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{
  "resourceType": "StructureDefinition",
  "id": "ISiKMedikationsVerabreichung",
  "url": "https://gematik.de/fhir/isik/v3/Medikation/StructureDefinition/ISiKMedikationsVerabreichung",
  "version": "3.0.5",
  "name": "ISiKMedikationsVerabreichung",
  "status": "active",
  "experimental": false,
  "date": "2025-02-24",
  "publisher": "gematik GmbH",
  "description": "Dieses Profil ermöglicht die Abbildung der Verabreichung von Medikamenten für einen Patienten in ISiK Szenarien.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "MedicationAdministration",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "MedicationAdministration.status",
        "path": "MedicationAdministration.status",
        "short": "Status der Verabreichungsinformation",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]",
        "path": "MedicationAdministration.medication[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept",
        "path": "MedicationAdministration.medication[x]",
        "sliceName": "medicationCodeableConcept",
        "short": "Medikament in codierter Form oder ggf. als Freitext",
        "comment": "kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding",
        "path": "MedicationAdministration.medication[x].coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN",
        "path": "MedicationAdministration.medication[x].coding",
        "sliceName": "PZN",
        "min": 0,
        "max": "1",
        "patternCoding": {
          "system": "http://fhir.de/CodeSystem/ifa/pzn"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN.system",
        "path": "MedicationAdministration.medication[x].coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN.code",
        "path": "MedicationAdministration.medication[x].coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN.display",
        "path": "MedicationAdministration.medication[x].coding.display",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE",
        "path": "MedicationAdministration.medication[x].coding",
        "sliceName": "ATC-DE",
        "min": 0,
        "max": "1",
        "patternCoding": {
          "system": "http://fhir.de/CodeSystem/bfarm/atc"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE.system",
        "path": "MedicationAdministration.medication[x].coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE.code",
        "path": "MedicationAdministration.medication[x].coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE.display",
        "path": "MedicationAdministration.medication[x].coding.display",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14",
        "path": "MedicationAdministration.medication[x].coding",
        "sliceName": "WG14",
        "min": 0,
        "max": "1",
        "patternCoding": {
          "system": "http://fhir.de/CodeSystem/abdata/wg14"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14.system",
        "path": "MedicationAdministration.medication[x].coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14.code",
        "path": "MedicationAdministration.medication[x].coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14.display",
        "path": "MedicationAdministration.medication[x].coding.display",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.text",
        "path": "MedicationAdministration.medication[x].text",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationReference",
        "path": "MedicationAdministration.medication[x]",
        "sliceName": "medicationReference",
        "short": "Referenz auf das Medikament (Medication-Ressource)",
        "comment": "wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Medication"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.medication[x]:medicationReference.reference",
        "path": "MedicationAdministration.medication[x].reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.subject",
        "path": "MedicationAdministration.subject",
        "short": "Referenz auf den Patienten",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.subject.reference",
        "path": "MedicationAdministration.subject.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.context",
        "path": "MedicationAdministration.context",
        "short": "Referenz auf den Abteilungskontakt",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.context.reference",
        "path": "MedicationAdministration.context.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.effective[x]",
        "path": "MedicationAdministration.effective[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "MedicationAdministration.effective[x]:effectiveDateTime",
        "path": "MedicationAdministration.effective[x]",
        "sliceName": "effectiveDateTime",
        "short": "Zeitpunkt der Verabreichung",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.effective[x]:effectivePeriod",
        "path": "MedicationAdministration.effective[x]",
        "sliceName": "effectivePeriod",
        "short": "Zeitraum der Verabreichung",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Period"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.effective[x]:effectivePeriod.start",
        "path": "MedicationAdministration.effective[x].start",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.effective[x]:effectivePeriod.end",
        "path": "MedicationAdministration.effective[x].end",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.performer",
        "path": "MedicationAdministration.performer",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.performer.actor",
        "path": "MedicationAdministration.performer.actor",
        "short": "Referenz auf die verabreichende Person",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.performer.actor.reference",
        "path": "MedicationAdministration.performer.actor.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.reasonReference",
        "path": "MedicationAdministration.reasonReference",
        "short": "Grund der Medikation (Referenz)",
        "comment": "Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Ein System KANN demnach statt .reasonReference auch .reasonCode in der Ausgabe verwenden. .reasonReference MUSS aber weiterhin interpretiert werden können.\n\n  Begründung zu Must-Support: Konsolidierung mit MII.",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.reasonReference.reference",
        "path": "MedicationAdministration.reasonReference.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.note",
        "path": "MedicationAdministration.note",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.note.text",
        "path": "MedicationAdministration.note.text",
        "short": "Freitext-Notiz",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage",
        "path": "MedicationAdministration.dosage",
        "short": "Dosierungsangaben",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.text",
        "path": "MedicationAdministration.dosage.text",
        "short": "Freitext-Dosierungsangabe",
        "comment": "Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme  die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.\n\n    Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.\n\n    Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://simplifier.net/guide/isik-basis-401/Einfuehrung/UebergreifendeFestlegungen/UebergreifendeFestlegungen_Must-Support-Flags.page.md?version=current): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.' \n\n    Zum Beispiel kann die textuelle Information '1L Infusion mit Rate 50ml/h' in eine entsprechende, strukturierte Form überführt werden - d.h. in die Angabe von 'dose' und 'rateQuantity'.",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site",
        "path": "MedicationAdministration.dosage.site",
        "short": "Körperstelle der Verabreichung",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site.coding",
        "path": "MedicationAdministration.dosage.site.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT",
        "path": "MedicationAdministration.dosage.site.coding",
        "sliceName": "SNOMED-CT",
        "min": 0,
        "max": "1",
        "patternCoding": {
          "system": "http://snomed.info/sct"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT.system",
        "path": "MedicationAdministration.dosage.site.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT.code",
        "path": "MedicationAdministration.dosage.site.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT.display",
        "path": "MedicationAdministration.dosage.site.coding.display",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.site.text",
        "path": "MedicationAdministration.dosage.site.text",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route",
        "path": "MedicationAdministration.dosage.route",
        "short": "Route",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding",
        "path": "MedicationAdministration.dosage.route.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:EDQM",
        "path": "MedicationAdministration.dosage.route.coding",
        "sliceName": "EDQM",
        "min": 0,
        "max": "1",
        "patternCoding": {
          "system": "http://standardterms.edqm.eu"
        },
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration"
        }
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:EDQM.system",
        "path": "MedicationAdministration.dosage.route.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:EDQM.code",
        "path": "MedicationAdministration.dosage.route.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:EDQM.display",
        "path": "MedicationAdministration.dosage.route.coding.display",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT",
        "path": "MedicationAdministration.dosage.route.coding",
        "sliceName": "SNOMED-CT",
        "min": 0,
        "max": "1",
        "patternCoding": {
          "system": "http://snomed.info/sct"
        },
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://gematik.de/fhir/isik/v3/Medikation/ValueSet/SctRouteOfAdministration"
        }
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT.system",
        "path": "MedicationAdministration.dosage.route.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT.code",
        "path": "MedicationAdministration.dosage.route.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT.display",
        "path": "MedicationAdministration.dosage.route.coding.display",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.route.text",
        "path": "MedicationAdministration.dosage.route.text",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.dose",
        "path": "MedicationAdministration.dosage.dose",
        "short": "verabreichte Dosis",
        "patternQuantity": {
          "system": "http://unitsofmeasure.org"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.dose.value",
        "path": "MedicationAdministration.dosage.dose.value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.dose.unit",
        "path": "MedicationAdministration.dosage.dose.unit",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.dose.system",
        "path": "MedicationAdministration.dosage.dose.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.dose.code",
        "path": "MedicationAdministration.dosage.dose.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]",
        "path": "MedicationAdministration.dosage.rate[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio",
        "path": "MedicationAdministration.dosage.rate[x]",
        "sliceName": "rateRatio",
        "short": "Verabreichungs-Rate (Verhältnis)",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Ratio"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator",
        "path": "MedicationAdministration.dosage.rate[x].numerator",
        "patternQuantity": {
          "system": "http://unitsofmeasure.org"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.value",
        "path": "MedicationAdministration.dosage.rate[x].numerator.value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.unit",
        "path": "MedicationAdministration.dosage.rate[x].numerator.unit",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.system",
        "path": "MedicationAdministration.dosage.rate[x].numerator.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.code",
        "path": "MedicationAdministration.dosage.rate[x].numerator.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator",
        "path": "MedicationAdministration.dosage.rate[x].denominator",
        "patternQuantity": {
          "system": "http://unitsofmeasure.org"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.value",
        "path": "MedicationAdministration.dosage.rate[x].denominator.value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.unit",
        "path": "MedicationAdministration.dosage.rate[x].denominator.unit",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.system",
        "path": "MedicationAdministration.dosage.rate[x].denominator.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.code",
        "path": "MedicationAdministration.dosage.rate[x].denominator.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateQuantity",
        "path": "MedicationAdministration.dosage.rate[x]",
        "sliceName": "rateQuantity",
        "short": "Verabreichungs-Rate",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
            ]
          }
        ],
        "patternQuantity": {
          "system": "http://unitsofmeasure.org"
        },
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.value",
        "path": "MedicationAdministration.dosage.rate[x].value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.unit",
        "path": "MedicationAdministration.dosage.rate[x].unit",
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.system",
        "path": "MedicationAdministration.dosage.rate[x].system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.code",
        "path": "MedicationAdministration.dosage.rate[x].code",
        "min": 1,
        "mustSupport": true
      }
    ]
  }
}

name : ISiKMedikationsVerabreichung

{

}