ISiKMedikationsInformation
Dieses Profil ermöglicht die Abbildung von Informationen zur Medikation eines Patienten in ISiK Szenarien.
Hinweis zur Auswahl des Profils: In Abgrenzung zu ISiKMedikationsVerabreichung (MedicationAdministration) wird mittels des vorliegenden Profils die Verabreichung eines Medikaments an einen Patienten mit einer lediglich Datums-genauen Angabe abgebildet (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe). Zur sekunden-genauen Angabe der Verabreichung eines Medikaments (im Sinne einer medizinischen Verabreichungsdokumentation durch medizinisches Personal) an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden. Siehe entsprechende Profilseite für weitere Begründung.
Hinweis zur Pausierung einer Medikation (Best-Practice):
Für die Abbildung der Pausierung einer Medikation wird empfohlen, mehrere MedicationStatement-Ressourcen zu verwenden, anstatt eine bestehende zu überschreiben. Dies bringt folgende Vorteile:
Korrekte Statusabbildung:
Dasstatus-Feld muss stets aktuell gepflegt werden, um den momentanen Zustand der Medikation systemweit sichtbar und durchsuchbar zu halten.Effiziente Abfragen über REST API:
In Kombination miteffective[x]ermöglicht dasstatus-Feld die gezielte Abfrage aller aktuell gültigen Medikationseinträge über die REST API.
Wird stattdessen nur dasdosage-Element verändert, ist keine zuverlässige Filterung möglich – alleMedicationStatementsmüssten abgerufen und manuell analysiert werden.Erhalt von Verlaufsinformationen:
Wenn z. B. auch einstatusReason(z. B. „pausiert wegen Nebenwirkungen“) dokumentiert wird, ginge diese Information bei einem Update der bestehenden Ressource verloren, sobald die Medikation fortgesetzt wird.
Durch neueMedicationStatement-Einträge bleibt die Verlaufshistorie erhalten.
(Dieser Anwendungsfall ist aktuell nicht gefordert, aber zukünftig denkbar.)
Bestätigungsrelevanz
| Verbindlichkeit | SHALL |
|---|
Metadaten
| Canonical | https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsInformation |
|---|---|
| Status | active |
| Version | 5.1.0 |
| Basis | http://hl7.org/fhir/StructureDefinition/MedicationStatement |
Inhalt
| ISiKMedikationsInformation (MedicationStatement) | C | MedicationStatement | |
| id | S Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| versionId | Σ | 0..1 | id |
| lastUpdated | Σ | 0..1 | instant |
| source | Σ | 0..1 | uri |
| profile | Σ | 0..* | canonical(StructureDefinition) |
| security | Σ | 0..* | CodingBinding |
| tag | Σ | 0..* | Coding |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | S C | 0..* | Extension |
| acceptedRisk | S C | 0..1 | Extension(string) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 1..1 | |
| valueString | string | ||
| medikationsart | S C | 0..1 | Extension(Coding) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 1..1 | Binding | |
| valueCoding | Coding | ||
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | S Σ | 1..1 | uri |
| version | Σ | 0..1 | string |
| code | S Σ | 1..1 | code |
| display | S Σ | 0..1 | string |
| userSelected | Σ | 0..1 | boolean |
| selbstmedikation | S C | 0..1 | Extension(boolean) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 1..1 | |
| valueBoolean | boolean | ||
| behandlungsziel | S C | 0..1 | Extension(string) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 1..1 | |
| valueString | string | ||
| medicationStatementReplaces | S C | 0..1 | Extension(Reference(MedicationStatement)) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | S | 1..1 | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| reference | S Σ C | 1..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| valueReference | Reference(MedicationStatement) | ||
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ServiceRequest) |
| partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation) |
| status | S Σ ?! | 1..1 | codeBinding |
| statusReason | 0..* | CodeableConcept | |
| category | Σ | 0..1 | CodeableConceptBinding |
| medication[x] | S Σ | 1..1 | |
| medicationCodeableConcept | S Σ | 0..1 | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 0..* | Coding |
| PZN | S Σ | 0..* | ISiKPZNCodingPattern |
| ATC-DE | S Σ | 0..* | ISiKATCCodingPattern |
| SCT | S Σ | 0..1 | ISiKSnomedCTCodingPattern |
| text | S Σ | 0..1 | string |
| medicationReference | S Σ | 0..1 | Reference(Medication) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| reference | S Σ C | 1..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| subject | S Σ | 1..1 | Reference(Patient) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| reference | S Σ C | 1..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| context | S Σ | 0..1 | Reference(Encounter | EpisodeOfCare) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| reference | S Σ C | 1..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| effective[x] | S Σ | 1..1 | |
| effectiveDateTime | S Σ | 0..1 | dateTime |
| effectivePeriod | S Σ | 0..1 | Period |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| start | S Σ C | 0..1 | dateTime |
| end | S Σ C | 0..1 | dateTime |
| dateAsserted | S Σ | 0..1 | dateTime |
| informationSource | 0..1 | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) | |
| derivedFrom | 0..* | Reference(Resource) | |
| reasonCode | S | 0..* | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 0..* | Coding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| system | S Σ | 1..1 | uri |
| version | Σ | 0..1 | string |
| code | S Σ | 1..1 | code |
| display | S Σ | 0..1 | string |
| userSelected | Σ | 0..1 | boolean |
| text | S Σ | 0..1 | string |
| reasonReference | S | 0..* | Reference(Condition | Observation | DiagnosticReport) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| reference | S Σ C | 1..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| note | S | 0..* | Annotation |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| author[x] | Σ | 0..1 | |
| authorString | string | ||
| authorReference | Reference(Practitioner | Patient | RelatedPerson | Organization) | ||
| time | Σ | 0..1 | dateTime |
| text | S Σ | 1..1 | markdown |
| dosage | S C | 0..* | DosageDE |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| sequence | Σ | 0..1 | integer |
| text | S Σ | 0..1 | string |
| additionalInstruction | Σ | 0..* | CodeableConcept |
| patientInstruction | S Σ | 0..1 | string |
| timing | S Σ | 0..1 | TimingDE |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| event | S Σ | 0..* | dateTime |
| repeat | S Σ C | 0..1 | Element |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| bounds[x] | S Σ | 0..1 | |
| boundsDuration | S Σ | 0..1 | DurationPattern |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| value | S Σ | 1..1 | decimal |
| comparator | Σ ?! | 0..1 | codeBinding |
| unit | S Σ | 0..1 | string |
| system | S Σ C | 1..1 | uriFixed ValuePattern |
| code | S Σ | 1..1 | code |
| boundsRange | S Σ | 0..1 | Range |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| low | S Σ | 0..1 | SimpleQuantityPattern |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| value | S Σ | 1..1 | decimal |
| comparator | Σ ?! | 0..0 | codeBinding |
| unit | S Σ | 0..1 | string |
| system | S Σ C | 1..1 | uriPattern |
| code | S Σ | 1..1 | code |
| high | S Σ | 0..1 | SimpleQuantityPattern |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| value | S Σ | 1..1 | decimal |
| comparator | Σ ?! | 0..0 | codeBinding |
| unit | S Σ | 0..1 | string |
| system | S Σ C | 1..1 | uriPattern |
| code | S Σ | 1..1 | code |
| boundsPeriod | S Σ | 0..1 | Period |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| start | S Σ C | 0..1 | dateTime |
| end | S Σ C | 0..1 | dateTime |
| count | S Σ | 0..1 | positiveInt |
| countMax | S Σ | 0..1 | positiveInt |
| duration | S Σ | 0..1 | decimal |
| durationMax | S Σ | 0..1 | decimal |
| durationUnit | S Σ | 0..1 | codeBinding |
| frequency | S Σ | 0..1 | positiveInt |
| frequencyMax | S Σ | 0..1 | positiveInt |
| period | S Σ | 0..1 | decimal |
| periodMax | S Σ | 0..1 | decimal |
| periodUnit | S Σ | 0..1 | codeBinding |
| dayOfWeek | S Σ | 0..* | codeBinding |
| timeOfDay | S Σ | 0..* | time |
| when | S Σ | 0..* | codeBinding |
| offset | S Σ | 0..1 | unsignedInt |
| code | Σ | 0..1 | CodeableConceptBinding |
| asNeeded[x] | Σ | 0..1 | |
| asNeededCodeableConcept | CodeableConcept | ||
| asNeededBoolean | S Σ | 0..1 | boolean |
| site | S Σ | 0..1 | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 0..* | Coding |
| SNOMED-CT | S Σ | 0..1 | ISiKSnomedCTCodingPattern |
| text | S Σ | 0..1 | string |
| route | S Σ | 0..1 | CodeableConcept |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| coding | S Σ | 0..* | Coding |
| EDQM | S Σ | 0..1 | ISiKCodingBindingPattern |
| SNOMED-CT | S Σ | 0..1 | ISiKSnomedCTCodingBindingPattern |
| text | S Σ | 0..1 | string |
| method | Σ | 0..1 | CodeableConcept |
| doseAndRate | S Σ | 0..* | Element |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| type | Σ | 0..1 | CodeableConcept |
| dose[x] | Σ | 0..1 | |
| doseQuantity | S Σ C | 0..1 | MedicationQuantityBinding |
| doseRange | S Σ | 0..1 | Range |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| low | S Σ C | 0..1 | MedicationQuantity |
| high | S Σ C | 0..1 | MedicationQuantity |
| rate[x] | Σ | 0..1 | |
| rateRatio | S Σ | 0..1 | Ratio |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| numerator | S Σ C | 1..1 | MedicationQuantity |
| denominator | S Σ C | 1..1 | MedicationQuantity |
| rateRange | S Σ | 0..1 | Range |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| low | S Σ C | 0..1 | MedicationQuantity |
| high | S Σ C | 0..1 | MedicationQuantity |
| rateQuantity | S Σ C | 0..1 | MedicationQuantity |
| maxDosePerPeriod | S Σ C | 0..1 | Ratio |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| numerator | S Σ C | 0..1 | MedicationQuantity |
| denominator | S Σ C | 0..1 | MedicationQuantity |
| maxDosePerAdministration | S Σ C | 0..1 | MedicationQuantity |
| maxDosePerLifetime | Σ C | 0..1 | SimpleQuantity |
Constraints/Invarianten
Terminology-Bindings
| Element | Staerke | ValueSet |
|---|---|---|
| MedicationStatement.dosage.route.coding:EDQM | required | http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration |
| MedicationStatement.dosage.route.coding:SNOMED-CT | required | https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration |