DataStandardsWales-Dosage
FQL
Profile | Type | Status | Canonical |
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DataStandardsWalesDosage | Dosage | draft | https://fhir.nhs.wales/StructureDefinition/DataStandardsWales-Dosage |
The Dosage resource is a record of a medication that is administered to a patient. For information on dosage prescribed or planned for administration, this will be captured in the DosageInstruction
element of the medication resource.
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
DataStandardsWalesDosage (Dosage) | Dosage | There are no (further) constraints on this element Element idDosage How the medication is/was taken or should be taken DefinitionIndicates how the medication is/was taken or should be taken by the patient.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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.
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sequence | S Σ | 0..1 | integer | Element idDosage.sequence Multi-sequence dosage instructions. DefinitionTBD 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. 32 bit number; for values larger than this, use decimal
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text | S Σ | 0..1 | string | Element idDosage.text The complete dosage instruction as a human readable string. DefinitionTBD 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. Note that FHIR strings SHALL NOT exceed 1MB in size
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additionalInstruction | S Σ | 0..* | CodeableConcept | Element idDosage.additionalInstruction Additional dosage instructions that can be either SNOMED-CT coded terms or free-text instructions. DefinitionTBD 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. 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. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
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patientInstruction | S Σ | 0..1 | string | Element idDosage.patientInstruction Patient or consumer oriented instructions DefinitionTBD Note that FHIR strings SHALL NOT exceed 1MB in size
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timing | S Σ | 0..1 | Timing | Element idDosage.timing When medication should be administered DefinitionTBD 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. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.timing.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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.
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event | Σ | 0..* | dateTime | There are no (further) constraints on this element Element idDosage.timing.event When the event occurs DefinitionIdentifies specific times when the event occurs. In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
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repeat | Σ I | 0..1 | Element | There are no (further) constraints on this element Element idDosage.timing.repeat When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.timing.repeat.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.repeat.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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bounds[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.timing.repeat.bounds[x] Length/Range of lengths, or (Start and/or end) limits DefinitionEither 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.
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boundsDuration | Duration | Data type | ||
boundsRange | Range | Data type | ||
boundsPeriod | Period | Data type | ||
count | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.count Number of times to repeat DefinitionA 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. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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countMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.countMax Maximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. 32 bit number; for values larger than this, use decimal
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duration | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.duration How long when it happens DefinitionHow 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. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.durationMax How long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM).
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frequency | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.frequency Event occurs frequency times per period DefinitionThe 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. 32 bit number; for values larger than this, use decimal If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
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frequencyMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.frequencyMax Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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period | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.period Event occurs frequency times per period DefinitionIndicates 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. 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)
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periodMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.periodMax Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. 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)
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periodUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM).
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dayOfWeek | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.dayOfWeek mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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timeOfDay | Σ | 0..* | time | There are no (further) constraints on this element Element idDosage.timing.repeat.timeOfDay Time of day for action DefinitionSpecified time of day for action to take place. 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.
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when | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.when Code for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events. Real world event relating to the schedule.
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offset | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idDosage.timing.repeat.offset Minutes from event (before or after) DefinitionThe 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. 32 bit number; for values larger than this, use decimal
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code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDosage.timing.code BID | TID | QID | AM | PM | QD | QOD | + DefinitionA 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). 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). Code for a known / defined timing pattern.
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asNeeded[x] | S Σ | 0..1 | Element idDosage.asNeeded[x] Take "as needed" (for x) DefinitionTBD 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". 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.
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asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
site | S Σ | 0..1 | CodeableConcept | Element idDosage.site Body site to administer to DefinitionTBD A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body.
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route | S Σ | 0..1 | CodeableConcept | Element idDosage.route How drug should enter body DefinitionTBD A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. 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. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
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method | S Σ | 0..1 | CodeableConcept | Element idDosage.method Technique for administering medication DefinitionTBD 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered.
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doseAndRate | Σ | 0..* | Element | Element idDosage.doseAndRate Amount of medication administered DefinitionTBD
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.doseAndRate.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.doseAndRate.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idDosage.doseAndRate.type The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". 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. The kind of dose or rate specified.
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dose[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.doseAndRate.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | Data type | ||
doseQuantity | SimpleQuantity | Data type | ||
rate[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.doseAndRate.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateRange | Range | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
maxDosePerPeriod | S Σ I | 0..1 | Ratio | Element idDosage.maxDosePerPeriod Upper limit on medication per unit of time DefinitionTBD 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. 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".
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maxDosePerAdministration | Σ I | 0..1 | SimpleQuantity | Element idDosage.maxDosePerAdministration Upper limit on medication per administration DefinitionTBD The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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maxDosePerLifetime | Σ I | 0..1 | SimpleQuantity | Element idDosage.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionTBD The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. 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.
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DataStandardsWalesDosage (Dosage) | Dosage | There are no (further) constraints on this element Element idDosage How the medication is/was taken or should be taken DefinitionIndicates how the medication is/was taken or should be taken by the patient.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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.
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sequence | S Σ | 0..1 | integer | Element idDosage.sequence Multi-sequence dosage instructions. DefinitionTBD 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. 32 bit number; for values larger than this, use decimal
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text | S Σ | 0..1 | string | Element idDosage.text The complete dosage instruction as a human readable string. DefinitionTBD 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. Note that FHIR strings SHALL NOT exceed 1MB in size
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additionalInstruction | S Σ | 0..* | CodeableConcept | Element idDosage.additionalInstruction Additional dosage instructions that can be either SNOMED-CT coded terms or free-text instructions. DefinitionTBD 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. 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. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
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patientInstruction | S Σ | 0..1 | string | Element idDosage.patientInstruction Patient or consumer oriented instructions DefinitionTBD Note that FHIR strings SHALL NOT exceed 1MB in size
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timing | S Σ | 0..1 | Timing | Element idDosage.timing When medication should be administered DefinitionTBD 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. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.timing.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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.
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event | Σ | 0..* | dateTime | There are no (further) constraints on this element Element idDosage.timing.event When the event occurs DefinitionIdentifies specific times when the event occurs. In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
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repeat | Σ I | 0..1 | Element | There are no (further) constraints on this element Element idDosage.timing.repeat When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.timing.repeat.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.repeat.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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bounds[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.timing.repeat.bounds[x] Length/Range of lengths, or (Start and/or end) limits DefinitionEither 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.
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boundsDuration | Duration | Data type | ||
boundsRange | Range | Data type | ||
boundsPeriod | Period | Data type | ||
count | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.count Number of times to repeat DefinitionA 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. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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countMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.countMax Maximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. 32 bit number; for values larger than this, use decimal
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duration | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.duration How long when it happens DefinitionHow 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. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.durationMax How long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM).
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frequency | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.frequency Event occurs frequency times per period DefinitionThe 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. 32 bit number; for values larger than this, use decimal If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
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frequencyMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.frequencyMax Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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period | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.period Event occurs frequency times per period DefinitionIndicates 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. 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)
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periodMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.periodMax Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. 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)
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periodUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM).
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dayOfWeek | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.dayOfWeek mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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timeOfDay | Σ | 0..* | time | There are no (further) constraints on this element Element idDosage.timing.repeat.timeOfDay Time of day for action DefinitionSpecified time of day for action to take place. 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.
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when | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.when Code for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events. Real world event relating to the schedule.
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offset | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idDosage.timing.repeat.offset Minutes from event (before or after) DefinitionThe 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. 32 bit number; for values larger than this, use decimal
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code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDosage.timing.code BID | TID | QID | AM | PM | QD | QOD | + DefinitionA 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). 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). Code for a known / defined timing pattern.
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asNeeded[x] | S Σ | 0..1 | Element idDosage.asNeeded[x] Take "as needed" (for x) DefinitionTBD 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". 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.
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asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
site | S Σ | 0..1 | CodeableConcept | Element idDosage.site Body site to administer to DefinitionTBD A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body.
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route | S Σ | 0..1 | CodeableConcept | Element idDosage.route How drug should enter body DefinitionTBD A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. 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. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
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method | S Σ | 0..1 | CodeableConcept | Element idDosage.method Technique for administering medication DefinitionTBD 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered.
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doseAndRate | Σ | 0..* | Element | Element idDosage.doseAndRate Amount of medication administered DefinitionTBD
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.doseAndRate.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.doseAndRate.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idDosage.doseAndRate.type The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". 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. The kind of dose or rate specified.
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dose[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.doseAndRate.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | Data type | ||
doseQuantity | SimpleQuantity | Data type | ||
rate[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.doseAndRate.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateRange | Range | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
maxDosePerPeriod | S Σ I | 0..1 | Ratio | Element idDosage.maxDosePerPeriod Upper limit on medication per unit of time DefinitionTBD 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. 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".
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maxDosePerAdministration | Σ I | 0..1 | SimpleQuantity | Element idDosage.maxDosePerAdministration Upper limit on medication per administration DefinitionTBD The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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maxDosePerLifetime | Σ I | 0..1 | SimpleQuantity | Element idDosage.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionTBD The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. 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.
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DataStandardsWalesDosage (Dosage) | Dosage | There are no (further) constraints on this element Element idDosage How the medication is/was taken or should be taken DefinitionIndicates how the medication is/was taken or should be taken by the patient.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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.
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sequence | S Σ | 0..1 | integer | Element idDosage.sequence Multi-sequence dosage instructions. DefinitionTBD 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. 32 bit number; for values larger than this, use decimal
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text | S Σ | 0..1 | string | Element idDosage.text The complete dosage instruction as a human readable string. DefinitionTBD 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. Note that FHIR strings SHALL NOT exceed 1MB in size
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additionalInstruction | S Σ | 0..* | CodeableConcept | Element idDosage.additionalInstruction Additional dosage instructions that can be either SNOMED-CT coded terms or free-text instructions. DefinitionTBD 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. 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. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
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patientInstruction | S Σ | 0..1 | string | Element idDosage.patientInstruction Patient or consumer oriented instructions DefinitionTBD Note that FHIR strings SHALL NOT exceed 1MB in size
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timing | S Σ | 0..1 | Timing | Element idDosage.timing When medication should be administered DefinitionTBD 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. 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.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.timing.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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.
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event | Σ | 0..* | dateTime | There are no (further) constraints on this element Element idDosage.timing.event When the event occurs DefinitionIdentifies specific times when the event occurs. In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
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repeat | Σ I | 0..1 | Element | There are no (further) constraints on this element Element idDosage.timing.repeat When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.timing.repeat.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.timing.repeat.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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bounds[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.timing.repeat.bounds[x] Length/Range of lengths, or (Start and/or end) limits DefinitionEither 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.
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boundsDuration | Duration | Data type | ||
boundsRange | Range | Data type | ||
boundsPeriod | Period | Data type | ||
count | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.count Number of times to repeat DefinitionA 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. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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countMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.countMax Maximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. 32 bit number; for values larger than this, use decimal
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duration | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.duration How long when it happens DefinitionHow 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. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.durationMax How long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM).
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frequency | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.frequency Event occurs frequency times per period DefinitionThe 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. 32 bit number; for values larger than this, use decimal If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
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frequencyMax | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idDosage.timing.repeat.frequencyMax Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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period | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.period Event occurs frequency times per period DefinitionIndicates 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. 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)
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periodMax | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idDosage.timing.repeat.periodMax Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. 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)
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periodUnit | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM).
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dayOfWeek | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.dayOfWeek mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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timeOfDay | Σ | 0..* | time | There are no (further) constraints on this element Element idDosage.timing.repeat.timeOfDay Time of day for action DefinitionSpecified time of day for action to take place. 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.
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when | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element idDosage.timing.repeat.when Code for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events. Real world event relating to the schedule.
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offset | Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element idDosage.timing.repeat.offset Minutes from event (before or after) DefinitionThe 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. 32 bit number; for values larger than this, use decimal
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code | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idDosage.timing.code BID | TID | QID | AM | PM | QD | QOD | + DefinitionA 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). 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). Code for a known / defined timing pattern.
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asNeeded[x] | S Σ | 0..1 | Element idDosage.asNeeded[x] Take "as needed" (for x) DefinitionTBD 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". 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.
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asNeededBoolean | boolean | There are no (further) constraints on this element Data type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
site | S Σ | 0..1 | CodeableConcept | Element idDosage.site Body site to administer to DefinitionTBD A coded specification of the anatomic site where the medication first enters the body. 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. A coded concept describing the site location the medicine enters into or onto the body.
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route | S Σ | 0..1 | CodeableConcept | Element idDosage.route How drug should enter body DefinitionTBD A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. 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. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
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method | S Σ | 0..1 | CodeableConcept | Element idDosage.method Technique for administering medication DefinitionTBD 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. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered.
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doseAndRate | Σ | 0..* | Element | Element idDosage.doseAndRate Amount of medication administered DefinitionTBD
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id | 0..1 | string | There are no (further) constraints on this element Element idDosage.doseAndRate.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idDosage.doseAndRate.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idDosage.doseAndRate.type The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". 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. The kind of dose or rate specified.
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dose[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.doseAndRate.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | Data type | ||
doseQuantity | SimpleQuantity | Data type | ||
rate[x] | Σ | 0..1 | There are no (further) constraints on this element Element idDosage.doseAndRate.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateRange | Range | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
maxDosePerPeriod | S Σ I | 0..1 | Ratio | Element idDosage.maxDosePerPeriod Upper limit on medication per unit of time DefinitionTBD 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. 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".
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maxDosePerAdministration | Σ I | 0..1 | SimpleQuantity | Element idDosage.maxDosePerAdministration Upper limit on medication per administration DefinitionTBD The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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maxDosePerLifetime | Σ I | 0..1 | SimpleQuantity | Element idDosage.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionTBD The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. 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.
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UK Core Dose Syntax Guidance:
Example Usage Scenarios
The following are example usage scenarios for the Dosage profile:
- Example Dosage - Drops Query for the dosage of an Eye Drops medication using the query parameter
Dosage.timing.repeat.when
when the time value is undefined. - Example Dosage - Inhaler Query for the dosage of an Inhaler medication using query parameters such as
Dosage.additionalInstruction
. - Example Dosage - Oral Solution PRN Query for the dosage of an Oral Solution PRN medication using query parameters such as
Dosage.asNeededCodeableConcept
andDosage.doseAndRate.doseRange
.
*Examples provided have been clinically assured on the 07-Aug-2024
Profile Specific Implementation Guidance:
Mandatory and Must Support Data Elements
Refer to the Mandatory and Must Support page for guidance on how these elements should be interpreted.
Each Dosage must support:
Element | Reason |
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Dosage.sequence |
Indicates the order in which the dosage instructions should be applied or interpreted. |
Dosage.text |
Free text that can be used for cases where the instructions are too complex to code. |
Dosage.additionalInstruction |
Supplemental instructions or warnings. |
Dosage.patientInstruction |
Supplemental instructions to the patient on how to take the medication. |
Dosage.timing |
The timing schedule for taking or administering the medication. |
Dosage.asNeeded |
It indicates if there is a precondition for taking the medication. |
Dosage.site |
Body site to administer to. |
Dosage.route |
Indication on how the drug should enter the body. |
Dosage.method |
Technique for administering the medication. |
Dosage.maxDosePerPeriod |
Upper limit on medication per unit of time. |
doseAndRate
By preference, use UCUM for dose units. Examples of these units of measure are “gram” or “milliliter” or “percent”.
Where a UCUM unit of measure is not defined, use a SNOMED-CT. Examples of when a SNOMED-CT unit of measure would typically be used are “tablet”, “capsule” or “ampule”.
Recommendation: Dose is used to specify the quantity of the medication administered and not the strength of the active ingredient. This information will be specified on Medication.ingredient.strength
.