HL7 FHIR® CareConnect Baseline Profiles for STU3 (Draft Standard for Trial Use)

Important Announcement regarding CareConnect STU3

As of 19/09/2023, CareConnect has been deprecated and all development on the CareConnect FHIR assets has ceased.
Therefore, vendors looking to start new implementations or looking to update existing implementations should use UK Core R4 based solutions. Vendors continuing to implement CareConnect based solutions do so at their own risk and on the understanding that no maintenance or support will be available.

StructureDefinition-CareConnect-MedicationAdministration

Describes the event of a patient consuming or otherwise being administered a medication.

Snapshot View

CareConnect-MedicationAdministration-1 (MedicationAdministration)

MedicationAdministration

There are no (further) constraints on this element

Element id

MedicationAdministration

Short description

Administration of medication to a patient

Definition

Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.

Comments

The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html).

Data type

MedicationAdministration

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
mad-2: Reason not given is only permitted if NotGiven is true
reasonNotGiven.empty() or notGiven = true
mad-3: Reason given is only permitted if NotGiven is false
reasonCode.empty() or notGiven.empty() or notGiven = 'false'

Mappings

rim: Entity. Role, or Act
workflow: ..Event
rim: SubstanceAdministration
w5: clinical.medication

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

MedicationAdministration.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationAdministration.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationAdministration.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, dom-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationAdministration.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier

Short description

External identifier

Definition

External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: …identifier
rim: .id
w5: id

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.use

Short description

usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

0..1

uri

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(CareConnect-Organization-1)

Element id

MedicationAdministration.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(CareConnect-Organization-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

definition

Σ C

0..*

Reference(ActivityDefinition | PlanDefinition)

There are no (further) constraints on this element

Element id

MedicationAdministration.definition

Short description

Instantiates protocol or definition

Definition

A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Data type

Reference(ActivityDefinition | PlanDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …definition
rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]

partOf

Σ C

0..*

Reference(CareConnect-MedicationAdministration-1 | CareConnect-Procedure-1)

Element id

MedicationAdministration.partOf

Short description

Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Comments

Data type

Reference(CareConnect-MedicationAdministration-1 | CareConnect-Procedure-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …part of
rim: .outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.status

Short description

Definition

Will generally be set to show that the administration has been completed. For some long running administrations such as infusions it is possible for an administration to be started but not completed or it may be paused while some other process is under way.

Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Data type

code

Binding

A set of codes indicating the current status of a MedicationAdministration.

MedicationAdministrationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …status
v2: RXA-20-Completion Status
rim: .statusCode
w5: status

category

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.category

Short description

Type of medication usage

Definition

Indicates the type of medication administration and where the medication is expected to be consumed or administered.

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Data type

CodeableConcept

Binding

A coded concept describing where the medication administered is expected to occur

MedicationAdministrationCategory (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

medication[x]

1..1

Element id

MedicationAdministration.medication[x]

Short description

What was administered

Definition

Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example if you require form or lot number, then you must reference the Medication resource. .

Binding

Codes identifying substance or product that can be administered.

SNOMED CT Medication Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …code
v2: RXA-5-Administered Code
rim: .participation[typeCode=CSM].role[classCode=ADMM]
w5: what

medicationCodeableConcept

CodeableConcept

Data type

CodeableConcept

medicationReference

Reference(CareConnect-Medication-1)

Data type

Reference(CareConnect-Medication-1)

subject

Σ C

1..1

Reference(Group | CareConnect-Patient-1)

Element id

MedicationAdministration.subject

Short description

Who received medication

Definition

The person or animal or group receiving the medication.

Comments

Data type

Reference(Group | CareConnect-Patient-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …subject
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: who.focus

context

0..1

Reference(CareConnect-Encounter-1 | CareConnect-EpisodeOfCare-1)

Element id

MedicationAdministration.context

Short description

Encounter or Episode of Care administered as part of

Definition

The visit, admission or other contact between patient and health care provider the medication administration was performed as part of.

Comments

Data type

Reference(CareConnect-Encounter-1 | CareConnect-EpisodeOfCare-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …context
v2: PV1-19-Visit Number
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
w5: context

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationAdministration.supportingInformation

Short description

Additional information to support administration

Definition

Additional information (for example, patient height and weight) that supports the administration of the medication.

Comments

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
w5: context

effective[x]

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.effective[x]

Short description

Start and end time of administration

Definition

A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …occurrence[x]
v2: RXA-3-Date/Time Start of Administration / RXA-4-Date/Time End of Administration
rim: .effectiveTime
w5: when.done

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

performer

0..*

BackboneElement

There are no (further) constraints on this element

Element id

MedicationAdministration.performer

Short description

Who administered substance

Definition

The individual who was responsible for giving the medication to the patient.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …performer
v2: RXA-10-Administering Provider / PRT-5-Participation Person: PRT-4-Participation='AP' (RXA-10 is deprecated)
rim: .participation[typeCode=PRF]
w5: who.actor

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

actor

Σ C

1..1

Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Element id

MedicationAdministration.performer.actor

Short description

Individual who was performing

Definition

The device, practitioner, etc. who performed the action.

Comments

Data type

Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: ….actor
rim: .role

onBehalfOf

0..1

Reference(CareConnect-Organization-1)

Element id

MedicationAdministration.performer.onBehalfOf

Short description

Organization organization was acting for

Definition

The organization the device or practitioner was acting on behalf of.

Comments

Data type

Reference(CareConnect-Organization-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: ….onBehalfOf
rim: .role.scopingOrganization

notGiven

Σ ?!

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationAdministration.notGiven

Short description

True if medication not administered

Definition

Set this to true if the record is saying that the medication was NOT administered.

Comments

This element is labeled as a modifier because it indicates that a administration didn't happen.

Meaning when missing

If this is missing, then the medication was administered

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …notDone
v2: RXA-20-Completion Status='NA'
rim: .actionNegationInd

reasonNotGiven

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonNotGiven

Short description

Reason administration not performed

Definition

A code indicating why the administration was not performed.

Comments

Data type

CodeableConcept

Binding

A set of codes indicating the reason why the MedicationAdministration is negated.

SNOMED CT Reason Medication Not Given Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, mad-2

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: …notDoneReason
v2: RXA-9-Administration Notes / RXA-18 Substance/Treatment Refusal Reason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason not given"].value

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonCode

Short description

Reason administration performed

Definition

A code indicating why the medication was given.

Comments

Data type

CodeableConcept

Binding

A set of codes indicating the reason why the MedicationAdministration was made.

Reason Medication Given Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, mad-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: …reasonGivenCodeableConcept
v2: RXE-27 Give Indication
rim: .reasonCode

reasonReference

0..*

Reference(CareConnect-Condition-1 | CareConnect-Observation-1)

Element id

MedicationAdministration.reasonReference

Short description

Condition or Observation that supports why the medication was administered

Definition

Condition or observation that supports why the medication was administered.

Comments

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

Data type

Reference(CareConnect-Condition-1 | CareConnect-Observation-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …reasonReference
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use ASSERTION"].value
w3c.prov: no mapping
w5: why

prescription

0..1

Reference(CareConnect-MedicationRequest-1)

Element id

MedicationAdministration.prescription

Short description

Request administration performed against

Definition

The original request, instruction or authority to perform the administration.

Comments

Data type

Reference(CareConnect-MedicationRequest-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …basedOn
v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim: InFullfillmentOf->SubstanceAdministration

device

0..*

Reference(Device)

There are no (further) constraints on this element

Element id

MedicationAdministration.device

Short description

Device used to administer

Definition

The device used in administering the medication to the patient. For example, a particular infusion pump.

Comments

Data type

Reference(Device)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PRT-10 Participation Device / RXR-3 Administrative Device
rim: device->Access OR device->AssignedDevice

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationAdministration.note

Short description

Information about the administration

Definition

Extra information about the medication administration that is not conveyed by the other attributes.

Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: …note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.note.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.note.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

author[x]

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.participant[typeCode=AUT].role

authorReference

Reference(CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Data type

Reference(CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

authorString

string

Data type

string

time

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationAdministration.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.effectiveTime

text

1..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.note.text

Short description

The annotation - text content

Definition

The text of the annotation.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.text

dosage

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage

Short description

Details of how medication was taken

Definition

Describes the medication dosage information details e.g. dose, rate, site, route, etc.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
dose.exists() or rate.exists()

Mappings

rim: n/a
rim: component->SubstanceAdministrationEvent

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: .text

site

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.site

Short description

Body site administered to

Definition

A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both.

Data type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMED CT Anatomical Structure for Administration Site Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier
rim: .approachSiteCode

route

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route

Short description

Path of substance into body

Definition

A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

Comments

Data type

CodeableConcept

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMED CT Route Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-1-Route
rim: .routeCode

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

MedicationAdministration.dosage.route.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Slicing

Unordered, Open, by system(Value)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..1

Coding

Element id

MedicationAdministration.dosage.route.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

Care Connect Medication Dosage Route (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

MedicationAdministration.dosage.route.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

SnomedCTDescriptionId

0..1

Extension(Complex)

Element id

MedicationAdministration.dosage.route.coding:snomedCT.extension:SnomedCTDescriptionId

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

MedicationAdministration.dosage.route.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

method

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.method

Short description

How drug was administered

Definition

A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.

Comments

One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.

Data type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMED CT Administration Method Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-4-Administration Method
rim: .methodCode

dose

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.dose

Short description

Amount of medication per dose

Definition

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

Comments

If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
v2: RXA-6 Administered Amount / RXA-7 Administered Units
rim: .doseQuantity

rate[x]

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.rate[x]

Short description

Dose quantity per unit of time

Definition

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.

Comments

If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: RXA-12-Administered Per (Time Unit)
rim: .rateQuantity

rateQuantity

SimpleQuantity

There are no (further) constraints on this element

Data type

SimpleQuantity

rateRatio

Ratio

There are no (further) constraints on this element

Data type

Ratio

eventHistory

0..*

Reference(Provenance)

There are no (further) constraints on this element

Element id

MedicationAdministration.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

A summary of the events of interest that have occurred, such as when the administration was verified.

Comments

This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Differential View

CareConnect-MedicationAdministration-1 (MedicationAdministration)

MedicationAdministration

There are no (further) constraints on this element

Element id

MedicationAdministration

Short description

Administration of medication to a patient

Definition

Comments

The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html).

Data type

MedicationAdministration

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
mad-2: Reason not given is only permitted if NotGiven is true
reasonNotGiven.empty() or notGiven = true
mad-3: Reason given is only permitted if NotGiven is false
reasonCode.empty() or notGiven.empty() or notGiven = 'false'

Mappings

rim: Entity. Role, or Act
workflow: ..Event
rim: SubstanceAdministration
w5: clinical.medication

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

MedicationAdministration.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationAdministration.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Comments

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationAdministration.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, dom-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationAdministration.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier

Short description

External identifier

Definition

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: …identifier
rim: .id
w5: id

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.use

Short description

usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

0..1

uri

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(CareConnect-Organization-1)

Element id

MedicationAdministration.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(CareConnect-Organization-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

definition

Σ C

0..*

Reference(ActivityDefinition | PlanDefinition)

There are no (further) constraints on this element

Element id

MedicationAdministration.definition

Short description

Instantiates protocol or definition

Definition

A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event.

Comments

Data type

Reference(ActivityDefinition | PlanDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …definition
rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]

partOf

Σ C

0..*

Reference(CareConnect-MedicationAdministration-1 | CareConnect-Procedure-1)

Element id

MedicationAdministration.partOf

Short description

Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Comments

Data type

Reference(CareConnect-MedicationAdministration-1 | CareConnect-Procedure-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …part of
rim: .outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.status

Short description

Definition

Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Data type

code

Binding

A set of codes indicating the current status of a MedicationAdministration.

MedicationAdministrationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …status
v2: RXA-20-Completion Status
rim: .statusCode
w5: status

category

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.category

Short description

Type of medication usage

Definition

Indicates the type of medication administration and where the medication is expected to be consumed or administered.

Comments

Data type

CodeableConcept

Binding

A coded concept describing where the medication administered is expected to occur

MedicationAdministrationCategory (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

medication[x]

1..1

Element id

MedicationAdministration.medication[x]

Short description

What was administered

Definition

Comments

Binding

Codes identifying substance or product that can be administered.

SNOMED CT Medication Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …code
v2: RXA-5-Administered Code
rim: .participation[typeCode=CSM].role[classCode=ADMM]
w5: what

medicationCodeableConcept

CodeableConcept

Data type

CodeableConcept

medicationReference

Reference(CareConnect-Medication-1)

Data type

Reference(CareConnect-Medication-1)

subject

Σ C

1..1

Reference(Group | CareConnect-Patient-1)

Element id

MedicationAdministration.subject

Short description

Who received medication

Definition

The person or animal or group receiving the medication.

Comments

Data type

Reference(Group | CareConnect-Patient-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …subject
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: who.focus

context

0..1

Reference(CareConnect-Encounter-1 | CareConnect-EpisodeOfCare-1)

Element id

MedicationAdministration.context

Short description

Encounter or Episode of Care administered as part of

Definition

The visit, admission or other contact between patient and health care provider the medication administration was performed as part of.

Comments

Data type

Reference(CareConnect-Encounter-1 | CareConnect-EpisodeOfCare-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …context
v2: PV1-19-Visit Number
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
w5: context

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationAdministration.supportingInformation

Short description

Additional information to support administration

Definition

Additional information (for example, patient height and weight) that supports the administration of the medication.

Comments

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
w5: context

effective[x]

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.effective[x]

Short description

Start and end time of administration

Definition

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …occurrence[x]
v2: RXA-3-Date/Time Start of Administration / RXA-4-Date/Time End of Administration
rim: .effectiveTime
w5: when.done

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

performer

0..*

BackboneElement

There are no (further) constraints on this element

Element id

MedicationAdministration.performer

Short description

Who administered substance

Definition

The individual who was responsible for giving the medication to the patient.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …performer
v2: RXA-10-Administering Provider / PRT-5-Participation Person: PRT-4-Participation='AP' (RXA-10 is deprecated)
rim: .participation[typeCode=PRF]
w5: who.actor

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

actor

Σ C

1..1

Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Element id

MedicationAdministration.performer.actor

Short description

Individual who was performing

Definition

The device, practitioner, etc. who performed the action.

Comments

Data type

Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: ….actor
rim: .role

onBehalfOf

0..1

Reference(CareConnect-Organization-1)

Element id

MedicationAdministration.performer.onBehalfOf

Short description

Organization organization was acting for

Definition

The organization the device or practitioner was acting on behalf of.

Comments

Data type

Reference(CareConnect-Organization-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: ….onBehalfOf
rim: .role.scopingOrganization

notGiven

Σ ?!

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationAdministration.notGiven

Short description

True if medication not administered

Definition

Set this to true if the record is saying that the medication was NOT administered.

Comments

This element is labeled as a modifier because it indicates that a administration didn't happen.

Meaning when missing

If this is missing, then the medication was administered

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …notDone
v2: RXA-20-Completion Status='NA'
rim: .actionNegationInd

reasonNotGiven

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonNotGiven

Short description

Reason administration not performed

Definition

A code indicating why the administration was not performed.

Comments

Data type

CodeableConcept

Binding

A set of codes indicating the reason why the MedicationAdministration is negated.

SNOMED CT Reason Medication Not Given Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, mad-2

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: …notDoneReason
v2: RXA-9-Administration Notes / RXA-18 Substance/Treatment Refusal Reason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason not given"].value

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonCode

Short description

Reason administration performed

Definition

A code indicating why the medication was given.

Comments

Data type

CodeableConcept

Binding

A set of codes indicating the reason why the MedicationAdministration was made.

Reason Medication Given Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, mad-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: …reasonGivenCodeableConcept
v2: RXE-27 Give Indication
rim: .reasonCode

reasonReference

0..*

Reference(CareConnect-Condition-1 | CareConnect-Observation-1)

Element id

MedicationAdministration.reasonReference

Short description

Condition or Observation that supports why the medication was administered

Definition

Condition or observation that supports why the medication was administered.

Comments

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

Data type

Reference(CareConnect-Condition-1 | CareConnect-Observation-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …reasonReference
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use ASSERTION"].value
w3c.prov: no mapping
w5: why

prescription

0..1

Reference(CareConnect-MedicationRequest-1)

Element id

MedicationAdministration.prescription

Short description

Request administration performed against

Definition

The original request, instruction or authority to perform the administration.

Comments

Data type

Reference(CareConnect-MedicationRequest-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …basedOn
v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim: InFullfillmentOf->SubstanceAdministration

device

0..*

Reference(Device)

There are no (further) constraints on this element

Element id

MedicationAdministration.device

Short description

Device used to administer

Definition

The device used in administering the medication to the patient. For example, a particular infusion pump.

Comments

Data type

Reference(Device)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PRT-10 Participation Device / RXR-3 Administrative Device
rim: device->Access OR device->AssignedDevice

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationAdministration.note

Short description

Information about the administration

Definition

Extra information about the medication administration that is not conveyed by the other attributes.

Comments

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: …note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.note.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.note.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

author[x]

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.participant[typeCode=AUT].role

authorReference

Reference(CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Data type

Reference(CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

authorString

string

Data type

string

time

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationAdministration.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.effectiveTime

text

1..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.note.text

Short description

The annotation - text content

Definition

The text of the annotation.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.text

dosage

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage

Short description

Details of how medication was taken

Definition

Describes the medication dosage information details e.g. dose, rate, site, route, etc.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
dose.exists() or rate.exists()

Mappings

rim: n/a
rim: component->SubstanceAdministrationEvent

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: .text

site

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.site

Short description

Body site administered to

Definition

A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

Comments

Data type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMED CT Anatomical Structure for Administration Site Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier
rim: .approachSiteCode

route

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route

Short description

Path of substance into body

Definition

A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

Comments

Data type

CodeableConcept

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMED CT Route Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-1-Route
rim: .routeCode

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

MedicationAdministration.dosage.route.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..1

Coding

Element id

MedicationAdministration.dosage.route.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

Care Connect Medication Dosage Route (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

MedicationAdministration.dosage.route.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

SnomedCTDescriptionId

0..1

Extension(Complex)

Element id

MedicationAdministration.dosage.route.coding:snomedCT.extension:SnomedCTDescriptionId

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

MedicationAdministration.dosage.route.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

method

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.method

Short description

How drug was administered

Definition

Comments

Data type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMED CT Administration Method Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-4-Administration Method
rim: .methodCode

dose

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.dose

Short description

Amount of medication per dose

Definition

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

Comments

If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
v2: RXA-6 Administered Amount / RXA-7 Administered Units
rim: .doseQuantity

rate[x]

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.rate[x]

Short description

Dose quantity per unit of time

Definition

Comments

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: RXA-12-Administered Per (Time Unit)
rim: .rateQuantity

rateQuantity

SimpleQuantity

There are no (further) constraints on this element

Data type

SimpleQuantity

rateRatio

Ratio

There are no (further) constraints on this element

Data type

Ratio

eventHistory

0..*

Reference(Provenance)

There are no (further) constraints on this element

Element id

MedicationAdministration.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

A summary of the events of interest that have occurred, such as when the administration was verified.

Comments

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Hybrid View

CareConnect-MedicationAdministration-1 (MedicationAdministration)

MedicationAdministration

There are no (further) constraints on this element

Element id

MedicationAdministration

Short description

Administration of medication to a patient

Definition

Comments

The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html).

Data type

MedicationAdministration

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
mad-2: Reason not given is only permitted if NotGiven is true
reasonNotGiven.empty() or notGiven = true
mad-3: Reason given is only permitted if NotGiven is false
reasonCode.empty() or notGiven.empty() or notGiven = 'false'

Mappings

rim: Entity. Role, or Act
workflow: ..Event
rim: SubstanceAdministration
w5: clinical.medication

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

MedicationAdministration.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

MedicationAdministration.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Comments

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

MedicationAdministration.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, dom-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

MedicationAdministration.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier

Short description

External identifier

Definition

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: …identifier
rim: .id
w5: id

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.use

Short description

usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

0..1

uri

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

MedicationAdministration.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(CareConnect-Organization-1)

Element id

MedicationAdministration.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(CareConnect-Organization-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

definition

Σ C

0..*

Reference(ActivityDefinition | PlanDefinition)

There are no (further) constraints on this element

Element id

MedicationAdministration.definition

Short description

Instantiates protocol or definition

Definition

A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event.

Comments

Data type

Reference(ActivityDefinition | PlanDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …definition
rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]

partOf

Σ C

0..*

Reference(CareConnect-MedicationAdministration-1 | CareConnect-Procedure-1)

Element id

MedicationAdministration.partOf

Short description

Part of referenced event

Definition

A larger event of which this particular event is a component or step.

Comments

Data type

Reference(CareConnect-MedicationAdministration-1 | CareConnect-Procedure-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …part of
rim: .outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.status

Short description

Definition

Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Data type

code

Binding

A set of codes indicating the current status of a MedicationAdministration.

MedicationAdministrationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …status
v2: RXA-20-Completion Status
rim: .statusCode
w5: status

category

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationAdministration.category

Short description

Type of medication usage

Definition

Indicates the type of medication administration and where the medication is expected to be consumed or administered.

Comments

Data type

CodeableConcept

Binding

A coded concept describing where the medication administered is expected to occur

MedicationAdministrationCategory (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value

medication[x]

1..1

Element id

MedicationAdministration.medication[x]

Short description

What was administered

Definition

Comments

Binding

Codes identifying substance or product that can be administered.

SNOMED CT Medication Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …code
v2: RXA-5-Administered Code
rim: .participation[typeCode=CSM].role[classCode=ADMM]
w5: what

medicationCodeableConcept

CodeableConcept

Data type

CodeableConcept

medicationReference

Reference(CareConnect-Medication-1)

Data type

Reference(CareConnect-Medication-1)

subject

Σ C

1..1

Reference(Group | CareConnect-Patient-1)

Element id

MedicationAdministration.subject

Short description

Who received medication

Definition

The person or animal or group receiving the medication.

Comments

Data type

Reference(Group | CareConnect-Patient-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …subject
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: who.focus

context

0..1

Reference(CareConnect-Encounter-1 | CareConnect-EpisodeOfCare-1)

Element id

MedicationAdministration.context

Short description

Encounter or Episode of Care administered as part of

Definition

The visit, admission or other contact between patient and health care provider the medication administration was performed as part of.

Comments

Data type

Reference(CareConnect-Encounter-1 | CareConnect-EpisodeOfCare-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …context
v2: PV1-19-Visit Number
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
w5: context

supportingInformation

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

MedicationAdministration.supportingInformation

Short description

Additional information to support administration

Definition

Additional information (for example, patient height and weight) that supports the administration of the medication.

Comments

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
w5: context

effective[x]

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.effective[x]

Short description

Start and end time of administration

Definition

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …occurrence[x]
v2: RXA-3-Date/Time Start of Administration / RXA-4-Date/Time End of Administration
rim: .effectiveTime
w5: when.done

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

performer

0..*

BackboneElement

There are no (further) constraints on this element

Element id

MedicationAdministration.performer

Short description

Who administered substance

Definition

The individual who was responsible for giving the medication to the patient.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …performer
v2: RXA-10-Administering Provider / PRT-5-Participation Person: PRT-4-Participation='AP' (RXA-10 is deprecated)
rim: .participation[typeCode=PRF]
w5: who.actor

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

actor

Σ C

1..1

Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Element id

MedicationAdministration.performer.actor

Short description

Individual who was performing

Definition

The device, practitioner, etc. who performed the action.

Comments

Data type

Reference(Device | CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: ….actor
rim: .role

onBehalfOf

0..1

Reference(CareConnect-Organization-1)

Element id

MedicationAdministration.performer.onBehalfOf

Short description

Organization organization was acting for

Definition

The organization the device or practitioner was acting on behalf of.

Comments

Data type

Reference(CareConnect-Organization-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: ….onBehalfOf
rim: .role.scopingOrganization

notGiven

Σ ?!

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationAdministration.notGiven

Short description

True if medication not administered

Definition

Set this to true if the record is saying that the medication was NOT administered.

Comments

This element is labeled as a modifier because it indicates that a administration didn't happen.

Meaning when missing

If this is missing, then the medication was administered

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
workflow: …notDone
v2: RXA-20-Completion Status='NA'
rim: .actionNegationInd

reasonNotGiven

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonNotGiven

Short description

Reason administration not performed

Definition

A code indicating why the administration was not performed.

Comments

Data type

CodeableConcept

Binding

A set of codes indicating the reason why the MedicationAdministration is negated.

SNOMED CT Reason Medication Not Given Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, mad-2

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: …notDoneReason
v2: RXA-9-Administration Notes / RXA-18 Substance/Treatment Refusal Reason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason not given"].value

reasonCode

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonCode

Short description

Reason administration performed

Definition

A code indicating why the medication was given.

Comments

Data type

CodeableConcept

Binding

A set of codes indicating the reason why the MedicationAdministration was made.

Reason Medication Given Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, mad-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: …reasonGivenCodeableConcept
v2: RXE-27 Give Indication
rim: .reasonCode

reasonReference

0..*

Reference(CareConnect-Condition-1 | CareConnect-Observation-1)

Element id

MedicationAdministration.reasonReference

Short description

Condition or Observation that supports why the medication was administered

Definition

Condition or observation that supports why the medication was administered.

Comments

This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

Data type

Reference(CareConnect-Condition-1 | CareConnect-Observation-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …reasonReference
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use ASSERTION"].value
w3c.prov: no mapping
w5: why

prescription

0..1

Reference(CareConnect-MedicationRequest-1)

Element id

MedicationAdministration.prescription

Short description

Request administration performed against

Definition

The original request, instruction or authority to perform the administration.

Comments

Data type

Reference(CareConnect-MedicationRequest-1)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: …basedOn
v2: ORC-2-Placer Order Number / ORC-3-Filler Order Number
rim: InFullfillmentOf->SubstanceAdministration

device

0..*

Reference(Device)

There are no (further) constraints on this element

Element id

MedicationAdministration.device

Short description

Device used to administer

Definition

The device used in administering the medication to the patient. For example, a particular infusion pump.

Comments

Data type

Reference(Device)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PRT-10 Participation Device / RXR-3 Administrative Device
rim: device->Access OR device->AssignedDevice

note

0..*

Annotation

There are no (further) constraints on this element

Element id

MedicationAdministration.note

Short description

Information about the administration

Definition

Extra information about the medication administration that is not conveyed by the other attributes.

Comments

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act
workflow: …note
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.note.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.note.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

author[x]

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.participant[typeCode=AUT].role

authorReference

Reference(CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

Data type

Reference(CareConnect-Patient-1 | CareConnect-Practitioner-1 | CareConnect-RelatedPerson-1)

authorString

string

Data type

string

time

0..1

dateTime

There are no (further) constraints on this element

Element id

MedicationAdministration.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.effectiveTime

text

1..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.note.text

Short description

The annotation - text content

Definition

The text of the annotation.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Act.text

dosage

0..1

BackboneElement

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage

Short description

Details of how medication was taken

Definition

Describes the medication dosage information details e.g. dose, rate, site, route, etc.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
dose.exists() or rate.exists()

Mappings

rim: n/a
rim: component->SubstanceAdministrationEvent

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

The dosage instructions should reflect the dosage of the medication that was administered.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
rim: .text

site

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.site

Short description

Body site administered to

Definition

A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

Comments

Data type

CodeableConcept

Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMED CT Anatomical Structure for Administration Site Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier
rim: .approachSiteCode

route

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route

Short description

Path of substance into body

Definition

A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

Comments

Data type

CodeableConcept

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMED CT Route Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-1-Route
rim: .routeCode

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

MedicationAdministration.dosage.route.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..1

Coding

Element id

MedicationAdministration.dosage.route.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.

Care Connect Medication Dosage Route (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

MedicationAdministration.dosage.route.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

SnomedCTDescriptionId

0..1

Extension(Complex)

Element id

MedicationAdministration.dosage.route.coding:snomedCT.extension:SnomedCTDescriptionId

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

MedicationAdministration.dosage.route.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

method

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.method

Short description

How drug was administered

Definition

Comments

Data type

CodeableConcept

Binding

A coded concept describing the technique by which the medicine is administered.

SNOMED CT Administration Method Codes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: RXR-4-Administration Method
rim: .methodCode

dose

0..1

SimpleQuantity

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.dose

Short description

Amount of medication per dose

Definition

The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

Comments

If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

Data type

SimpleQuantity

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
sqty-1: The comparator is not used on a SimpleQuantity
comparator.empty()

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
v2: RXA-6 Administered Amount / RXA-7 Administered Units
rim: .doseQuantity

rate[x]

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.rate[x]

Short description

Dose quantity per unit of time

Definition

Comments

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())

Mappings

rim: n/a
v2: RXA-12-Administered Per (Time Unit)
rim: .rateQuantity

rateQuantity

SimpleQuantity

There are no (further) constraints on this element

Data type

SimpleQuantity

rateRatio

Ratio

There are no (further) constraints on this element

Data type

Ratio

eventHistory

0..*

Reference(Provenance)

There are no (further) constraints on this element

Element id

MedicationAdministration.eventHistory

Short description

A list of events of interest in the lifecycle

Definition

A summary of the events of interest that have occurred, such as when the administration was verified.

Comments

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Table View

MedicationAdministration		..
MedicationAdministration.identifier		..
MedicationAdministration.identifier.assigner	Reference(CareConnect-Organization-1)	..
MedicationAdministration.partOf	Reference(CareConnect-MedicationAdministration-1 \| CareConnect-Procedure-1)	..
MedicationAdministration.medication[x]	CodeableConcept \| Reference(CareConnect-Medication-1)	..
MedicationAdministration.subject	Reference(Group \| CareConnect-Patient-1)	..
MedicationAdministration.context	Reference(CareConnect-Encounter-1 \| CareConnect-EpisodeOfCare-1)	..
MedicationAdministration.performer		..
MedicationAdministration.performer.actor	Reference(Device \| CareConnect-Patient-1 \| CareConnect-Practitioner-1 \| CareConnect-RelatedPerson-1)	..
MedicationAdministration.performer.onBehalfOf	Reference(CareConnect-Organization-1)	..
MedicationAdministration.reasonReference	Reference(CareConnect-Condition-1 \| CareConnect-Observation-1)	..
MedicationAdministration.prescription	Reference(CareConnect-MedicationRequest-1)	..
MedicationAdministration.note		..
MedicationAdministration.note.author[x]	Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1 \| CareConnect-RelatedPerson-1) \| string	..
MedicationAdministration.dosage		..
MedicationAdministration.dosage.route		..
MedicationAdministration.dosage.route.coding		..
MedicationAdministration.dosage.route.coding:snomedCT		..1
MedicationAdministration.dosage.route.coding:snomedCT.extension		0..
MedicationAdministration.dosage.route.coding:snomedCT.extension:SnomedCTDescriptionId	Extension	0..
MedicationAdministration.dosage.route.coding:snomedCT.system		1..
MedicationAdministration.dosage.route.coding:snomedCT.code		1..
MedicationAdministration.dosage.route.coding:snomedCT.display		1..

Examples

Profile specific implementation guidance:

There is no specific guidance for this profile.