HdBe-MedicationAdministration2
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HdBe-MedicationAdministration2 | Medication administration is the registration of the individual administrations of the medicine on the patient by the administrator (e.g. a nurse or patient themselves), in relation to the entered agreements. | draft | https://fhir.healthdata.be/StructureDefinition/HdBe-MedicationAdministration2 |
MedicationAdministration | I | MedicationAdministration | Element IdMedicationAdministration MedicationAdministration Alternate namesMedicatieToediening DefinitionDescribes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.
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extension | I | 0..* | Extension | Element IdMedicationAdministration.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 resource. 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) Constraints
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agreedDateTime | I | 0..1 | Extension(dateTime) | Element IdMedicationAdministration.extension:agreedDateTime Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:agreedDateTime.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime
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value[x] | 0..1 | Element IdMedicationAdministration.extension:agreedDateTime.value[x] AgreedDateTime Alternate namesAfgesprokenDatumTijd DefinitionThe date and time at which the medication was administered.
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valueDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
doubleCheckPerformed | I | 0..1 | Extension(boolean) | Element IdMedicationAdministration.extension:doubleCheckPerformed Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DoubleCheckPerformed Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:doubleCheckPerformed.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DoubleCheckPerformed
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value[x] | 0..1 | Element IdMedicationAdministration.extension:doubleCheckPerformed.value[x] DoubleCheckPerformed Alternate namesDubbeleControleUitgevoerd DefinitionWas a double check performed prior to the administration? This is only legally required for certain medication. MedicationAdministration has another way to capture that a double check has been performed, namely by marking a performer as verifier. Therefore, if a
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deviatingAdministration | I | 0..1 | Extension(boolean) | Element IdMedicationAdministration.extension:deviatingAdministration Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DeviatingAdministration Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:deviatingAdministration.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DeviatingAdministration
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value[x] | 0..1 | Element IdMedicationAdministration.extension:deviatingAdministration.value[x] DeviatingAdministration Alternate namesAfwijkendeToediening DefinitionIn the administration, was there a deviation from the medication or administration agreement? This can be a deviation in product, time, amount, route of administration or administering speed or foregoing administration altogether.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||
medicationAdministrationReasonForDeviation | I | 0..1 | Extension(CodeableConcept) | Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation
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value[x] | 0..1 | Binding | Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation.value[x] MedicationAdministrationReasonForDeviation Alternate namesMedicatieToedieningRedenVanAfwijken DefinitionReason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes. This MedicationAdministrationReasonForDeviation extension has overlap with MedicationAdministrationReasonForDeviation (required) Constraints
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valueCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
identifier | 0..* | Identifier | There are no (further) constraints on this element Element IdMedicationAdministration.identifier External identifier DefinitionIdentifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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instantiates | Σ | 0..* | uri | There are no (further) constraints on this element Element IdMedicationAdministration.instantiates Instantiates protocol or definition DefinitionA protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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partOf | Σ I | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element IdMedicationAdministration.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | Procedure) Constraints
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status | Σ ?! | 1..1 | codeBinding | Element IdMedicationAdministration.status MedicationAdministrationStatus Alternate namesMedicatieToedieningStatus DefinitionThe status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used:
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Use ConceptMap 'MedicationAdministrationStatus-to-MedicationAdministrationStatus' to translate CBB terminology to profile terminology in ValueSet 'MedicationAdministrationStatus'. MedicationAdministration Status Codes (required)Permitted Values MedicationAdministrationStatus_to_MedicationAdministrationStatusCodes Constraints
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statusReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.statusReason Reason administration not performed DefinitionA code indicating why the administration was not performed. 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 set of codes indicating the reason why the MedicationAdministration is negated. SNOMEDCTReasonMedicationNotGivenCodes (example)Constraints
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category | 1..1 | CodeableConceptBinding | Element IdMedicationAdministration.category Type of medication usage DefinitionIndicates where the medication is expected to be consumed or administered. 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 where the medication administered is expected to occur. MedicationAdministration Category Codes (preferred)Constraints
{ "coding": [ { "system": "http://snomed.info/sct", "code": "18629005" } ] }
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medication[x] | Σ | 1..1 | Element IdMedicationAdministration.medication[x] What was administered DefinitionIdentifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Unordered, Open, by $this(Type) BindingCodes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)Constraints
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medicationCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
medicationReference | Σ | 0..1 | Reference(Medication | HdBe PharmaceuticalProduct) | Element IdMedicationAdministration.medication[x]:medicationReference AdministrationProduct Alternate namesToedieningsProduct DefinitionThe product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Reference(Medication | HdBe PharmaceuticalProduct) BindingCodes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)Constraints
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subject | Σ I | 1..1 | Reference(Patient | Group | HdBe Patient) | Element IdMedicationAdministration.subject Who received medication DefinitionThe person or animal or group receiving the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Group | HdBe Patient) Constraints
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationAdministration.context Encounter or Episode of Care administered as part of DefinitionThe visit, admission, or other contact between patient and health care provider during which the medication administration was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource) | Element IdMedicationAdministration.supportingInformation Additional information to support administration DefinitionAdditional information (for example, patient height and weight) that supports the administration of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Unordered, Open, by resolve()(Profile) Constraints
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administrationAgreement | I | 0..1 | Reference(Resource | https://fhir.healthdata.be/StructureDefinition/HdBe-AdministrationAgreement) | Element IdMedicationAdministration.supportingInformation:administrationAgreement AdministrationAgreement Alternate namesToedieningsafspraak DefinitionAdministration agreement on which this administration is based. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Resource | https://fhir.healthdata.be/StructureDefinition/HdBe-AdministrationAgreement) Constraints
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effective[x] | Σ | 1..1 | Element IdMedicationAdministration.effective[x] Start and end time of administration DefinitionA specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Unordered, Open, by $this(Type) Constraints
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effectivePeriod | Period | There are no (further) constraints on this element Data Type | ||
effectiveDateTime | Σ | 0..1 | dateTime | Element IdMedicationAdministration.effective[x]:effectiveDateTime AdministrationDateTime Alternate namesToedieningsDatumTijd DefinitionThe date and time at which the medication was administered.
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performer | Σ | 0..1 | BackboneElement | Element IdMedicationAdministration.performer Administrator Alternate namesToediener DefinitionThe concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
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function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.performer.function Type of performance DefinitionDistinguishes the type of involvement of the performer in the medication administration. 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 code describing the role an individual played in administering the medication. MedicationAdministration Performer Function Codes (example)Constraints
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actor | Σ I | 1..1 | pattern HealthProfessional Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | HdBe Patient | HdBe HealthProfessional PractitionerRole | HdBe ContactPerson) | Element IdMedicationAdministration.performer.actor Patient / HealthProfessional / Caregiver Alternate namesPatiënt, Zorgverlener, Mantelzorger DefinitionThe concept describes the person who administered the product. This is a professional authorised administrator. Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. pattern HealthProfessional Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | HdBe Patient | HdBe HealthProfessional PractitionerRole | HdBe ContactPerson) Constraints
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.reasonCode Reason administration performed DefinitionA code indicating why the medication was given. 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 set of codes indicating the reason why the MedicationAdministration was made. ReasonMedicationGivenCodes (example)Constraints
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reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element IdMedicationAdministration.reasonReference Condition or observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Reference(Condition | Observation | DiagnosticReport) Constraints
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request | I | 0..1 | Reference(HdBe MedicationAgreement | MedicationRequest) | Element IdMedicationAdministration.request MedicationAgreement Alternate namesMedicatieafspraak DefinitionMedication agreement on which this administration is based. This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value. Reference(HdBe MedicationAgreement | MedicationRequest) Constraints
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device | I | 0..* | Reference(Device) | There are no (further) constraints on this element Element IdMedicationAdministration.device Device used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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note | 0..1 | Annotation | There are no (further) constraints on this element Element IdMedicationAdministration.note Information about the administration DefinitionExtra information about the medication administration that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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author[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationAdministration.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment.
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authorString | string | There are no (further) constraints on this element Data Type | ||
authorReference | Reference(Practitioner | Patient | RelatedPerson | Organization) | There are no (further) constraints on this element Data Type Reference(Practitioner | Patient | RelatedPerson | Organization) | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationAdministration.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | Σ | 1..1 | markdown | Element IdMedicationAdministration.note.text Comment Alternate namesToelichting DefinitionComments on administering the medication. Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
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dosage | I | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationAdministration.dosage Details of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
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extension | I | 0..* | Extension | Element IdMedicationAdministration.dosage.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) Constraints
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administeringSpeedRange | I | 0..1 | Extension(Range) | Element IdMedicationAdministration.dosage.extension:administeringSpeedRange Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AdministeringSpeedRange Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AdministeringSpeedRange
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value[x] | 0..1 | Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x] AdministeringSpeed Alternate namesToedieningssnelheid DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour:
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valueRange | Range | There are no (further) constraints on this element Data Type | ||
low | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x].low minimumValue Alternate namesminimumWaarde DefinitionThe minimal value of the range. The boundary is inclusive. If the low element is missing, the low boundary is not known.
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high | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x].high maximumValue Alternate namesmaximumWaarde DefinitionThe maximum value of the range. The boundary is inclusive. If the high element is missing, the high boundary is not known.
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text | 0..1 | string | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Note that FHIR strings SHALL NOT exceed 1MB in size
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site | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.site Body site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm". 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints
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route | 0..1 | CodeableConceptBinding | Element IdMedicationAdministration.dosage.route RouteOfAdministration Alternate namesToedieningsweg DefinitionThe route through which the medication is administered (oral, nasal, intravenous,...). 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. RouteOfMedicationAdministration (required)Constraints
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method | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.method How drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints
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dose | I | 0..1 | SimpleQuantity | Element IdMedicationAdministration.dosage.dose AdministeredAmount Alternate namesToegediendeHoeveelheid DefinitionAmount of the administered product. If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.
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rate[x] | 0..1 | Element IdMedicationAdministration.dosage.rate[x] Dose quantity per unit of time DefinitionIdentifies 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. If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate. Unordered, Open, by $this(Type) Constraints
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rateRatio | Ratio | There are no (further) constraints on this element Data Type | ||
rateQuantity | 0..1 | SimpleQuantity | Element IdMedicationAdministration.dosage.rate[x]:rateQuantity AdministeringSpeed / nominalValue Alternate namesToedieningssnelheid, nominaleWaarde DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour:
The extension MedicationAdministration2AdministeringSpeedRange extends
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eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationAdministration.eventHistory A list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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MedicationAdministration | I | MedicationAdministration | Element IdMedicationAdministration MedicationAdministration Alternate namesMedicatieToediening DefinitionDescribes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.
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extension | I | 0..* | Extension | Element IdMedicationAdministration.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 resource. 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) Constraints
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agreedDateTime | I | 0..1 | Extension(dateTime) | Element IdMedicationAdministration.extension:agreedDateTime Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:agreedDateTime.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime
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value[x] | 0..1 | Element IdMedicationAdministration.extension:agreedDateTime.value[x] AgreedDateTime Alternate namesAfgesprokenDatumTijd DefinitionThe date and time at which the medication was administered.
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valueDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
doubleCheckPerformed | I | 0..1 | Extension(boolean) | Element IdMedicationAdministration.extension:doubleCheckPerformed Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DoubleCheckPerformed Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:doubleCheckPerformed.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DoubleCheckPerformed
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value[x] | 0..1 | Element IdMedicationAdministration.extension:doubleCheckPerformed.value[x] DoubleCheckPerformed Alternate namesDubbeleControleUitgevoerd DefinitionWas a double check performed prior to the administration? This is only legally required for certain medication. MedicationAdministration has another way to capture that a double check has been performed, namely by marking a performer as verifier. Therefore, if a
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deviatingAdministration | I | 0..1 | Extension(boolean) | Element IdMedicationAdministration.extension:deviatingAdministration Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DeviatingAdministration Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:deviatingAdministration.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DeviatingAdministration
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value[x] | 0..1 | Element IdMedicationAdministration.extension:deviatingAdministration.value[x] DeviatingAdministration Alternate namesAfwijkendeToediening DefinitionIn the administration, was there a deviation from the medication or administration agreement? This can be a deviation in product, time, amount, route of administration or administering speed or foregoing administration altogether.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||
medicationAdministrationReasonForDeviation | I | 0..1 | Extension(CodeableConcept) | Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation
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value[x] | 0..1 | Binding | Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation.value[x] MedicationAdministrationReasonForDeviation Alternate namesMedicatieToedieningRedenVanAfwijken DefinitionReason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes. This MedicationAdministrationReasonForDeviation extension has overlap with MedicationAdministrationReasonForDeviation (required) Constraints
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valueCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
identifier | 0..* | Identifier | There are no (further) constraints on this element Element IdMedicationAdministration.identifier External identifier DefinitionIdentifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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instantiates | Σ | 0..* | uri | There are no (further) constraints on this element Element IdMedicationAdministration.instantiates Instantiates protocol or definition DefinitionA protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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partOf | Σ I | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element IdMedicationAdministration.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | Procedure) Constraints
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status | Σ ?! | 1..1 | codeBinding | Element IdMedicationAdministration.status MedicationAdministrationStatus Alternate namesMedicatieToedieningStatus DefinitionThe status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used:
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Use ConceptMap 'MedicationAdministrationStatus-to-MedicationAdministrationStatus' to translate CBB terminology to profile terminology in ValueSet 'MedicationAdministrationStatus'. MedicationAdministration Status Codes (required)Permitted Values MedicationAdministrationStatus_to_MedicationAdministrationStatusCodes Constraints
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statusReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.statusReason Reason administration not performed DefinitionA code indicating why the administration was not performed. 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 set of codes indicating the reason why the MedicationAdministration is negated. SNOMEDCTReasonMedicationNotGivenCodes (example)Constraints
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category | 1..1 | CodeableConceptBinding | Element IdMedicationAdministration.category Type of medication usage DefinitionIndicates where the medication is expected to be consumed or administered. 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 where the medication administered is expected to occur. MedicationAdministration Category Codes (preferred)Constraints
{ "coding": [ { "system": "http://snomed.info/sct", "code": "18629005" } ] }
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medication[x] | Σ | 1..1 | Element IdMedicationAdministration.medication[x] What was administered DefinitionIdentifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Unordered, Open, by $this(Type) BindingCodes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)Constraints
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medicationCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
medicationReference | Σ | 0..1 | Reference(Medication | HdBe PharmaceuticalProduct) | Element IdMedicationAdministration.medication[x]:medicationReference AdministrationProduct Alternate namesToedieningsProduct DefinitionThe product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Reference(Medication | HdBe PharmaceuticalProduct) BindingCodes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)Constraints
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subject | Σ I | 1..1 | Reference(Patient | Group | HdBe Patient) | Element IdMedicationAdministration.subject Who received medication DefinitionThe person or animal or group receiving the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Group | HdBe Patient) Constraints
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationAdministration.context Encounter or Episode of Care administered as part of DefinitionThe visit, admission, or other contact between patient and health care provider during which the medication administration was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource) | Element IdMedicationAdministration.supportingInformation Additional information to support administration DefinitionAdditional information (for example, patient height and weight) that supports the administration of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Unordered, Open, by resolve()(Profile) Constraints
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administrationAgreement | I | 0..1 | Reference(Resource | https://fhir.healthdata.be/StructureDefinition/HdBe-AdministrationAgreement) | Element IdMedicationAdministration.supportingInformation:administrationAgreement AdministrationAgreement Alternate namesToedieningsafspraak DefinitionAdministration agreement on which this administration is based. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Resource | https://fhir.healthdata.be/StructureDefinition/HdBe-AdministrationAgreement) Constraints
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effective[x] | Σ | 1..1 | Element IdMedicationAdministration.effective[x] Start and end time of administration DefinitionA specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Unordered, Open, by $this(Type) Constraints
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effectivePeriod | Period | There are no (further) constraints on this element Data Type | ||
effectiveDateTime | Σ | 0..1 | dateTime | Element IdMedicationAdministration.effective[x]:effectiveDateTime AdministrationDateTime Alternate namesToedieningsDatumTijd DefinitionThe date and time at which the medication was administered.
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performer | Σ | 0..1 | BackboneElement | Element IdMedicationAdministration.performer Administrator Alternate namesToediener DefinitionThe concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
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function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.performer.function Type of performance DefinitionDistinguishes the type of involvement of the performer in the medication administration. 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 code describing the role an individual played in administering the medication. MedicationAdministration Performer Function Codes (example)Constraints
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actor | Σ I | 1..1 | pattern HealthProfessional Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | HdBe Patient | HdBe HealthProfessional PractitionerRole | HdBe ContactPerson) | Element IdMedicationAdministration.performer.actor Patient / HealthProfessional / Caregiver Alternate namesPatiënt, Zorgverlener, Mantelzorger DefinitionThe concept describes the person who administered the product. This is a professional authorised administrator. Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. pattern HealthProfessional Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | HdBe Patient | HdBe HealthProfessional PractitionerRole | HdBe ContactPerson) Constraints
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.reasonCode Reason administration performed DefinitionA code indicating why the medication was given. 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 set of codes indicating the reason why the MedicationAdministration was made. ReasonMedicationGivenCodes (example)Constraints
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reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element IdMedicationAdministration.reasonReference Condition or observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Reference(Condition | Observation | DiagnosticReport) Constraints
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request | I | 0..1 | Reference(HdBe MedicationAgreement | MedicationRequest) | Element IdMedicationAdministration.request MedicationAgreement Alternate namesMedicatieafspraak DefinitionMedication agreement on which this administration is based. This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value. Reference(HdBe MedicationAgreement | MedicationRequest) Constraints
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device | I | 0..* | Reference(Device) | There are no (further) constraints on this element Element IdMedicationAdministration.device Device used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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note | 0..1 | Annotation | There are no (further) constraints on this element Element IdMedicationAdministration.note Information about the administration DefinitionExtra information about the medication administration that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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author[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationAdministration.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment.
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authorString | string | There are no (further) constraints on this element Data Type | ||
authorReference | Reference(Practitioner | Patient | RelatedPerson | Organization) | There are no (further) constraints on this element Data Type Reference(Practitioner | Patient | RelatedPerson | Organization) | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationAdministration.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | Σ | 1..1 | markdown | Element IdMedicationAdministration.note.text Comment Alternate namesToelichting DefinitionComments on administering the medication. Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
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dosage | I | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationAdministration.dosage Details of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
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extension | I | 0..* | Extension | Element IdMedicationAdministration.dosage.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) Constraints
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administeringSpeedRange | I | 0..1 | Extension(Range) | Element IdMedicationAdministration.dosage.extension:administeringSpeedRange Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AdministeringSpeedRange Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AdministeringSpeedRange
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value[x] | 0..1 | Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x] AdministeringSpeed Alternate namesToedieningssnelheid DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour:
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valueRange | Range | There are no (further) constraints on this element Data Type | ||
low | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x].low minimumValue Alternate namesminimumWaarde DefinitionThe minimal value of the range. The boundary is inclusive. If the low element is missing, the low boundary is not known.
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high | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x].high maximumValue Alternate namesmaximumWaarde DefinitionThe maximum value of the range. The boundary is inclusive. If the high element is missing, the high boundary is not known.
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text | 0..1 | string | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Note that FHIR strings SHALL NOT exceed 1MB in size
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site | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.site Body site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm". 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints
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route | 0..1 | CodeableConceptBinding | Element IdMedicationAdministration.dosage.route RouteOfAdministration Alternate namesToedieningsweg DefinitionThe route through which the medication is administered (oral, nasal, intravenous,...). 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. RouteOfMedicationAdministration (required)Constraints
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method | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.method How drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints
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dose | I | 0..1 | SimpleQuantity | Element IdMedicationAdministration.dosage.dose AdministeredAmount Alternate namesToegediendeHoeveelheid DefinitionAmount of the administered product. If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.
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rate[x] | 0..1 | Element IdMedicationAdministration.dosage.rate[x] Dose quantity per unit of time DefinitionIdentifies 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. If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate. Unordered, Open, by $this(Type) Constraints
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rateRatio | Ratio | There are no (further) constraints on this element Data Type | ||
rateQuantity | 0..1 | SimpleQuantity | Element IdMedicationAdministration.dosage.rate[x]:rateQuantity AdministeringSpeed / nominalValue Alternate namesToedieningssnelheid, nominaleWaarde DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour:
The extension MedicationAdministration2AdministeringSpeedRange extends
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eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationAdministration.eventHistory A list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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MedicationAdministration | I | MedicationAdministration | Element IdMedicationAdministration MedicationAdministration Alternate namesMedicatieToediening DefinitionDescribes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.
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extension | I | 0..* | Extension | Element IdMedicationAdministration.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 resource. 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) Constraints
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agreedDateTime | I | 0..1 | Extension(dateTime) | Element IdMedicationAdministration.extension:agreedDateTime Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:agreedDateTime.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime
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value[x] | 0..1 | Element IdMedicationAdministration.extension:agreedDateTime.value[x] AgreedDateTime Alternate namesAfgesprokenDatumTijd DefinitionThe date and time at which the medication was administered.
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valueDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
doubleCheckPerformed | I | 0..1 | Extension(boolean) | Element IdMedicationAdministration.extension:doubleCheckPerformed Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DoubleCheckPerformed Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:doubleCheckPerformed.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DoubleCheckPerformed
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value[x] | 0..1 | Element IdMedicationAdministration.extension:doubleCheckPerformed.value[x] DoubleCheckPerformed Alternate namesDubbeleControleUitgevoerd DefinitionWas a double check performed prior to the administration? This is only legally required for certain medication. MedicationAdministration has another way to capture that a double check has been performed, namely by marking a performer as verifier. Therefore, if a
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deviatingAdministration | I | 0..1 | Extension(boolean) | Element IdMedicationAdministration.extension:deviatingAdministration Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DeviatingAdministration Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:deviatingAdministration.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.DeviatingAdministration
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value[x] | 0..1 | Element IdMedicationAdministration.extension:deviatingAdministration.value[x] DeviatingAdministration Alternate namesAfwijkendeToediening DefinitionIn the administration, was there a deviation from the medication or administration agreement? This can be a deviation in product, time, amount, route of administration or administering speed or foregoing administration altogether.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||
medicationAdministrationReasonForDeviation | I | 0..1 | Extension(CodeableConcept) | Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation
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value[x] | 0..1 | Binding | Element IdMedicationAdministration.extension:medicationAdministrationReasonForDeviation.value[x] MedicationAdministrationReasonForDeviation Alternate namesMedicatieToedieningRedenVanAfwijken DefinitionReason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes. This MedicationAdministrationReasonForDeviation extension has overlap with MedicationAdministrationReasonForDeviation (required) Constraints
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valueCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
identifier | 0..* | Identifier | There are no (further) constraints on this element Element IdMedicationAdministration.identifier External identifier DefinitionIdentifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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instantiates | Σ | 0..* | uri | There are no (further) constraints on this element Element IdMedicationAdministration.instantiates Instantiates protocol or definition DefinitionA protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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partOf | Σ I | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element IdMedicationAdministration.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | Procedure) Constraints
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status | Σ ?! | 1..1 | codeBinding | Element IdMedicationAdministration.status MedicationAdministrationStatus Alternate namesMedicatieToedieningStatus DefinitionThe status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used:
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Use ConceptMap 'MedicationAdministrationStatus-to-MedicationAdministrationStatus' to translate CBB terminology to profile terminology in ValueSet 'MedicationAdministrationStatus'. MedicationAdministration Status Codes (required)Permitted Values MedicationAdministrationStatus_to_MedicationAdministrationStatusCodes Constraints
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statusReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.statusReason Reason administration not performed DefinitionA code indicating why the administration was not performed. 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 set of codes indicating the reason why the MedicationAdministration is negated. SNOMEDCTReasonMedicationNotGivenCodes (example)Constraints
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category | 1..1 | CodeableConceptBinding | Element IdMedicationAdministration.category Type of medication usage DefinitionIndicates where the medication is expected to be consumed or administered. 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 where the medication administered is expected to occur. MedicationAdministration Category Codes (preferred)Constraints
{ "coding": [ { "system": "http://snomed.info/sct", "code": "18629005" } ] }
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medication[x] | Σ | 1..1 | Element IdMedicationAdministration.medication[x] What was administered DefinitionIdentifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Unordered, Open, by $this(Type) BindingCodes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)Constraints
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medicationCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
medicationReference | Σ | 0..1 | Reference(Medication | HdBe PharmaceuticalProduct) | Element IdMedicationAdministration.medication[x]:medicationReference AdministrationProduct Alternate namesToedieningsProduct DefinitionThe product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Reference(Medication | HdBe PharmaceuticalProduct) BindingCodes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)Constraints
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subject | Σ I | 1..1 | Reference(Patient | Group | HdBe Patient) | Element IdMedicationAdministration.subject Who received medication DefinitionThe person or animal or group receiving the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Group | HdBe Patient) Constraints
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationAdministration.context Encounter or Episode of Care administered as part of DefinitionThe visit, admission, or other contact between patient and health care provider during which the medication administration was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource) | Element IdMedicationAdministration.supportingInformation Additional information to support administration DefinitionAdditional information (for example, patient height and weight) that supports the administration of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Unordered, Open, by resolve()(Profile) Constraints
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administrationAgreement | I | 0..1 | Reference(Resource | https://fhir.healthdata.be/StructureDefinition/HdBe-AdministrationAgreement) | Element IdMedicationAdministration.supportingInformation:administrationAgreement AdministrationAgreement Alternate namesToedieningsafspraak DefinitionAdministration agreement on which this administration is based. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Resource | https://fhir.healthdata.be/StructureDefinition/HdBe-AdministrationAgreement) Constraints
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effective[x] | Σ | 1..1 | Element IdMedicationAdministration.effective[x] Start and end time of administration DefinitionA specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Unordered, Open, by $this(Type) Constraints
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effectivePeriod | Period | There are no (further) constraints on this element Data Type | ||
effectiveDateTime | Σ | 0..1 | dateTime | Element IdMedicationAdministration.effective[x]:effectiveDateTime AdministrationDateTime Alternate namesToedieningsDatumTijd DefinitionThe date and time at which the medication was administered.
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performer | Σ | 0..1 | BackboneElement | Element IdMedicationAdministration.performer Administrator Alternate namesToediener DefinitionThe concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
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function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.performer.function Type of performance DefinitionDistinguishes the type of involvement of the performer in the medication administration. 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 code describing the role an individual played in administering the medication. MedicationAdministration Performer Function Codes (example)Constraints
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actor | Σ I | 1..1 | pattern HealthProfessional Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | HdBe Patient | HdBe HealthProfessional PractitionerRole | HdBe ContactPerson) | Element IdMedicationAdministration.performer.actor Patient / HealthProfessional / Caregiver Alternate namesPatiënt, Zorgverlener, Mantelzorger DefinitionThe concept describes the person who administered the product. This is a professional authorised administrator. Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. pattern HealthProfessional Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device | HdBe Patient | HdBe HealthProfessional PractitionerRole | HdBe ContactPerson) Constraints
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reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.reasonCode Reason administration performed DefinitionA code indicating why the medication was given. 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 set of codes indicating the reason why the MedicationAdministration was made. ReasonMedicationGivenCodes (example)Constraints
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reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element IdMedicationAdministration.reasonReference Condition or observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Reference(Condition | Observation | DiagnosticReport) Constraints
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request | I | 0..1 | Reference(HdBe MedicationAgreement | MedicationRequest) | Element IdMedicationAdministration.request MedicationAgreement Alternate namesMedicatieafspraak DefinitionMedication agreement on which this administration is based. This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value. Reference(HdBe MedicationAgreement | MedicationRequest) Constraints
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device | I | 0..* | Reference(Device) | There are no (further) constraints on this element Element IdMedicationAdministration.device Device used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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note | 0..1 | Annotation | There are no (further) constraints on this element Element IdMedicationAdministration.note Information about the administration DefinitionExtra information about the medication administration that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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author[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationAdministration.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment.
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authorString | string | There are no (further) constraints on this element Data Type | ||
authorReference | Reference(Practitioner | Patient | RelatedPerson | Organization) | There are no (further) constraints on this element Data Type Reference(Practitioner | Patient | RelatedPerson | Organization) | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationAdministration.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | Σ | 1..1 | markdown | Element IdMedicationAdministration.note.text Comment Alternate namesToelichting DefinitionComments on administering the medication. Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
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dosage | I | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationAdministration.dosage Details of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
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extension | I | 0..* | Extension | Element IdMedicationAdministration.dosage.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) Constraints
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administeringSpeedRange | I | 0..1 | Extension(Range) | Element IdMedicationAdministration.dosage.extension:administeringSpeedRange Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. https://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AdministeringSpeedRange Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttps://fhir.healthdata.be/StructureDefinition/ext-MedicationAdministration2.AdministeringSpeedRange
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value[x] | 0..1 | Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x] AdministeringSpeed Alternate namesToedieningssnelheid DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour:
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valueRange | Range | There are no (further) constraints on this element Data Type | ||
low | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x].low minimumValue Alternate namesminimumWaarde DefinitionThe minimal value of the range. The boundary is inclusive. If the low element is missing, the low boundary is not known.
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high | Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.extension:administeringSpeedRange.value[x].high maximumValue Alternate namesmaximumWaarde DefinitionThe maximum value of the range. The boundary is inclusive. If the high element is missing, the high boundary is not known.
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text | 0..1 | string | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Note that FHIR strings SHALL NOT exceed 1MB in size
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site | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.site Body site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm". 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints
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route | 0..1 | CodeableConceptBinding | Element IdMedicationAdministration.dosage.route RouteOfAdministration Alternate namesToedieningsweg DefinitionThe route through which the medication is administered (oral, nasal, intravenous,...). 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. RouteOfMedicationAdministration (required)Constraints
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method | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationAdministration.dosage.method How drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints
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dose | I | 0..1 | SimpleQuantity | Element IdMedicationAdministration.dosage.dose AdministeredAmount Alternate namesToegediendeHoeveelheid DefinitionAmount of the administered product. If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.
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rate[x] | 0..1 | Element IdMedicationAdministration.dosage.rate[x] Dose quantity per unit of time DefinitionIdentifies 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. If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate. Unordered, Open, by $this(Type) Constraints
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rateRatio | Ratio | There are no (further) constraints on this element Data Type | ||
rateQuantity | 0..1 | SimpleQuantity | Element IdMedicationAdministration.dosage.rate[x]:rateQuantity AdministeringSpeed / nominalValue Alternate namesToedieningssnelheid, nominaleWaarde DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour:
The extension MedicationAdministration2AdministeringSpeedRange extends
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eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationAdministration.eventHistory A list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Mapping FHIR profile to CBB
Path | map | CBB |
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MedicationAdministration | MedicationAdministration | HdBe-MedicationAdministration2 |
MedicationAdministration.extension:agreedDateTime.value[x] | MedicationAdministration.AgreedDateTime | HdBe-MedicationAdministration2 |
MedicationAdministration.extension:doubleCheckPerformed.value[x] | MedicationAdministration.DoubleCheckPerformed | HdBe-MedicationAdministration2 |
MedicationAdministration.extension:deviatingAdministration.value[x] | MedicationAdministration.DeviatingAdministration | HdBe-MedicationAdministration2 |
MedicationAdministration.extension:medicationAdministrationReasonForDeviation.value[x] | MedicationAdministration.MedicationAdministrationReasonForDeviation | HdBe-MedicationAdministration2 |
MedicationAdministration.status | MedicationAdministration.MedicationAdministrationStatus | HdBe-MedicationAdministration2 |
MedicationAdministration.medication[x]:medicationReference | MedicationAdministration.AdministrationProduct | HdBe-MedicationAdministration2 |
MedicationAdministration.supportingInformation:administrationAgreement | MedicationAdministration.RelatedAgreement.AdministrationAgreement | HdBe-MedicationAdministration2 |
MedicationAdministration.effective[x]:effectiveDateTime | MedicationAdministration.AdministrationDateTime | HdBe-MedicationAdministration2 |
MedicationAdministration.performer | MedicationAdministration.Administrator | HdBe-MedicationAdministration2 |
MedicationAdministration.performer.actor | MedicationAdministration.Administrator.Patient | HdBe-MedicationAdministration2 |
MedicationAdministration.performer.actor | MedicationAdministration.Administrator.HealthProfessional | HdBe-MedicationAdministration2 |
MedicationAdministration.performer.actor | MedicationAdministration.Administrator.Caregiver | HdBe-MedicationAdministration2 |
MedicationAdministration.request | MedicationAdministration.RelatedAgreement.MedicationAgreement | HdBe-MedicationAdministration2 |
MedicationAdministration.note.text | MedicationAdministration.Comment | HdBe-MedicationAdministration2 |
MedicationAdministration.dosage.extension:administeringSpeedRange.value[x] | MedicationAdministration.AdministeringSpeed | HdBe-MedicationAdministration2 |
MedicationAdministration.dosage.route | MedicationAdministration.RouteOfAdministration | HdBe-MedicationAdministration2 |
MedicationAdministration.dosage.dose | MedicationAdministration.AdministeredAmount | HdBe-MedicationAdministration2 |
MedicationAdministration.dosage.rate[x]:rateQuantity | MedicationAdministration.AdministeringSpeed | HdBe-MedicationAdministration2 |
MedicationAdministration.dosage.rate[x]:rateQuantity | Range.NominalValue | HdBe-Range |
zib MedicationAdministration difference
Concept | Category | Description |
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status |
terminology | Replaced codes of the MedicationAdministrationStatus ValueSet with SNOMED codes where applicable and added the CodeSystem MedicationAdministrationStatus for the replacement of other codes. |
status |
terminology | Adapted ConceptMap-MedicationAdministrationStatus-to-MedicationAdministrationStatus to align source mappings with the adapted MedicationAdministrationStatus ValueSet. |
status |
textual | Aligned description of the values with the used valueSet. |
dosage.route |
terminology | Replaced Gstandaard codes with SNOMED hierarchy containing descendents of 284009009 (Route of administration value) (zib ticket #1781) and renamed it to RouteOfMedicationAdministration to reuse the ValueSet both here and in InstructionsForUse. |
dosage.dose |
type | Removed pattern-GstdQuantity as Quantity type because the Dutch Gstandard is not used. |
dosage.rate[x].rateQuantity |
textual | Removed context about use of Dutch NHG table. |
dosage.extension:administeringSpeedRange.value[x] |
textual | Removed context about use of Dutch NHG table. |
extension:doubleCheckPerformed.value[x] |
textual | Fixed typo: verfier --> verifier |
extension:medicationAdministrationReasonForDeviation.value[x] |
terminology | Replaced NL-CM-CS or ActReason codes with SNOMED codes as found in the 2022 CodeList. Also added SNOMED codes for Unknown and Other. SNOMED NL codes are replaced with custom codes as defined the CodeSystem MedicationAdministrationReasonForDeviation. |
Terminology Bindings
Path | Name | Strength | URL | ConceptMap |
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MedicationAdministration.status | medication-admin-status|4.0.1 | required | http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1 | https://fhir.healthdata.be/ConceptMap/MedicationAdministrationStatus-to-MedicationAdministrationStatus |
MedicationAdministration.dosage.route | RouteOfMedicationAdministration | required | https://fhir.healthdata.be/ValueSet/RouteOfMedicationAdministration | No bound ConceptMap |