RDC EMR Implementation Guide

Overview

`The below overview shows the elements of the resource, data type and the cardinality of each. Further details like "Binding"/"Fixed values"/"contraints" etc can be found on clicking on each element.

Canonical url - http://roche.com/fhir/rdc/StructureDefinition/medication-administration

medication-administration (MedicationAdministration)	I		MedicationAdministration	There are no (further) constraints on this element Element id MedicationAdministration Short description Administration of medication to a patient Definition Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner. Comments The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html). Data type MedicationAdministration 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()` mad-2: Reason not given is only permitted if NotGiven is true `reasonNotGiven.empty() or notGiven = true` mad-3: Reason given is only permitted if NotGiven is false `reasonCode.empty() or notGiven.empty() or notGiven = 'false'` 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 MedicationAdministration.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
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationAdministration.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
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationAdministration.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
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationAdministration.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)
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationAdministration.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 Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationAdministration.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: N/A
extension		1..*	Extension	Element id MedicationAdministration.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) Mappings rim: N/A
parentDeviceMetric		1..1	Extension	Element id MedicationAdministration.extension:parentDeviceMetric 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/parent-device-metric Mappings rim: N/A
slotId		0..*	Extension	Element id MedicationAdministration.extension:slotId 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/slot-id Mappings rim: N/A
tsb		0..*	Extension	Element id MedicationAdministration.extension:tsb 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/tsb Mappings rim: N/A
observationEventTiming	I	0..*	Extension(CodeableConcept)	Element id MedicationAdministration.extension:observationEventTiming Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(CodeableConcept) Extension URL http://roche.com/fhir/rdc/StructureDefinition/observation-event-timing 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
registeredTimeStamp	I	0..*	Extension(dateTime)	Element id MedicationAdministration.extension:registeredTimeStamp Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(dateTime) Extension URL http://roche.com/fhir/rdc/StructureDefinition/registered-timestamp Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (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
gdpr-controller		0..*	Extension	Element id MedicationAdministration.extension:gdpr-controller 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/gdpr-controller Mappings rim: N/A
timezone		0..*	Extension	Element id MedicationAdministration.extension:timezone Short description Optional Extension Element 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/patient-timezone Mappings rim: N/A
source		0..*	Extension	Element id MedicationAdministration.extension:source 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/provenance-source Mappings rim: N/A
channel		0..*	Extension	Element id MedicationAdministration.extension:channel 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/provenance-channel Mappings rim: N/A
modifierExtension	?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.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 Mappings rim: N/A
identifier		0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.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 Mappings workflow: …identifier rim: .id w5: id
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.identifier.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.identifier.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 Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationAdministration.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationAdministration.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Mappings v2: CX.5 rim: Role.code or implied by context
system	Σ	0..1	uriBinding	Element id MedicationAdministration.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Data type uri Binding ?? (required) Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Data type string Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id MedicationAdministration.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id MedicationAdministration.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
definition	Σ	0..*	Reference(PlanDefinition \| ActivityDefinition)	There are no (further) constraints on this element Element id MedicationAdministration.definition Short description Instantiates protocol or definition Definition A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event. Data type Reference(PlanDefinition \| ActivityDefinition) Mappings workflow: …definition rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]
partOf	Σ	0..*	Reference(medication-administration \| Procedure)	Element id MedicationAdministration.partOf Short description Part of referenced event Definition A larger event of which this particular event is a component or step. Data type Reference(medication-administration \| Procedure) Mappings workflow: …part of rim: .outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]
status	Σ ?!	1..1	codeBinding	Element id MedicationAdministration.status Short description in-progress \| on-hold \| completed \| entered-in-error \| stopped \| unknown Definition in MedicationAdministration we use status="completed" Comments in MedicationAdministration we use status="completed" Data type code Binding A set of codes indicating the current status of a MedicationAdministration. MedicationAdministrationStatus (required) Mappings workflow: …status v2: RXA-20-Completion Status rim: .statusCode w5: status ACSPIX2FHIR: completed
category		0..1	CodeableConceptBinding	Element id MedicationAdministration.category Short description Type of medication usage Definition Indicates the type of medication administration and where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A coded concept describing where the medication administered is expected to occur MedicationAdministrationCategory (preferred) Mappings rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medication[x]	Σ	1..1		Element id MedicationAdministration.medication[x] Short description What was administered Definition Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. 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. . Sliced: Unordered, Open, by $this(Type) Binding Codes identifying substance or product that can be administered. SNOMED CT Medication Codes (example) Mappings workflow: …code v2: RXA-5-Administered Code rim: .participation[typeCode=CSM].role[classCode=ADMM] w5: what
CodeableConcept	Σ	0..1	CodeableConceptBinding	Element id MedicationAdministration.medication[x]:CodeableConcept Short description What was administered Definition Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. 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. . Data type CodeableConcept Binding Codes identifying substance or product that can be administered. insulin-codes (required) Mappings workflow: …code v2: RXA-5-Administered Code rim: .participation[typeCode=CSM].role[classCode=ADMM] w5: what
Reference	Σ	0..1	Reference(http://roche.com/fhir/rdc/StructureDefinition/Medication)	Element id MedicationAdministration.medication[x]:Reference Short description What was administered Definition Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. 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. . Data type Reference(http://roche.com/fhir/rdc/StructureDefinition/Medication) Mappings workflow: …code v2: RXA-5-Administered Code rim: .participation[typeCode=CSM].role[classCode=ADMM] w5: what
subject	Σ	1..1	Reference(http://roche.com/fhir/rdc/StructureDefinition/patient)	Element id MedicationAdministration.subject Short description Who received medication Definition The person or animal or group receiving the medication. Data type Reference(http://roche.com/fhir/rdc/StructureDefinition/patient) Mappings workflow: …subject v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: who.focus
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.subject.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.subject.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 Mappings rim: n/a
reference	Σ I	0..1	string	Element id MedicationAdministration.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Mappings rim: N/A ACSPIX2FHIR: Patient/${patientId}
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data type Identifier Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Mappings rim: N/A
context		0..1	Reference(Encounter \| EpisodeOfCare)	There are no (further) constraints on this element Element id MedicationAdministration.context Short description Encounter or Episode of Care administered as part of Definition The visit, admission or other contact between patient and health care provider the medication administration was performed as part of. Data type Reference(Encounter \| EpisodeOfCare) Mappings workflow: …context v2: PV1-19-Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"] w5: context
supportingInformation		0..*	Reference(Resource \| EWM-observation \| http://roche.com/fhir/rdc/StructureDefinition/careplan-basal)	Element id MedicationAdministration.supportingInformation Short description Additional information to support administration Definition Additional information (for example, patient height and weight) that supports the administration of the medication. Comments This field will be used to reference to: a) A Observation EWM related with the actual MedAdministration b) A Basal Careplan (IPPROFILE ACSPIX ) related with the actual MedAdministration (Ex. BASAL Dt="2018-10-16" Tm="17:00" cbrf="0.70" profile="3" /> --> In this case it will reference the Basal Careplan asociated to profile=3) Data type Reference(Resource \| EWM-observation \| http://roche.com/fhir/rdc/StructureDefinition/careplan-basal) Mappings rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)] w5: context
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.supportingInformation.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.supportingInformation.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 Mappings rim: n/a
reference	Σ I	0..1	string	Element id MedicationAdministration.supportingInformation.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Mappings rim: N/A ACSPIX2FHIR: Observation/${relatedObservationId} : CarePlan/${cpId}
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.supportingInformation.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data type Identifier Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.supportingInformation.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Mappings rim: N/A
effective[x]	Σ	1..1		Element id MedicationAdministration.effective[x] Short description Start and end time of administration Definition A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Mappings workflow: …occurrence[x] v2: RXA-3-Date/Time Start of Administration / RXA-4-Date/Time End of Administration rim: .effectiveTime w5: when.done ACSPIX2FHIR: ${Dt}T${Tm}:00+02:00
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
performer	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationAdministration.performer Short description Who administered substance Definition The individual who was responsible for giving the medication to the patient. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings workflow: …performer v2: RXA-10-Administering Provider / PRT-5-Participation Person: PRT-4-Participation='AP' (RXA-10 is deprecated) rim: .participation[typeCode=PRF] w5: who.actor
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.performer.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 Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.performer.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, 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 Mappings rim: N/A
actor	Σ	1..1	Reference(http://roche.com/fhir/rdc/StructureDefinition/practitioner \| http://roche.com/fhir/rdc/StructureDefinition/patient \| phg-device)	Element id MedicationAdministration.performer.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. Data type Reference(http://roche.com/fhir/rdc/StructureDefinition/practitioner \| http://roche.com/fhir/rdc/StructureDefinition/patient \| phg-device) Mappings workflow: ….actor rim: .role
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.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 Mappings rim: n/a
reference	Σ I	0..1	string	Element id MedicationAdministration.performer.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Mappings rim: N/A ACSPIX2FHIR: Patient/${patientId}
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data type Identifier Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Mappings rim: N/A
onBehalfOf		0..1	Reference(http://roche.com/fhir/rdc/StructureDefinition/organization)	Element id MedicationAdministration.performer.onBehalfOf Short description Organization organization was acting for Definition The organization the device or practitioner was acting on behalf of. Data type Reference(http://roche.com/fhir/rdc/StructureDefinition/organization) Mappings workflow: ….onBehalfOf rim: .role.scopingOrganization
notGiven	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id MedicationAdministration.notGiven Short description True if medication not administered Definition Set this to true if the record is saying that the medication was NOT administered. Comments This element is labeled as a modifier because it indicates that a administration didn't happen. Meaning when missing If this is missing, then the medication was administered Data type boolean Mappings workflow: …notDone v2: RXA-20-Completion Status='NA' rim: .actionNegationInd
reasonNotGiven	I	0..*	CodeableConceptBinding	Element id MedicationAdministration.reasonNotGiven Short description Reason administration not performed Definition A code indicating why the administration was not performed. Data type CodeableConcept Binding A set of codes indicating the reason why the MedicationAdministration is negated. ?? (required) Mappings workflow: …notDoneReason v2: RXA-9-Administration Notes / RXA-18 Substance/Treatment Refusal Reason rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason not given"].value
reasonCode	I	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.reasonCode Short description Reason administration performed Definition A code indicating why the medication was given. Data type CodeableConcept Binding A set of codes indicating the reason why the MedicationAdministration was made. Reason Medication Given Codes (example) Mappings workflow: …reasonGivenCodeableConcept v2: RXE-27 Give Indication rim: .reasonCode
reasonReference		0..*	Reference(EWM-observation)	Element id MedicationAdministration.reasonReference Short description Condition or Observation that supports why the medication was administered Definition Condition or observation that supports why the medication was administered. Comments This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Data type Reference(EWM-observation) Mappings workflow: …reasonReference rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use ASSERTION"].value w3c.prov: no mapping w5: why
prescription		0..1	Reference(MedicationRequest)	There are no (further) constraints on this element Element id MedicationAdministration.prescription Short description Request administration performed against Definition The original request, instruction or authority to perform the administration. Data type Reference(MedicationRequest) Mappings workflow: …basedOn v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number rim: InFullfillmentOf->SubstanceAdministration
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.prescription.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.prescription.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 Mappings rim: n/a
reference	Σ I	0..1	string	Element id MedicationAdministration.prescription.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Mappings rim: N/A ACSPIX2FHIR: MedicationRequest/${input.medRequestId
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.prescription.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data type Identifier Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.prescription.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Mappings rim: N/A
device		0..*	Reference(phg-device)	Element id MedicationAdministration.device Short description Device used to administer Definition The device used in administering the medication to the patient. For example, a particular infusion pump. Data type Reference(phg-device) Mappings v2: PRT-10 Participation Device / RXR-3 Administrative Device rim: device->Access OR device->AssignedDevice
note		0..1	Annotation	There are no (further) constraints on this element Element id MedicationAdministration.note Short description Information about the administration Definition Extra information about the medication administration that is not conveyed by the other attributes. Data type Annotation Mappings workflow: …note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosage	I	0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationAdministration.dosage Short description Details of how medication was taken Definition Describes the medication dosage information details e.g. dose, rate, site, route, etc. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] `dose.exists() or rate.exists()` Mappings rim: component->SubstanceAdministrationEvent
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.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. Data type string Mappings rim: n/a
extension		0..*	Extension	Element id MedicationAdministration.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) Mappings rim: n/a
adminType		0..*	Extension	Element id MedicationAdministration.dosage.extension:adminType 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/medication-administration-dosage/admin-type Mappings rim: n/a
tbr		0..*	Extension	Element id MedicationAdministration.dosage.extension:tbr 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/tbr Mappings rim: n/a
bolusCorrectionInsulinUnits		0..1	Extension	Element id MedicationAdministration.dosage.extension:bolusCorrectionInsulinUnits 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/bolus-correction-insulin-units Mappings rim: n/a
bolusFoodInsulinUnits		0..1	Extension	Element id MedicationAdministration.dosage.extension:bolusFoodInsulinUnits Short description Optional Extension Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/bolus-food-insulin-units Mappings rim: n/a
extendedBolusDuration		0..1	Extension	Element id MedicationAdministration.dosage.extension:extendedBolusDuration 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/extended-bolus-duration Mappings rim: n/a
extendedBolusInsulinAmount		0..1	Extension	Element id MedicationAdministration.dosage.extension:extendedBolusInsulinAmount 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/extended-bolus-insulin-amount Mappings rim: n/a
immediateBolusInsulinAmount		0..1	Extension	Element id MedicationAdministration.dosage.extension:immediateBolusInsulinAmount 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/immediate-bolus-insulin-amount Mappings rim: n/a
bolusActivationType		0..*	Extension	Element id MedicationAdministration.dosage.extension:bolusActivationType 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 Extension URL http://roche.com/fhir/rdc/StructureDefinition/bolus-activation-type Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.dosage.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, 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 Mappings rim: N/A
text		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Data type string Mappings rim: .text
site		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.dosage.site Short description Body site administered to Definition A coded specification of the anatomic site where the medication first entered the body. For example, "left arm". 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) Mappings v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier rim: .approachSiteCode
route		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.dosage.route Short description Path of substance into body Definition A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc. 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) Mappings v2: RXR-1-Route rim: .routeCode
method		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.dosage.method Short description How drug was administered Definition A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. Comments One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example) Mappings v2: RXR-4-Administration Method rim: .methodCode
dose		0..1	SimpleQuantityBinding	Element id MedicationAdministration.dosage.dose Short description Amount of medication per dose Definition The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection. Comments If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration. Data type SimpleQuantity Binding MetricUnits (required) Mappings v2: RXA-6 Administered Amount / RXA-7 Administered Units rim: .doseQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.dose.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. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.dosage.dose.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 Mappings rim: n/a
value	Σ	0..1	decimal	Element id MedicationAdministration.dosage.dose.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value ACSPIX2FHIR: BG.Ins1 : BG.Ins2 : IPDATA.BOLUS.amount
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationAdministration.dosage.dose.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	Element id MedicationAdministration.dosage.dose.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit ACSPIX2FHIR: [iU]
system	Σ I	0..1	uri	Element id MedicationAdministration.dosage.dose.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem ACSPIX2FHIR: http://unitsofmeasure.org
code	Σ	0..1	code	Element id MedicationAdministration.dosage.dose.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code ACSPIX2FHIR: [iU]
rate[x]		0..1	Binding	Element id MedicationAdministration.dosage.rate[x] Short description Dose quantity per unit of time Definition 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. Comments If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate. Binding MetricUnits (required) Mappings v2: RXA-12-Administered Per (Time Unit) rim: .rateQuantity
rateRatio			Ratio	There are no (further) constraints on this element Data type Ratio
rateQuantity			SimpleQuantity	There are no (further) constraints on this element Data type SimpleQuantity
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationAdministration.eventHistory Short description A list of events of interest in the lifecycle Definition A summary of the events of interest that have occurred, such as when the administration was verified. Comments This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject. Data type Reference(Provenance) Mappings rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]