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{
  "resourceType": "StructureDefinition",
  "id": "zib-InstructionsForUse",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-InstructionsForUse",
  "version": "2.0.5",
  "name": "Zib InstructionsForUse",
  "title": "HCIM InstructionsForUse",
  "status": "active",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "This profile is based on the Dutch Health and Care Information model (Dutch: Zorginformatiebouwsteen or ZIB) InstructionsForUse version 1.1, year 2017. 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.",
  "purpose": "InstructionsForUse gives an insight into the manner a drug is to be used.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-instructionsforuse-v1.1-2017EN",
      "uri": "https://zibs.nl/wiki/InstructionsForUse-v1.1(2017EN)",
      "name": "HCIM InstructionsForUse-v1.1(2017EN)"
    }
  ],
  "kind": "complex-type",
  "abstract": false,
  "type": "Dosage",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Dosage",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Dosage",
        "path": "Dosage",
        "short": "InstructionsForUse",
        "definition": "Instructions for the use 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",
        "comment": "The wiki page https://informatiestandaarden.nictiz.nl/wiki/mp:V9.0_Voorbeelden_doseringen provides dosage instruction examples. These examples consists of functional data and their representation in FHIR and CDA.",
        "alias": [
          "Gebruiksinstructie"
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.22504",
            "comment": "InstructionsForUse"
          }
        ]
      },
      {
        "id": "Dosage.sequence",
        "path": "Dosage.sequence",
        "short": "SequenceNumber",
        "definition": "This indicates the sequence of the dosing instructions within the medication agreement.",
        "alias": [
          "Volgnummer"
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.22503",
            "comment": "SequenceNumber"
          }
        ]
      },
      {
        "id": "Dosage.text",
        "path": "Dosage.text",
        "short": "Description",
        "definition": "Textual description of the complete instructions for use including the period of use.",
        "alias": [
          "Omschrijving"
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.9581",
            "comment": "Description"
          }
        ]
      },
      {
        "id": "Dosage.additionalInstruction",
        "path": "Dosage.additionalInstruction",
        "short": "AdditionalInstructions",
        "definition": "The additional instructions contain extra information on the use of or considerations for the current prescription. This can also include 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.                                  The G standard contains many texts that can support this attribute, in for example G standard table 362, which contains texts from the general practitioners’ standard WCIA table 25. If desired, these texts can be used to structure this concept.",
        "alias": [
          "AanvullendeInstructie"
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "AdditionalInstruction"
            }
          ],
          "strength": "extensible",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.9--20160407000000",
            "display": "AanvullendeGebruiksinstructie"
          }
        },
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.19944",
            "comment": "AdditionalInstructions"
          }
        ]
      },
      {
        "id": "Dosage.timing",
        "path": "Dosage.timing",
        "definition": "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”, “one-time only”), to be entered in the NumberOfDoses concept.",
        "type": [
          {
            "code": "Timing",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/zib-AdministrationSchedule"
          }
        ]
      },
      {
        "id": "Dosage.asNeeded[x]:asNeededCodeableConcept",
        "path": "Dosage.asNeededCodeableConcept",
        "sliceName": "asNeededCodeableConcept",
        "short": "AsNeeded",
        "definition": "As needed means that the dose is only to be administered under certain conditions.",
        "comment": "Using the term 'as needed' or a specific reason (eg 'in case of pain') to use medication leads to ambiguity. It is not always clear whether the whole dose is 'as needed' or only part of the dose. For example: 1x daily 1-2 tablets as needed. This can mean: 1 tablet fixed per day and 1 tablet as needed or, as needed, a maximum of 2 tablets.As needed medication is not included in GDS. In the first situation, 1 tablet comes in the GDS (drug dispensing systems) and 1 tablet is delivered separately. In the second situation there is only separate delivery.The system must make sufficiently clear whether the entire instruction or part of the dose is necessary. The HCIM supports both options described above.",
        "alias": [
          "Zo nodig",
          "Criterium"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "MedicationAsNeededReason"
            }
          ],
          "strength": "extensible",
          "description": "ZonodigCriteriumCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.4--20171231000000",
            "display": "ZonodigCriteriumCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.22512",
            "comment": "AsNeeded"
          },
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.19945",
            "comment": "Condition"
          }
        ]
      },
      {
        "id": "Dosage.route",
        "path": "Dosage.route",
        "short": "RouteOfAdministration",
        "definition": "The route through which the medication is administered (oral, nasal, intravenous, etc.)",
        "alias": [
          "Toedieningsweg"
        ],
        "example": [
          {
            "label": "Example of RouteOfAdministration",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "urn:oid:2.16.840.1.113883.2.4.4.9",
                  "code": "oraal",
                  "display": "Oraal"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "ToedieningswegCodelijst",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.1--20171231000000",
            "display": "ToedieningswegCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.19941",
            "comment": "RouteOfAdministration"
          }
        ]
      },
      {
        "id": "Dosage.dose[x]",
        "path": "Dosage.dose[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "short": "Dose",
        "definition": "The dose indicates the dose amount per administration. \n \nThe dosage is described in the unit accompanying the product; usually, this is just a number of units or doses. Liquids and other divisible products will usually include a unit of volume (preferably \"ml\"). \n \nIn many cases, the prescriber will want to indicate the dose in units of weight of the active ingredient.  \n \nIf only the ingredient is included and not the product, then the amount of that ingredient will be given. Paracetamol 1000mg is equivalent to 2 Paracetamol 500mg tablets or units. \n \nThe dosage is sometimes given as a calculation, in which the patient’s body weight or body surface area is used as a parameter. The calculation is however no more than an aid in reaching a decision. \n \nIn the event of constant administration, sometimes the dose is given in addition to the administration speed (infusion rate) (e.g. 20ml in a syringe or 500ml in a bag), but it is often also omitted. \n \nA general dosage recommendation such as ‘Use according to protocol’ or ‘See instructions’ can be sufficient. In that case, no dose is given.",
        "alias": [
          "Keerdosis"
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.19940",
            "comment": "Dose"
          }
        ]
      },
      {
        "id": "Dosage.dose[x]:doseQuantity",
        "path": "Dosage.dose[x]",
        "sliceName": "doseQuantity",
        "type": [
          {
            "code": "Quantity",
            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "GstdTabel902",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453",
            "display": "GstdTabel902"
          }
        }
      },
      {
        "id": "Dosage.dose[x]:doseRange",
        "path": "Dosage.dose[x]",
        "sliceName": "doseRange",
        "type": [
          {
            "code": "Range"
          }
        ]
      },
      {
        "id": "Dosage.dose[x]:doseRange.low",
        "path": "Dosage.dose[x].low",
        "binding": {
          "strength": "required",
          "description": "GstdTabel902",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453",
            "display": "GstdTabel902"
          }
        }
      },
      {
        "id": "Dosage.dose[x]:doseRange.high",
        "path": "Dosage.dose[x].high",
        "binding": {
          "strength": "required",
          "description": "GstdTabel902",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453",
            "display": "GstdTabel902"
          }
        }
      },
      {
        "id": "Dosage.maxDosePerPeriod",
        "path": "Dosage.maxDosePerPeriod",
        "short": "MaximumDose",
        "definition": "A maximum dose indicates the maximum duration a product can be used with an ‘as needed’ prescription.\r\n\r\nFor example:\r\n- Max 6 units per day\r\n- Max 200ml per week",
        "alias": [
          "Maximale dosering",
          "Maximale dosis (per dag enz.)"
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.19946",
            "comment": "MaximumDose"
          }
        ]
      },
      {
        "id": "Dosage.maxDosePerPeriod.numerator",
        "path": "Dosage.maxDosePerPeriod.numerator",
        "binding": {
          "strength": "required",
          "description": "GstdTabel902",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.27--20160830202453",
            "display": "GstdTabel902"
          }
        }
      },
      {
        "id": "Dosage.rate[x]",
        "path": "Dosage.rate[x]",
        "short": "AdministeringSpeed",
        "definition": "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": [
          "Toedieningssnelheid",
          "Inloopsnelheid"
        ],
        "mapping": [
          {
            "identity": "hcim-instructionsforuse-v1.1-2017EN",
            "map": "NL-CM:9.12.19942",
            "comment": "AdministeringSpeed"
          }
        ]
      }
    ]
  }
}

name : Zib InstructionsForUse

{

}