MedicationAdministration

Official URL: https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationAdministration				Version: 1.0.0
Parent: http://hl7.org/fhir/StructureDefinition/MedicationAdministration				Computable Name: RdcMedicationAdministration

Represent the event of a patient consuming or otherwise being administered a medication. Medications are generally insulin, but are not limited to insulin (either manually reported or reported by an insulin pump).

The MedicationAdministration.category element is assigned the following values:

System	Code	Display
https://roche.com/fhir/iop/cs	67866001_short_acting	67866001_short_acting
https://roche.com/fhir/iop/cs	67866001_long_acting	67866001_long_acting

Formal Views of Profile Content

RdcMedicationAdministration (MedicationAdministration)	I		MedicationAdministration	There are no (further) constraints on this element Element id MedicationAdministration Short description Administration of medication to a patient Definition Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner. Data type MedicationAdministration Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().ofType(canonical) \| %resource.descendants().ofType(uri) \| %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity, Role, or Act,SubstanceAdministration workflow: Event w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id MedicationAdministration.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationAdministration.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
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 IETF language tag for a human language AllLanguages (required) Additional bindings: CommonLanguages (starter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationAdministration.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can 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 a 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 information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained	I	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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. 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. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	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. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	Σ ?! I	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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier		0..0	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.identifier Short description External identifier Definition Identifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. Comments This is a business identifier, not a resource identifier. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id
basedOn		0..0	Reference(CarePlan)	There are no (further) constraints on this element Element id MedicationAdministration.basedOn Short description Plan this is fulfilled by this administration Definition A plan that is fulfilled in whole or in part by this MedicationAdministration. Data type Reference(CarePlan) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=FLFS].target
partOf	Σ	0..*	Reference(RdcMedicationAdministration)	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 MedicationDispense will be used to indicate waste. Data type Reference(RdcMedicationAdministration) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf 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 in-progress \| not-done \| on-hold \| completed \| entered-in-error \| stopped \| unknown 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. MedicationAdministrationStatusCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status v2: RXA-20 Completion Status rim: .statusCode
statusReason		0..0	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.statusReason Short description Reason administration not performed Definition A code indicating why the administration was not performed. Data type CodeableConcept Binding A set of codes indicating the reason why the MedicationAdministration is negated. SNOMEDCTReasonMedicationNotGivenCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason 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
category		0..1	CodeableConceptBinding	Element id MedicationAdministration.category Short description Type of medication administration Definition Bolus Delivery type Data type CodeableConcept Binding A coded concept describing where the medication administered is expected to occur. InsulinCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medication	Σ	1..1	CodeableReference(Medication)	There are no (further) constraints on this element Element id MedicationAdministration.medication Short description What was administered Definition Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Data type CodeableReference(Medication) Binding Codes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] v2: RXA-5 Administered Code rim: .participation[typeCode=CSM].role[classCode=ADMM]
id		0..1	id	There are no (further) constraints on this element Element id MedicationAdministration.medication.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.medication.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. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
concept	Σ	0..1	CodeableConceptBinding	Element id MedicationAdministration.medication.concept Short description Reference to a concept (by class) Definition Informs the type of administration conducted (ex. Basal or Bolus) Data type CodeableConcept Binding InsulinCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
reference	Σ	0..1	Reference(Medication)	Element id MedicationAdministration.medication.reference Short description Reference to a resource (by instance) Definition Reference to specific medication administered (applicable only for commerical drugs - future implemention) Data type Reference(Medication) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
subject	Σ	1..1	Reference(RdcPatient)	Element id MedicationAdministration.subject Short description Who received medication Definition The person or animal or group receiving the medication. Data type Reference(RdcPatient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT]
encounter		0..0	Reference(Encounter)	There are no (further) constraints on this element Element id MedicationAdministration.encounter Short description Encounter administered as part of Definition The visit, admission, or other contact between patient and health care provider during which the medication administration was performed. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.encounter w5: FiveWs.context v2: PV1-19 Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation		0..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. This attribute can be used to provide documentation of specific characteristics of the patient present at the time of administration. For example, if the dose says "give "x" if the heartrate exceeds "y"", then the heart rate can be included using this attribute. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.context 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)]
occurence[x]	Σ	1..1		There are no (further) constraints on this element Element id MedicationAdministration.occurence[x] Short description Specific date/time or interval of time during which the administration took place (or did not take place) Definition A specific date/time or interval of time during which the administration took place (or did not take place). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 Date/Time Start of Administration / RXA-4 Date/Time End of Administration rim: .effectiveTime
occurenceDateTime			dateTime	Data type dateTime
occurencePeriod			Period	Data type Period
recorded	Σ	0..0	dateTime	There are no (further) constraints on this element Element id MedicationAdministration.recorded Short description When the MedicationAdministration was first captured in the subject's record Definition The date the occurrence of the MedicationAdministration was first captured in the record - potentially significantly after the occurrence of the event. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
isSubPotent		0..0	boolean	There are no (further) constraints on this element Element id MedicationAdministration.isSubPotent Short description Full dose was not administered Definition An indication that the full dose was not administered. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
subPotentReason		0..0	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.subPotentReason Short description Reason full dose was not administered Definition The reason or reasons why the full dose was not administered. Data type CodeableConcept Binding MedicationAdministrationSubpotentReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id MedicationAdministration.performer Short description Who or what performed the medication administration and what type of performance they did Definition The performer of the medication treatment. For devices this is the device that performed the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer w5: FiveWs.actor v2: RXA-10 Administering Provider / PRT-5 Participation Person: PRT-4 Participation='AP' (RXA-10 is deprecated) rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
function		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.performer.function Short description Type of performance Definition Distinguishes the type of involvement of the performer in the medication administration. Data type CodeableConcept Binding A code describing the role an individual played in administering the medication. MedicationAdministrationPerformerFunctionCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.function rim: participation[typeCode=PRF].functionCode
actor	Σ	1..1	CodeableReference(RdcDeviceInstance)	Element id MedicationAdministration.performer.actor Short description Who or what performed the medication administration Definition Indicates who or what performed the medication administration. Data type CodeableReference(RdcDeviceInstance) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor rim: .role
reason		0..0	CodeableReference(Condition \| Observation \| DiagnosticReport)	There are no (further) constraints on this element Element id MedicationAdministration.reason Short description Concept, condition or observation that supports why the medication was administered Definition A code, Condition or observation that supports why the medication was administered. Data type CodeableReference(Condition \| Observation \| DiagnosticReport) Binding A set of codes indicating the reason why the MedicationAdministration was made. ReasonMedicationGivenCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reason v2: RXE-27 Give Indication rim: .reasonCode
request		0..1	Reference(RdcMedicationRequest)	Element id MedicationAdministration.request Short description Request administration performed against Definition The original request, instruction or authority to perform the administration. Comments This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value. Data type Reference(RdcMedicationRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn v2: ORC-2 Placer Order Number / ORC-3 Filler Order Number rim: InFullfillmentOf->SubstanceAdministration
device		0..0	CodeableReference(Device)	There are no (further) constraints on this element Element id MedicationAdministration.device Short description Device used to administer Definition The device that is to be used for the administration of the medication (for example, PCA Pump). Data type CodeableReference(Device) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PRT-10 Participation Device / RXR-3 Administrative Device rim: device->Access OR device->AssignedDevice
note		0..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. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosage	I	0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationAdministration.dosage Short description Details of how medication was taken Definition Describes the medication dosage information details e.g. dose, rate, site, route, etc. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` mad-1: If dosage attribute is present then SHALL have at least one of dosage.text or dosage.dose or dosage.rate[x] `(dose.exists() or rate.exists() or text.exists())` Mappings rim: component->SubstanceAdministrationEvent
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	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 May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationAdministration.dosage.modifierExtension Short description Extensions that cannot be ignored even if unrecognized 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
text	I	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .text
site		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.dosage.site Short description Body site administered to Definition A coded specification of the anatomic site where the medication first entered the body. For example, "left arm". Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureAdministrationSites (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier rim: .approachSiteCode
route		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.dosage.route Short description Path of substance into body Definition A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc. Data type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-1 Route rim: .routeCode
method		0..1	CodeableConceptBinding	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. InsulinCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-4 Administration Method rim: .methodCode
dose	I	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 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-6 Administered Amount / RXA-7 Administered Units rim: .doseQuantity
rate[x]	I	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. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXA-12 Administered Per (Time Unit) rim: .rateQuantity
rateRatio			Ratio	There are no (further) constraints on this element Data type Ratio
rateQuantity			SimpleQuantity	There are no (further) constraints on this element Data type SimpleQuantity
eventHistory		0..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 might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject. Data type Reference(Provenance) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

MedicationAdministration
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.
Cardinality	0...*
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().ofType(canonical) \| %resource.descendants().ofType(uri) \| %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists()
Mappings	rim: Entity, Role, or Act,SubstanceAdministration workflow: Event w5: clinical.medication
MedicationAdministration.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	id
Summary	True
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
MedicationAdministration.meta
Definition	The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality	0...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationAdministration.implicitRules
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationAdministration.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	IETF language tag for a human language AllLanguages (required)
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).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationAdministration.text
Definition	A human-readable narrative that contains a summary of the resource and can 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.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	Contained resources do not have a 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 information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
MedicationAdministration.contained
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
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. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
Mappings	rim: N/A
MedicationAdministration.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationAdministration.modifierExtension
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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationAdministration.identifier
Definition	Identifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.
Cardinality	0...0
Type	Identifier
Comments	This is a business identifier, not a resource identifier.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.identifier w5: FiveWs.identifier rim: .id
MedicationAdministration.basedOn
Definition	A plan that is fulfilled in whole or in part by this MedicationAdministration.
Cardinality	0...0
Type	Reference(CarePlan)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=FLFS].target
MedicationAdministration.partOf
Definition	A larger event of which this particular event is a component or step.
Cardinality	0...*
Type	Reference(RdcMedicationAdministration)
Summary	True
Comments	MedicationDispense will be used to indicate waste.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]
MedicationAdministration.status
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.
Cardinality	1...1
Type	code
Binding	A set of codes indicating the current status of a MedicationAdministration. MedicationAdministrationStatusCodes (required)
Modifier	True
Summary	True
Comments	This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.status w5: FiveWs.status v2: RXA-20 Completion Status rim: .statusCode
MedicationAdministration.statusReason
Definition	A code indicating why the administration was not performed.
Cardinality	0...0
Type	CodeableConcept
Binding	A set of codes indicating the reason why the MedicationAdministration is negated. SNOMEDCTReasonMedicationNotGivenCodes (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.statusReason 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
MedicationAdministration.category
Definition	Bolus Delivery type
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept describing where the medication administered is expected to occur. InsulinCodes (required)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
MedicationAdministration.medication
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.
Cardinality	1...1
Type	CodeableReference(Medication)
Binding	Codes identifying substance or product that can be administered. SNOMEDCTMedicationCodes (example)
Summary	True
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.code w5: FiveWs.what[x] v2: RXA-5 Administered Code rim: .participation[typeCode=CSM].role[classCode=ADMM]
MedicationAdministration.medication.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	id
Mappings	rim: n/a
MedicationAdministration.medication.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationAdministration.medication.concept
Definition	Informs the type of administration conducted (ex. Basal or Bolus)
Cardinality	0...1
Type	CodeableConcept
Binding	InsulinCodes (required)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: N/A
MedicationAdministration.medication.reference
Definition	Reference to specific medication administered (applicable only for commerical drugs - future implemention)
Cardinality	0...1
Type	Reference(Medication)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: N/A
MedicationAdministration.subject
Definition	The person or animal or group receiving the medication.
Cardinality	1...1
Type	Reference(RdcPatient)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT]
MedicationAdministration.encounter
Definition	The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.
Cardinality	0...0
Type	Reference(Encounter)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.encounter w5: FiveWs.context v2: PV1-19 Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
MedicationAdministration.supportingInformation
Definition	Additional information (for example, patient height and weight) that supports the administration of the medication. This attribute can be used to provide documentation of specific characteristics of the patient present at the time of administration. For example, if the dose says "give "x" if the heartrate exceeds "y"", then the heart rate can be included using this attribute.
Cardinality	0...0
Type	Reference(Resource)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.context 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)]
MedicationAdministration.occurence[x]
Definition	A specific date/time or interval of time during which the administration took place (or did not take place). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.
Cardinality	1...1
Type	dateTime
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 Date/Time Start of Administration / RXA-4 Date/Time End of Administration rim: .effectiveTime
MedicationAdministration.recorded
Definition	The date the occurrence of the MedicationAdministration was first captured in the record - potentially significantly after the occurrence of the event.
Cardinality	0...0
Type	dateTime
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
MedicationAdministration.isSubPotent
Definition	An indication that the full dose was not administered.
Cardinality	0...0
Type	boolean
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationAdministration.subPotentReason
Definition	The reason or reasons why the full dose was not administered.
Cardinality	0...0
Type	CodeableConcept
Binding	MedicationAdministrationSubpotentReason (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationAdministration.performer
Definition	The performer of the medication treatment. For devices this is the device that performed the administration of the medication. An IV Pump would be an example of a device that is performing the administration. Both the IV Pump and the practitioner that set the rate or bolus on the pump can be listed as performers.
Cardinality	0...*
Type	BackboneElement
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer w5: FiveWs.actor v2: RXA-10 Administering Provider / PRT-5 Participation Person: PRT-4 Participation='AP' (RXA-10 is deprecated) rim: .participation[typeCode=PRF]
MedicationAdministration.performer.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationAdministration.performer.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationAdministration.performer.modifierExtension
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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationAdministration.performer.function
Definition	Distinguishes the type of involvement of the performer in the medication administration.
Cardinality	0...1
Type	CodeableConcept
Binding	A code describing the role an individual played in administering the medication. MedicationAdministrationPerformerFunctionCodes (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.function rim: participation[typeCode=PRF].functionCode
MedicationAdministration.performer.actor
Definition	Indicates who or what performed the medication administration.
Cardinality	1...1
Type	CodeableReference(RdcDeviceInstance)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.performer.actor rim: .role
MedicationAdministration.reason
Definition	A code, Condition or observation that supports why the medication was administered.
Cardinality	0...0
Type	CodeableReference(Condition \| Observation \| DiagnosticReport)
Binding	A set of codes indicating the reason why the MedicationAdministration was made. ReasonMedicationGivenCodes (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reason v2: RXE-27 Give Indication rim: .reasonCode
MedicationAdministration.request
Definition	The original request, instruction or authority to perform the administration.
Cardinality	0...1
Type	Reference(RdcMedicationRequest)
Comments	This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.basedOn v2: ORC-2 Placer Order Number / ORC-3 Filler Order Number rim: InFullfillmentOf->SubstanceAdministration
MedicationAdministration.device
Definition	The device that is to be used for the administration of the medication (for example, PCA Pump).
Cardinality	0...0
Type	CodeableReference(Device)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: PRT-10 Participation Device / RXR-3 Administrative Device rim: device->Access OR device->AssignedDevice
MedicationAdministration.note
Definition	Extra information about the medication administration that is not conveyed by the other attributes.
Cardinality	0...0
Type	Annotation
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationAdministration.dosage
Definition	Describes the medication dosage information details e.g. dose, rate, site, route, etc.
Cardinality	0...1
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` mad-1: If dosage attribute is present then SHALL have at least one of dosage.text or dosage.dose or dosage.rate[x] `(dose.exists() or rate.exists() or text.exists())`
Mappings	rim: component->SubstanceAdministrationEvent
MedicationAdministration.dosage.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationAdministration.dosage.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationAdministration.dosage.modifierExtension
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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationAdministration.dosage.text
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.
Cardinality	0...1
Type	string
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .text
MedicationAdministration.dosage.site
Definition	A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureAdministrationSites (example)
Comments	If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXR-2 Administration Site / RXR-6 Administration Site Modifier rim: .approachSiteCode
MedicationAdministration.dosage.route
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.
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXR-1 Route rim: .routeCode
MedicationAdministration.dosage.method
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.
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept describing the technique by which the medicine is administered. InsulinCodes (required)
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXR-4 Administration Method rim: .methodCode
MedicationAdministration.dosage.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.
Cardinality	0...1
Type	SimpleQuantity
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXA-6 Administered Amount / RXA-7 Administered Units rim: .doseQuantity
MedicationAdministration.dosage.rate[x]
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.
Cardinality	0...1
Type	Ratio
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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXA-12 Administered Per (Time Unit) rim: .rateQuantity
MedicationAdministration.eventHistory
Definition	A summary of the events of interest that have occurred, such as when the administration was verified.
Cardinality	0...0
Type	Reference(Provenance)
Comments	This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

rdc-MedicationAdministration-insulin-sample-bolus

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="rdc-MedicationAdministration" />
    <url value="https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationAdministration" />
    <name value="RdcMedicationAdministration" />
    <title value="RDC MedicationAdministration" />
    <status value="active" />
    <publisher value="F. Hoffmann-La Roche AG" />
    <description value="Represent the event of a patient consuming or otherwise being administered a medication. Medications are generally insulin, but are not limited to insulin (either manually reported or reported by an insulin pump)." />
    <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
    <fhirVersion value="5.0.0" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationAdministration" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationAdministration.identifier">
            <path value="MedicationAdministration.identifier" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.basedOn">
            <path value="MedicationAdministration.basedOn" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.partOf">
            <path value="MedicationAdministration.partOf" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationAdministration" />
            </type>
        </element>
        <element id="MedicationAdministration.statusReason">
            <path value="MedicationAdministration.statusReason" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.category">
            <path value="MedicationAdministration.category" />
            <definition value="Bolus Delivery type" />
            <max value="1" />
            <binding>
                <strength value="required" />
                <valueSet value="https://roche.com/fhir/iop/ValueSet/insulin-codes" />
            </binding>
        </element>
        <element id="MedicationAdministration.medication.concept">
            <path value="MedicationAdministration.medication.concept" />
            <definition value="Informs the type of administration conducted (ex. Basal or Bolus)" />
            <binding>
                <strength value="required" />
                <valueSet value="https://roche.com/fhir/iop/ValueSet/insulin-codes" />
            </binding>
        </element>
        <element id="MedicationAdministration.medication.reference">
            <path value="MedicationAdministration.medication.reference" />
            <definition value="Reference to specific medication administered (applicable only for commerical drugs - future implemention)" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
            </type>
        </element>
        <element id="MedicationAdministration.subject">
            <path value="MedicationAdministration.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://roche.com/fhir/iop/StructureDefinition/rdc-Patient" />
            </type>
        </element>
        <element id="MedicationAdministration.encounter">
            <path value="MedicationAdministration.encounter" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.supportingInformation">
            <path value="MedicationAdministration.supportingInformation" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.occurence[x]">
            <path value="MedicationAdministration.occurence[x]" />
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="Period" />
            </type>
        </element>
        <element id="MedicationAdministration.recorded">
            <path value="MedicationAdministration.recorded" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.isSubPotent">
            <path value="MedicationAdministration.isSubPotent" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.subPotentReason">
            <path value="MedicationAdministration.subPotentReason" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.performer.actor">
            <path value="MedicationAdministration.performer.actor" />
            <type>
                <code value="CodeableReference" />
                <targetProfile value="https://roche.com/fhir/iop/StructureDefinition/rdc-Device-Instance" />
            </type>
        </element>
        <element id="MedicationAdministration.reason">
            <path value="MedicationAdministration.reason" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.request">
            <path value="MedicationAdministration.request" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationRequest" />
            </type>
        </element>
        <element id="MedicationAdministration.device">
            <path value="MedicationAdministration.device" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.note">
            <path value="MedicationAdministration.note" />
            <max value="0" />
        </element>
        <element id="MedicationAdministration.dosage.method">
            <path value="MedicationAdministration.dosage.method" />
            <binding>
                <strength value="required" />
                <valueSet value="https://roche.com/fhir/iop/ValueSet/insulin-codes" />
            </binding>
        </element>
        <element id="MedicationAdministration.eventHistory">
            <path value="MedicationAdministration.eventHistory" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "rdc-MedicationAdministration",
    "url": "https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationAdministration",
    "name": "RdcMedicationAdministration",
    "title": "RDC MedicationAdministration",
    "status": "active",
    "publisher": "F. Hoffmann-La Roche AG",
    "description": "Represent the event of a patient consuming or otherwise being administered a medication. Medications are generally insulin, but are not limited to insulin (either manually reported or reported by an insulin pump).",
    "copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
    "fhirVersion": "5.0.0",
    "kind": "resource",
    "abstract": false,
    "type": "MedicationAdministration",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationAdministration.identifier",
                "path": "MedicationAdministration.identifier",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.basedOn",
                "path": "MedicationAdministration.basedOn",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.partOf",
                "path": "MedicationAdministration.partOf",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationAdministration"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationAdministration.statusReason",
                "path": "MedicationAdministration.statusReason",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.category",
                "path": "MedicationAdministration.category",
                "definition": "Bolus Delivery type",
                "max": "1",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://roche.com/fhir/iop/ValueSet/insulin-codes"
                }
            },
            {
                "id": "MedicationAdministration.medication.concept",
                "path": "MedicationAdministration.medication.concept",
                "definition": "Informs the type of administration conducted (ex. Basal or Bolus)",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://roche.com/fhir/iop/ValueSet/insulin-codes"
                }
            },
            {
                "id": "MedicationAdministration.medication.reference",
                "path": "MedicationAdministration.medication.reference",
                "definition": "Reference to specific medication administered (applicable only for commerical drugs - future implemention)",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Medication"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationAdministration.subject",
                "path": "MedicationAdministration.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://roche.com/fhir/iop/StructureDefinition/rdc-Patient"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationAdministration.encounter",
                "path": "MedicationAdministration.encounter",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.supportingInformation",
                "path": "MedicationAdministration.supportingInformation",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.occurence[x]",
                "path": "MedicationAdministration.occurence[x]",
                "type":  [
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "Period"
                    }
                ]
            },
            {
                "id": "MedicationAdministration.recorded",
                "path": "MedicationAdministration.recorded",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.isSubPotent",
                "path": "MedicationAdministration.isSubPotent",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.subPotentReason",
                "path": "MedicationAdministration.subPotentReason",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.performer.actor",
                "path": "MedicationAdministration.performer.actor",
                "type":  [
                    {
                        "code": "CodeableReference",
                        "targetProfile":  [
                            "https://roche.com/fhir/iop/StructureDefinition/rdc-Device-Instance"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationAdministration.reason",
                "path": "MedicationAdministration.reason",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.request",
                "path": "MedicationAdministration.request",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://roche.com/fhir/iop/StructureDefinition/rdc-MedicationRequest"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationAdministration.device",
                "path": "MedicationAdministration.device",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.note",
                "path": "MedicationAdministration.note",
                "max": "0"
            },
            {
                "id": "MedicationAdministration.dosage.method",
                "path": "MedicationAdministration.dosage.method",
                "binding": {
                    "strength": "required",
                    "valueSet": "https://roche.com/fhir/iop/ValueSet/insulin-codes"
                }
            },
            {
                "id": "MedicationAdministration.eventHistory",
                "path": "MedicationAdministration.eventHistory",
                "max": "0"
            }
        ]
    }
}

Referened in the following data flows

Medication insulin delivery

Resource examples

rdc-MedicationAdministration-insulin-sample-bolus