsForUse-v1.2.1(2020EN)" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <uri value="https://zibs.nl/wiki/Range-v1.0.1(2020EN)" /> <name value="zib Range-v1.0.1(2020EN)" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <uri value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-InstructionsForUse" /> <name value="HdBe logical model InstructionsForUse" /> </mapping> <mapping> <identity value="HdBe-Range" /> <uri value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-Range" /> <name value="HdBe logical model Range" /> </mapping> <kind value="complex-type" /> <abstract value="false" /> <type value="Dosage" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Dosage" /> <derivation value="constraint" /> <differential> <element id="Dosage"> <path value="Dosage" /> <short value="DosingInstructions" /> <comment value="This element _mostly_ represents the DosingInstructions container from CBB InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are **duplicated** in every repetition of this element, even though these concepts should be present just once according to the CBB. The RepeatPeriodCyclicalSchedule and Description elements of the CBB are not represented in this profile. When a HdBe profile contains a InstructionsForUse.DosageInstructions datatype, the RepeatPeriodCyclicalSchedule and Description elements are separately added to this profile as well. This element does not contain a mapping to the Dosage container from CBB InstructionsForUse. However, the child concepts of Dosage are all mapped. Multiple Dosage instances are represented by another DosingInstructions that contains a similiar SequenceNumber." /> <alias value="Doseerinstructie" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22095" /> <comment value="DosingInstructions" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions" /> </mapping> </element> <element id="Dosage.sequence"> <path value="Dosage.sequence" /> <short value="SequenceNumber" /> <definition value="This indicates the sequence of the dosing instructions within the medication agreement." /> <alias value="Volgnummer" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22503" /> <comment value="SequenceNumber" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.SequenceNumber" /> </mapping> </element> <element id="Dosage.additionalInstruction"> <path value="Dosage.additionalInstruction" /> <short value="AdditionalInstructions" /> <definition value="The additional instructions contain extra information on the use of the current prescription. This includes all instructions for use. The text can come from the original “paper" medication prescription, but can also be generated from the coded information. This concept may contain more information than what is structurally coded in the information below, but may not conflict with it. The instructions may not conflict with other components of the request for administration. The instructions can also refer to an existing protocol." /> <comment value="Please note that in contrast to the CBB, this AdditionalInstructions concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions." /> <alias value="AanvullendeInstructie" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19944" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.AdditionalInstructions" /> </mapping> </element> <element id="Dosage.timing"> <path value="Dosage.timing" /> <short value="AdministeringSchedule" /> <definition value="Specifications of the times at which the medication is to be administered. This is indicated as follows: * Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. * A specific number of times the medication is to be taken each day ("3x a day"), indicated with the frequency. * A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. * Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: * One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) * ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: * The end date and time has been reached * The total administration duration has been reached (14 days) * A specific amount of administrations has been reached (“20 doses”), to be entered in the Frequency concept." /> <alias value="Toedieningsschema" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19948" /> <comment value="AdministeringSchedule" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule" /> </mapping> </element> <element id="Dosage.timing.repeat.extension"> <path value="Dosage.timing.repeat.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> <min value="0" /> </element> <element id="Dosage.timing.repeat.extension:timingExact"> <path value="Dosage.timing.repeat.extension" /> <sliceName value="timingExact" /> <min value="0" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/timing-exact" /> </type> </element> <element id="Dosage.timing.repeat.extension:timingExact.value[x]"> <path value="Dosage.timing.repeat.extension.value[x]" /> <definition value="Indicates that the timing as specified by `.frequency`, `.period` and `.periodUnit` should be strictly interpreted. This is the case when the CBB concept Interval is expressed using these elements (as opposed to the CBB concept Frequency). The times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval (implicit, main mapping is on .frequency, .period and .periodMax)" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval" /> <comment value="implicit, main mapping is on .frequency, .period and .periodMax" /> </mapping> </element> <element id="Dosage.timing.repeat.bounds[x]"> <path value="Dosage.timing.repeat.bounds[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Dosage.timing.repeat.bounds[x]:boundsDuration"> <path value="Dosage.timing.repeat.bounds[x]" /> <sliceName value="boundsDuration" /> <short value="DoseDuration" /> <definition value="The intended time duration for these dosing instructions, e.g. 5 days or 8 weeks. In the case of medication for an indefinite period, the dosing duration is left empty in the last dosing instruction." /> <alias value="Doseerduur" /> <type> <code value="Duration" /> </type> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22506" /> <comment value="DoseDuration" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.DoseDuration" /> </mapping> </element> <element id="Dosage.timing.repeat.count"> <path value="Dosage.timing.repeat.count" /> <short value="Frequency / minimumValue / nominalValue" /> <definition value="Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by this `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <alias value="Frequentie" /> <alias value="nominaleWaarde" /> <alias value="minimumWaarde" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency (single use only)" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency" /> <comment value="single use only" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.NominalValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MinimumValue" /> </mapping> </element> <element id="Dosage.timing.repeat.countMax"> <path value="Dosage.timing.repeat.countMax" /> <short value="Frequency / maximumValue" /> <definition value="Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by the `.count` element and optionally `.countMax` if a range should be represented. A reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <alias value="Frequentie" /> <alias value="maximumWaarde" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MaximumValue" /> </mapping> </element> <element id="Dosage.timing.repeat.duration"> <path value="Dosage.timing.repeat.duration" /> <short value="DurationOfAdministration" /> <definition value="The duration of administration defines the length of time during which the drug is administered and is mainly used in the slow parenteral administration of fluids. The `durationUnit` defines the time unit." /> <alias value="Toedieningsduur" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.23141" /> <comment value="DurationOfAdministration" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration" /> </mapping> </element> <element id="Dosage.timing.repeat.durationUnit"> <path value="Dosage.timing.repeat.durationUnit" /> <short value="DurationOfAdministration" /> <definition value="The units of time, in UCUM units, for the duration of administration of time during which the drug is administered." /> <alias value="Toedieningsduur" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.23141" /> <comment value="DurationOfAdministration" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.DurationOfAdministration" /> </mapping> </element> <element id="Dosage.timing.repeat.frequency"> <path value="Dosage.timing.repeat.frequency" /> <short value="Frequency / minimumValue / nominalValue / Interval" /> <definition value="The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. If the `extension:timingExact` element is absent or set to _false_, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to _true_, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <alias value="Frequentie" /> <alias value="minimumWaarde" /> <alias value="nominaleWaarde" /> <alias value="Interval" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MinimumValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.NominalValue" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval" /> </mapping> </element> <element id="Dosage.timing.repeat.frequencyMax"> <path value="Dosage.timing.repeat.frequencyMax" /> <short value="Frequency / maximumValue" /> <definition value="If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. If the `extension:timingExact` element is absent or set to _false_, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to _true_, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <alias value="maximumWaarde" /> <alias value="Frequentie" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MaximumValue" /> </mapping> </element> <element id="Dosage.timing.repeat.period"> <path value="Dosage.timing.repeat.period" /> <short value="Frequency / Interval" /> <definition value="Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. If the `extension:timingExact` element is absent or set to _false_, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to _true_, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <alias value="Frequentie" /> <alias value="Interval" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval" /> </mapping> </element> <element id="Dosage.timing.repeat.periodUnit"> <path value="Dosage.timing.repeat.periodUnit" /> <short value="Frequency / Interval" /> <definition value="The units of time for the period in UCUM units for Frequency and Interval. If the `extension:timingExact` element is absent or set to _false_, a reasonable distribution over the day is expected, but exact times are not given. This is left to the patient. It is the most common manner of extramural prescription. In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics). If the `extension:timingExact` element is present and set to _true_, the times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics) In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the CBB concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency with a period of 1 and is represented in FHIR as just another frequency using `.frequency`, `.period` and `.periodUnit`. However, the CBB differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `extension:timingExact`. 2. On the other hand, the CBB Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * CBB concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * CBB concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <alias value="Frequentie" /> <alias value="Interval" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency. When frequency is used, set `extenstion.exact` to false." /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Frequency" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.Interval" /> </mapping> </element> <element id="Dosage.timing.repeat.dayOfWeek"> <path value="Dosage.timing.repeat.dayOfWeek" /> <short value="WeekDay" /> <definition value="WeekDay indicates a pattern of doses on fixed week days." /> <comment value="If no days are specified, the action is assumed to happen every day as otherwise specified." /> <alias value="Weekdag" /> <binding> <strength value="required" /> <description value="Use ConceptMap 'WeekDay_to_DaysOfWeek' to translate CBB terminology to profile terminology in ValueSet 'DaysOfWeek.'" /> <valueSet value="http://hl7.org/fhir/ValueSet/days-of-week|4.0.1"> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueCanonical value="https://fhir.healthdata.be/ConceptMap/WeekDay-to-DaysOfWeek" /> </extension> </valueSet> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19952" /> <comment value="WeekDay" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.WeekDay" /> </mapping> </element> <element id="Dosage.timing.repeat.timeOfDay"> <path value="Dosage.timing.repeat.timeOfDay" /> <short value="AdministrationTime" /> <definition value="The time of administration is a specific time of day (on the clock). This time usually isn’t (intended to be) exact. There can be multiple administering times in one day. The ideal time of administration can also be entered as a time of day (morning, afternoon, evening, night-time). The administration time is then to be left empty, and the time of day can be entered in the TimeOfDay concept." /> <comment value="If there's a timeOfDay, there cannot be a when, or vice versa." /> <alias value="Toedientijd" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19951" /> <comment value="AdministrationTime" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.AdministrationTime" /> </mapping> </element> <element id="Dosage.timing.repeat.when"> <path value="Dosage.timing.repeat.when" /> <short value="TimeOfDay" /> <definition value="Time of day: morning, afternoon, evening, night." /> <alias value="Dagdeel" /> <binding> <strength value="required" /> <description value="Use ConceptMap 'TimeOfDay_to_EventTiming' to translate CBB terminology to profile terminology in ValueSet 'EventTiming.'" /> <valueSet value="http://hl7.org/fhir/ValueSet/event-timing"> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueCanonical value="https://fhir.healthdata.be/ConceptMap/TimeOfDay-to-EventTiming" /> </extension> </valueSet> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19953" /> <comment value="TimeOfDay" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSchedule.TimeOfDay" /> </mapping> </element> <element id="Dosage.asNeeded[x]"> <path value="Dosage.asNeeded[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Dosage.asNeeded[x]:asNeededCodeableConcept"> <path value="Dosage.asNeeded[x]" /> <sliceName value="asNeededCodeableConcept" /> <short value="Condition" /> <definition value="The condition for administering medication can be: * a physiological measurement value (plasma glucose concentration, body temperature, blood pressure); * a symptom or other circumstance (in the event of a headache, or itch). Physiological measurement values or other conditions do not need to be coded. These can be expressed in free text in the Description concept." /> <alias value="Criterium" /> <type> <code value="CodeableConcept" /> </type> <binding> <strength value="required" /> <valueSet value="https://fhir.healthdata.be/ValueSet/AsNeededCriterium" /> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19945" /> <comment value="Condition" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AsNeeded.Condition" /> </mapping> </element> <element id="Dosage.route"> <path value="Dosage.route" /> <short value="RouteOfAdministration" /> <definition value="The route through which the medication is administered (oral, nasal, intravenous, etc.)." /> <comment value="Please note that in contrast to the CBB, this RouteOfAdministration concept is grouped under the DosingInstructions concept. This CBB concept should thus be duplicated when there are multiple DosingInstructions." /> <alias value="Toedieningsweg" /> <binding> <strength value="required" /> <valueSet value="https://fhir.healthdata.be/ValueSet/RouteOfMedicationAdministration" /> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19941" /> <comment value="RouteOfAdministration" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.RouteOfAdministration" /> </mapping> </element> <element id="Dosage.doseAndRate"> <path value="Dosage.doseAndRate" /> <short value="Dosage" /> <definition value="Instructions for the administrator to administer the medication (the patient themselves, a nurse or other aid). When taking stock of medication use, the dosage describes the pattern of use established by the patient. Once the dose schedule (distribution of doses over time) and the dose have been determined, then there should be one single instruction for use. Multiple parallel instructions for use can be included in the event of a changing dose within one day and in the event of a variable use frequency. Multiple sequential instructions for use can be included in the event of changing doses within one period and/or in the event of a changing dose schedule." /> <comment value="DurationOfAdministration is not mapped to this element but to `.timing.repeat.duration` and `.timing.repeat.durationUnit`." /> <alias value="Dosering" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19935" /> <comment value="Dosage" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]"> <path value="Dosage.doseAndRate.dose[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <short value="Dose" /> <definition value="The dose indicates the amount/unit per administration. The unit can be any unit that can occur with this particular medicine." /> <alias value="Keerdosis" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19940" /> <comment value="Dose" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.Dose" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseRange" /> <type> <code value="Range" /> </type> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange.low"> <path value="Dosage.doseAndRate.dose[x].low" /> <short value="minimumValue" /> <definition value="The minimal value of the range. The boundary is inclusive." /> <alias value="minimumWaarde" /> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MinimumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange.high"> <path value="Dosage.doseAndRate.dose[x].high" /> <short value="maximumValue" /> <definition value="The maximum value of the range. The boundary is inclusive." /> <alias value="maximumWaarde" /> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MaximumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseQuantity"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseQuantity" /> <short value="nominalValue" /> <definition value="Amount of medication per dose. The nominal value of the quantity." /> <alias value="nominaleWaarde" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.NominalValue" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]"> <path value="Dosage.doseAndRate.rate[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <short value="AdministeringSpeed" /> <definition value="The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: * amount = 10, * dose unit = ml, * time unit = hour" /> <alias value="Toedieningssnelheid" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19942" /> <comment value="AdministeringSpeed" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AdministeringSpeed" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]:rateRange"> <path value="Dosage.doseAndRate.rate[x]" /> <sliceName value="rateRange" /> <type> <code value="Range" /> </type> </element> <element id="Dosage.doseAndRate.rate[x]:rateRange.low"> <path value="Dosage.doseAndRate.rate[x].low" /> <short value="minimumValue" /> <definition value="The minimal value of the range. The boundary is inclusive." /> <alias value="minimumWaarde" /> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MinimumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]:rateRange.high"> <path value="Dosage.doseAndRate.rate[x].high" /> <short value="maximumValue" /> <definition value="The maximum value of the range. The boundary is inclusive." /> <alias value="maximumWaarde" /> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.MaximumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]:rateQuantity"> <path value="Dosage.doseAndRate.rate[x]" /> <sliceName value="rateQuantity" /> <short value="nominalValue" /> <definition value="The nominal value of the quantity." /> <alias value="nominaleWaarde" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> <mapping> <identity value="HdBe-Range" /> <map value="Range.NominalValue" /> </mapping> </element> <element id="Dosage.maxDosePerPeriod"> <path value="Dosage.maxDosePerPeriod" /> <short value="MaximumDose" /> <definition value="A maximum dose maximizes (in time) the usage of a drug in an 'as needed' prescription." /> <alias value="MaximaleDosering" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19946" /> <comment value="MaximumDose" /> </mapping> <mapping> <identity value="HdBe-InstructionsForUse" /> <map value="InstructionsForUse.DosingInstructions.Dosage.AsNeeded.MaximumDose" /> </mapping> </element> </differential> </StructureDefinition>