Leitfaden Basis DE (STU3)

Basisprofil Medikation eines Patienten (MedicationStatement)

Canonical URL: http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2

MedicationStatement	I		MedicationStatement	There are no (further) constraints on this element Element id MedicationStatement Short description Record of medication being taken by a patient Definition A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now, or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information. Comments When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error. Data type MedicationStatement Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` mst-1: Reason not taken is only permitted if Taken is No `reasonNotTaken.exists().not() or (taken = 'n')` Mappings rim: Entity. Role, or Act workflow: ..Event rim: SubstanceAdministration w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id MedicationStatement.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationStatement.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationStatement.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationStatement.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationStatement.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id MedicationStatement.identifier Short description External identifier Definition External identifier - FHIR will generate its own internal identifiers (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. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: …identifer rim: .id w5: id
basedOn	Σ I	0..*	Reference(MedicationRequest \| CarePlan \| ProcedureRequest \| ReferralRequest)	There are no (further) constraints on this element Element id MedicationStatement.basedOn Short description Fulfils plan, proposal or order Definition A plan, proposal or order that is fulfilled in whole or in part by this event. Requirements Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(MedicationRequest \| CarePlan \| ProcedureRequest \| ReferralRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: …basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
partOf	Σ I	0..*	Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation \| MedicationStatement, deutsches Basisprofil (Version 0.2))	Element id MedicationStatement.partOf Short description Part of referenced event Definition A larger event of which this particular event is a component or step. Requirements This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation \| MedicationStatement, deutsches Basisprofil (Version 0.2)) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: …part of rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]
context	Σ I	0..1	Reference(Encounter \| EpisodeOfCare)	There are no (further) constraints on this element Element id MedicationStatement.context Short description Encounter / Episode associated with MedicationStatement Definition The encounter or episode of care that establishes the context for this MedicationStatement. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Encounter \| EpisodeOfCare) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: …context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.status Short description active \| completed \| entered-in-error \| intended \| stopped \| on-hold Definition A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally this will be active or completed. Comments MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error). This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept indicating the current status of a MedicationStatement. MedicationStatementStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: …status rim: .statusCode w5: status
category	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationStatement.category Short description Type of medication usage Definition Indicates where type of medication statement and where the medication is expected to be consumed or administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered MedicationStatementCategory (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value w5: class
medication[x]	Σ	1..1		There are no (further) constraints on this element Element id MedicationStatement.medication[x] Short description What medication was taken Definition Identifies the medication being 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. Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example if you require form or lot number, then you must reference the Medication resource. . Binding A coded concept identifying the substance or product being taken. SNOMED CT Medication Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: …code rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU] w5: what
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
medicationReference			Reference(Medication \| Medication, deutsches Basisprofil (Version 0.2))	Data type Reference(Medication \| Medication, deutsches Basisprofil (Version 0.2))
effective[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.effective[x] Short description The date/time or interval when the medication was taken Definition The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true). Comments This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: …occurrence[x] rim: .effectiveTime w5: when.done
effectiveDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
effectivePeriod			Period	There are no (further) constraints on this element Data type Period
dateAsserted	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationStatement.dateAsserted Short description When the statement was asserted? Definition The date when the medication statement was asserted by the information source. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .participation[typeCode=AUT].time w5: when.recorded
informationSource	I	0..1	Reference(Patient \| Practitioner \| RelatedPerson \| Organization \| Patient, deutsches Basisprofil (Version 0.2) \| Practitioner, deutsches Basisprofil (Version 0.2))	Element id MedicationStatement.informationSource Short description Person or organization that provided the information about the taking of this medication Definition The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequest. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| Practitioner \| RelatedPerson \| Organization \| Patient, deutsches Basisprofil (Version 0.2) \| Practitioner, deutsches Basisprofil (Version 0.2)) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true) w5: who.source
subject	Σ I	1..1	Reference(Patient \| Group \| Patient, deutsches Basisprofil (Version 0.2))	Element id MedicationStatement.subject Short description Who is/was taking the medication Definition The person, animal or group who is/was taking the medication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| Group \| Patient, deutsches Basisprofil (Version 0.2)) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: …subject v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: who
derivedFrom	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationStatement.derivedFrom Short description Additional supporting information Definition Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. Comments Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]
taken	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.taken Short description y \| n \| unk \| na Definition Indicator of the certainty of whether the medication was taken by the patient. Comments This element is labeled as a modifier because it indicates that the medication was not taken. Data type code Binding A coded concept identifying level of certainty if patient has taken or has not taken the medication MedicationStatementTaken (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: …notDone rim: .actionNegationInd
reasonNotTaken	I	0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.reasonNotTaken Short description True if asserting medication was not given Definition A code indicating why the medication was not taken. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding A coded concept indicating the reason why the medication was not taken SNOMED CT Drugs not taken/completed Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason not taken"].value
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.reasonCode Short description Reason for why the medication is being/was taken Definition A reason for why the medication is being/was taken. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. Data type CodeableConcept Binding A coded concept identifying why the medication is being taken. Condition/Problem/Diagnosis Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: …reasoneCodeableConcept rim: .reasonCode w5: why
reasonReference	I	0..*	Reference(Condition \| Observation \| Deutsches Basisprofil einer Condition (Version 0.2) \| Observation, deutsches Basisprofil (Version 0.2))	Element id MedicationStatement.reasonReference Short description Condition or observation that supports why the medication is being/was taken Definition Condition or observation that supports why the medication is being/was taken. Comments This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode. Data type Reference(Condition \| Observation \| Deutsches Basisprofil einer Condition (Version 0.2) \| Observation, deutsches Basisprofil (Version 0.2)) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: …reasonReference rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value w5: why
note		0..*	Annotation	There are no (further) constraints on this element Element id MedicationStatement.note Short description Further information about the statement Definition Provides extra information about the medication statement that is not conveyed by the other attributes. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act workflow: …note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosage		0..*	Dosage	There are no (further) constraints on this element Element id MedicationStatement.dosage Short description Details of how medication is/was taken or should be taken Definition Indicates how the medication is/was or should be taken by the patient. Comments The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest. Data type Dosage Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT] rim: refer dosageInstruction mapping
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
sequence	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationStatement.dosage.sequence Short description The order of the dosage instructions Definition Indicates the order in which the dosage instructions should be applied or interpreted. Requirements If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Comments 32 bit number; for values larger than this, use decimal Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .text
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG. Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .text
additionalInstruction	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.additionalInstruction Short description Supplemental instruction - e.g. "with meals" Definition Supplemental instruction - e.g. "with meals". Requirements Additional instruction such as "Swallow with plenty of water" which may or may not be coded. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMED CT Additional Dosage Instructions (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .text
patientInstruction	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.patientInstruction Short description Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .text
timing	Σ	0..1	Timing	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing Short description When medication should be administered Definition When medication should be administered. Requirements The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments This attribute may not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Data type Timing Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: QSET<TS> (GTS) rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In an MAR, for instance, you need to take a general specification, and turn it into a precise specification. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: QLIST<TS>
repeat	Σ I	0..1	Element	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled. Requirements Many timing schedules are determined by regular repetitions. Data type Element Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) `offset.empty() or (when.exists() and ((when in ('C' \| 'CM' \| 'CD' \| 'CV')).not()))` tim-5: period SHALL be a non-negative value `period.exists() implies period >= 0` tim-6: If there's a periodMax, there must be a period `periodMax.empty() or period.exists()` tim-7: If there's a durationMax, there must be a duration `durationMax.empty() or duration.exists()` tim-8: If there's a countMax, there must be a count `countMax.empty() or count.exists()` tim-1: if there's a duration, there needs to be duration units `duration.empty() or durationUnit.exists()` tim-10: If there's a timeOfDay, there cannot be be a when, or vice versa `timeOfDay.empty() or when.empty()` tim-2: if there's a period, there needs to be period units `period.empty() or periodUnit.exists()` tim-4: duration SHALL be a non-negative value `duration.exists() implies duration >= 0` Mappings rim: n/a rim: Implies PIVL or EIVL
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.bounds[x] Short description Length/Range of lengths, or (Start and/or end) limits Definition Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: IVL(TS) used in a QSI
boundsDuration			Duration	There are no (further) constraints on this element Data type Duration
boundsRange			Range	There are no (further) constraints on this element Data type Range
boundsPeriod			Period	There are no (further) constraints on this element Data type Period
count	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.count Short description Number of times to repeat Definition A total count of the desired number of repetitions. Requirements Repetitions may be limited by end time or total occurrences. Comments If you have both bounds and count, then this should be understood as within the bounds period, until count times happens. Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.count
countMax	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.countMax Short description Maximum number of times to repeat Definition A maximum value for the count of the desired repetitions (e.g. do something 6-8 times). Comments 32 bit number; for values larger than this, use decimal Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.count
duration	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.duration Short description How long when it happens Definition How long this thing happens for when it happens. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase
durationMax	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.durationMax Short description How long when it happens (Max) Definition The upper limit of how long this thing happens for when it happens. Requirements Some activities are not instantaneous and need to be maintained for a period of time. Comments For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase
durationUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.durationUnit Short description s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Definition The units of time for the duration, in UCUM units. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase.unit
frequency	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.frequency Short description Event occurs frequency times per period Definition The number of times to repeat the action within the specified period / period range (i.e. both period and periodMax provided). Comments 32 bit number; for values larger than this, use decimal Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value 1 Mappings rim: n/a rim: PIVL.phase
frequencyMax	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.frequencyMax Short description Event occurs up to frequencyMax times per period Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. Comments 32 bit number; for values larger than this, use decimal Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase
period	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.period Short description Event occurs frequency times per period Definition 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. Comments Do not use a IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase
periodMax	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Comments Do not use a IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase
periodUnit	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.periodUnit Short description s \| min \| h \| d \| wk \| mo \| a - unit of time (UCUM) Definition The units of time for the period in UCUM units. Comments Note that FHIR strings may not exceed 1MB in size Data type code Binding A unit of time (units from UCUM). UnitsOfTime (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase.unit
dayOfWeek	Σ	0..*	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.dayOfWeek Short description mon \| tue \| wed \| thu \| fri \| sat \| sun Definition If one or more days of week is provided, then the action happens only on the specified day(s). Comments If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek. Data type code Binding DaysOfWeek (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.timeOfDay Short description Time of day for action Definition Specified time of day for action to take place. Comments When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.when Short description Regular life events the event is tied to Definition Real world events that the occurrence of the event should be tied to. Requirements Timings are frequently determined by occurrences such as waking, eating and sleep. Comments When more than one event is listed, the event is tied to the union of the specified events. Data type code Binding Real world event relating to the schedule. EventTiming (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: EIVL.event
offset	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing.repeat.offset Short description Minutes from event (before or after) Definition The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. Comments 32 bit number; for values larger than this, use decimal Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: EIVL.offset
code	Σ	0..1	CodeableConceptBinding	Element id MedicationStatement.dosage.timing.code Short description Einnahmezeitpunkt Definition Einnahmezeitpunkt (morgens, mittags, ...) Comments BID etc are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or the a structured representation should be used (in this case, specifying the two event times). Data type CodeableConcept Binding Code for a known / defined timing pattern. einnahmezeitpunkte (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: QSC.code
asNeeded[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMED CT Medication As Needed Reason Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBoolean			boolean	There are no (further) constraints on this element Data type boolean
asNeededCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
site	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.site Short description Body site to administer to Definition Body site to administer to. Requirements A coded specification of the anatomic site where the medication first enters the body. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. Data type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .approachSiteCode
route	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.route Short description How drug should enter body Definition How drug should enter body. Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .routeCode
method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.method Short description Technique for administering medication Definition Technique for administering medication. Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Comments Terminologies used often pre-coordinate this term with the route and or form of administration. Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .doseQuantity
dose[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.dose[x] Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .doseQuantity
doseRange			Range	There are no (further) constraints on this element Data type Range
doseQuantity			SimpleQuantity	There are no (further) constraints on this element Data type SimpleQuantity
maxDosePerPeriod	Σ I	0..1	Ratio	There are no (further) constraints on this element Element id MedicationStatement.dosage.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition Upper limit on medication per unit of time. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Data type Ratio Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())` Mappings rim: n/a v2: N/A rim: RTO rim: .maxDoseQuantity
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationStatement.dosage.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: not supported
maxDosePerLifetime	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationStatement.dosage.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: not supported
rate[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.rate[x] Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: .rateQuantity
rateRatio			Ratio	There are no (further) constraints on this element Data type Ratio
rateRange			Range	There are no (further) constraints on this element Data type Range
rateQuantity			SimpleQuantity	There are no (further) constraints on this element Data type SimpleQuantity

Beispiele

XML-Format

<MedicationStatement xmlns="http://hl7.org/fhir">
    <meta>
        <profile value="http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2" />
    </meta>
    <status value="active" />
    <medicationReference>
        <reference value="/Medication/987654" />
    </medicationReference>
    <effectivePeriod>
        <start value="2017-08-08" />
    </effectivePeriod>
    <dateAsserted value="2017-08-01" />
    <subject>
        <reference value="Patient/13345" />
    </subject>
    <taken value="y" />
    <dosage>
        <timing>
            <code>
                <coding>
                    <system value="http://hl7.org/fhir/v3/TimingEvent" />
                    <code value="CV" />
                </coding>
            </code>
        </timing>
        <doseQuantity>
            <value value="1" />
            <system value="http://fhir.de/CodeSystem/kbv/s-bmp-dosiereinheit" />
            <code value="1" />
        </doseQuantity>
    </dosage>
</MedicationStatement>

JSON-Format

{
    "resourceType": "MedicationStatement",
    "meta": {
        "profile":  [
            "http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2"
        ]
    },
    "status": "active",
    "medicationReference": {
        "reference": "/Medication/987654"
    },
    "effectivePeriod": {
        "start": "2017-08-08"
    },
    "dateAsserted": "2017-08-01",
    "subject": {
        "reference": "Patient/13345"
    },
    "taken": "y",
    "dosage":  [
        {
            "timing": {
                "code": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/v3/TimingEvent",
                            "code": "CV"
                        }
                    ]
                }
            },
            "doseQuantity": {
                "value": 1,
                "system": "http://fhir.de/CodeSystem/kbv/s-bmp-dosiereinheit",
                "code": "1"
            }
        }
    ]
}