Wales FHIR Implementation Guide

DataStandardsWales-Dosage

The Dosage resource is a record of a medication that is administered to a patient.

The DataStandardsWales-Dosage profile is derived from the HL7 Dosage Profile. It defines additional rules for use within health and care organisations in Wales.

A direct link to the Data Standards Wales asset can be accessed here - Data Standards Wales Dosage

Formal Views of Profile Content

Snapshot View
Differential View
Hybrid View
Examples

Dosage			Dosage	There are no (further) constraints on this element Element Id Dosage Short description How the medication is/was taken or should be taken Definition Indicates how the medication is/was taken or should be taken by the patient. Data Type Dosage Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
sequence	S Σ	0..1	integer	Element Id Dosage.sequence Short description Multi-sequence dosage instructions. Definition TBD 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() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-1 rim:.text
text	S Σ	0..1	string	Element Id Dosage.text Short description The complete dosage instruction as a human readable string. Definition TBD 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. Additional information about administration or preparation of the medication should be included as text. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-6; RXE-21 rim:.text
additionalInstruction	S Σ	0..*	CodeableConcept	Element Id Dosage.additionalInstruction Short description Additional dosage instructions that can be either SNOMED-CT coded terms or free-text instructions. Definition TBD Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-7 rim:.text
patientInstruction	S Σ	0..1	string	Element Id Dosage.patientInstruction Short description Patient or consumer oriented instructions Definition TBD Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-7 rim:.text
timing	S Σ	0..1	Timing	Element Id Dosage.timing Short description When medication should be administered Definition TBD Requirements The timing schedule for giving the medication to the patient. This 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 might 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() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS) rim:.effectiveTime
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element Id Dosage.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, 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() or (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 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() or (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 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
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element Id 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() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI
boundsDuration			Duration	Data Type Duration
boundsRange			Range	Data Type Range
boundsPeriod			Period	Data Type Period
count	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Dosage.timing.repeat.count Short description Number of times to repeat Definition A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. 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 positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Dosage.timing.repeat.countMax Short description Maximum number of times to repeat Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. Comments 32 bit number; for values larger than this, use decimal Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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 Dosage.timing.repeat.duration Short description How long when it happens Definition How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. 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() or (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 Dosage.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. 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() or (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 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 SHALL 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() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit
frequency	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id 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. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. Comments 32 bit number; for values larger than this, use decimal Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
frequencyMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id 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 positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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 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. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Comments Do not use an 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() or (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 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 an 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() or (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 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 SHALL 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() or (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 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() or (children().count() > id.count())` Mappings rim:n/a
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element Id 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() or (children().count() > id.count())` Mappings rim:n/a
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id Dosage.timing.repeat.when Short description Code for time period of occurrence Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. 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() or (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 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() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Dosage.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). 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 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. TimingAbbreviation (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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]	S Σ	0..1		Element Id Dosage.asNeeded[x] Short description Take "as needed" (for x) Definition TBD 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. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 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	S Σ	0..1	CodeableConcept	Element Id Dosage.site Short description Body site to administer to Definition TBD 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 bodySite. 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-2 rim:.approachSiteCode
route	S Σ	0..1	CodeableConcept	Element Id Dosage.route Short description How drug should enter body Definition TBD 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. SNOMEDCTRouteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-1 rim:.routeCode
method	S Σ	0..1	CodeableConcept	Element Id Dosage.method Short description Technique for administering medication Definition TBD 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. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-4 rim:.doseQuantity
doseAndRate	Σ	0..*	Element	Element Id Dosage.doseAndRate Short description Amount of medication administered Definition TBD Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-2
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id Dosage.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". 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 The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-21; RXE-23
dose[x]	Σ	0..1		There are no (further) constraints on this element Element Id Dosage.doseAndRate.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() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity
doseRange			Range	Data Type Range
doseQuantity			SimpleQuantity	Data Type SimpleQuantity
rate[x]	Σ	0..1		There are no (further) constraints on this element Element Id Dosage.doseAndRate.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. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 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
maxDosePerPeriod	S Σ I	0..1	Ratio	Element Id Dosage.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition TBD 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() or (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 v2:RXO-23, RXE-19 rim:.maxDoseQuantity
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	Element Id Dosage.maxDosePerAdministration Short description Upper limit on medication per administration Definition TBD 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() or (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	Element Id Dosage.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition TBD 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() or (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

Dosage			Dosage	There are no (further) constraints on this element Element Id Dosage Short description How the medication is/was taken or should be taken Definition Indicates how the medication is/was taken or should be taken by the patient. Data Type Dosage Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
sequence	S Σ	0..1	integer	Element Id Dosage.sequence Short description Multi-sequence dosage instructions. Definition TBD 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() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-1 rim:.text
text	S Σ	0..1	string	Element Id Dosage.text Short description The complete dosage instruction as a human readable string. Definition TBD 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. Additional information about administration or preparation of the medication should be included as text. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-6; RXE-21 rim:.text
additionalInstruction	S Σ	0..*	CodeableConcept	Element Id Dosage.additionalInstruction Short description Additional dosage instructions that can be either SNOMED-CT coded terms or free-text instructions. Definition TBD Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-7 rim:.text
patientInstruction	S Σ	0..1	string	Element Id Dosage.patientInstruction Short description Patient or consumer oriented instructions Definition TBD Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-7 rim:.text
timing	S Σ	0..1	Timing	Element Id Dosage.timing Short description When medication should be administered Definition TBD Requirements The timing schedule for giving the medication to the patient. This 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 might 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() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS) rim:.effectiveTime
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element Id Dosage.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, 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() or (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 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() or (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 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
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element Id 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() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI
boundsDuration			Duration	Data Type Duration
boundsRange			Range	Data Type Range
boundsPeriod			Period	Data Type Period
count	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Dosage.timing.repeat.count Short description Number of times to repeat Definition A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. 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 positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Dosage.timing.repeat.countMax Short description Maximum number of times to repeat Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. Comments 32 bit number; for values larger than this, use decimal Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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 Dosage.timing.repeat.duration Short description How long when it happens Definition How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. 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() or (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 Dosage.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. 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() or (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 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 SHALL 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() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit
frequency	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id 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. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. Comments 32 bit number; for values larger than this, use decimal Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
frequencyMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id 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 positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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 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. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Comments Do not use an 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() or (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 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 an 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() or (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 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 SHALL 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() or (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 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() or (children().count() > id.count())` Mappings rim:n/a
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element Id 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() or (children().count() > id.count())` Mappings rim:n/a
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id Dosage.timing.repeat.when Short description Code for time period of occurrence Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. 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() or (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 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() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Dosage.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). 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 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. TimingAbbreviation (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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]	S Σ	0..1		Element Id Dosage.asNeeded[x] Short description Take "as needed" (for x) Definition TBD 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. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 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	S Σ	0..1	CodeableConcept	Element Id Dosage.site Short description Body site to administer to Definition TBD 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 bodySite. 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-2 rim:.approachSiteCode
route	S Σ	0..1	CodeableConcept	Element Id Dosage.route Short description How drug should enter body Definition TBD 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. SNOMEDCTRouteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-1 rim:.routeCode
method	S Σ	0..1	CodeableConcept	Element Id Dosage.method Short description Technique for administering medication Definition TBD 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. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-4 rim:.doseQuantity
doseAndRate	Σ	0..*	Element	Element Id Dosage.doseAndRate Short description Amount of medication administered Definition TBD Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-2
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id Dosage.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". 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 The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-21; RXE-23
dose[x]	Σ	0..1		There are no (further) constraints on this element Element Id Dosage.doseAndRate.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() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity
doseRange			Range	Data Type Range
doseQuantity			SimpleQuantity	Data Type SimpleQuantity
rate[x]	Σ	0..1		There are no (further) constraints on this element Element Id Dosage.doseAndRate.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. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 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
maxDosePerPeriod	S Σ I	0..1	Ratio	Element Id Dosage.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition TBD 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() or (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 v2:RXO-23, RXE-19 rim:.maxDoseQuantity
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	Element Id Dosage.maxDosePerAdministration Short description Upper limit on medication per administration Definition TBD 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() or (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	Element Id Dosage.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition TBD 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() or (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

Dosage			Dosage	There are no (further) constraints on this element Element Id Dosage Short description How the medication is/was taken or should be taken Definition Indicates how the medication is/was taken or should be taken by the patient. Data Type Dosage Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
sequence	S Σ	0..1	integer	Element Id Dosage.sequence Short description Multi-sequence dosage instructions. Definition TBD 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() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-1 rim:.text
text	S Σ	0..1	string	Element Id Dosage.text Short description The complete dosage instruction as a human readable string. Definition TBD 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. Additional information about administration or preparation of the medication should be included as text. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-6; RXE-21 rim:.text
additionalInstruction	S Σ	0..*	CodeableConcept	Element Id Dosage.additionalInstruction Short description Additional dosage instructions that can be either SNOMED-CT coded terms or free-text instructions. Definition TBD Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. Data Type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-7 rim:.text
patientInstruction	S Σ	0..1	string	Element Id Dosage.patientInstruction Short description Patient or consumer oriented instructions Definition TBD Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-7 rim:.text
timing	S Σ	0..1	Timing	Element Id Dosage.timing Short description When medication should be administered Definition TBD Requirements The timing schedule for giving the medication to the patient. This 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 might 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() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:QSET<TS> (GTS) rim:.effectiveTime
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element Id Dosage.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, 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() or (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 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() or (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 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
bounds[x]	Σ	0..1		There are no (further) constraints on this element Element Id 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() or (children().count() > id.count())` Mappings rim:n/a rim:IVL(TS) used in a QSI
boundsDuration			Duration	Data Type Duration
boundsRange			Range	Data Type Range
boundsPeriod			Period	Data Type Period
count	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Dosage.timing.repeat.count Short description Number of times to repeat Definition A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. 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 positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.count
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Dosage.timing.repeat.countMax Short description Maximum number of times to repeat Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. Comments 32 bit number; for values larger than this, use decimal Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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 Dosage.timing.repeat.duration Short description How long when it happens Definition How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. 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() or (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 Dosage.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. 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() or (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 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 SHALL 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() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase.unit
frequency	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id 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. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. Comments 32 bit number; for values larger than this, use decimal Meaning When Missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:PIVL.phase
frequencyMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id 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 positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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 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. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Comments Do not use an 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() or (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 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 an 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() or (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 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 SHALL 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() or (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 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() or (children().count() > id.count())` Mappings rim:n/a
timeOfDay	Σ	0..*	time	There are no (further) constraints on this element Element Id 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() or (children().count() > id.count())` Mappings rim:n/a
when	Σ	0..*	codeBinding	There are no (further) constraints on this element Element Id Dosage.timing.repeat.when Short description Code for time period of occurrence Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. 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() or (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 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() or (children().count() > id.count())` Mappings rim:n/a rim:EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Dosage.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). 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 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. TimingAbbreviation (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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]	S Σ	0..1		Element Id Dosage.asNeeded[x] Short description Take "as needed" (for x) Definition TBD 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. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-9 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	S Σ	0..1	CodeableConcept	Element Id Dosage.site Short description Body site to administer to Definition TBD 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 bodySite. 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-2 rim:.approachSiteCode
route	S Σ	0..1	CodeableConcept	Element Id Dosage.route Short description How drug should enter body Definition TBD 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. SNOMEDCTRouteCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-1 rim:.routeCode
method	S Σ	0..1	CodeableConcept	Element Id Dosage.method Short description Technique for administering medication Definition TBD 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. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXR-4 rim:.doseQuantity
doseAndRate	Σ	0..*	Element	Element Id Dosage.doseAndRate Short description Amount of medication administered Definition TBD Data Type Element Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:TQ1-2
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element Id Dosage.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". 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 The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:RXO-21; RXE-23
dose[x]	Σ	0..1		There are no (further) constraints on this element Element Id Dosage.doseAndRate.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() or (children().count() > id.count())` Mappings rim:n/a v2:RXO-2, RXE-3 rim:.doseQuantity
doseRange			Range	Data Type Range
doseQuantity			SimpleQuantity	Data Type SimpleQuantity
rate[x]	Σ	0..1		There are no (further) constraints on this element Element Id Dosage.doseAndRate.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. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:RXE22, RXE23, RXE-24 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
maxDosePerPeriod	S Σ I	0..1	Ratio	Element Id Dosage.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition TBD 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() or (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 v2:RXO-23, RXE-19 rim:.maxDoseQuantity
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	Element Id Dosage.maxDosePerAdministration Short description Upper limit on medication per administration Definition TBD 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() or (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	Element Id Dosage.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition TBD 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() or (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

Currently under development

Mandatory and Must Support Data Elements

Refer to the Mandatory and Must Support page for guidance on how these elements should be interpreted.

Each MedicationAdministration must support:

sequence
text
additionalInstruction
patientInstruction
timing
asNeeded
site
route
method
maxDosePerPeriod