Implementierungsleitfaden ISiK-Medikation

ISiKMedikationsVerabreichung (MedicationAdministration)

ISiKMedikationsVerabreichung (MedicationAdministration)

ISiKMedikationsVerabreichung

Dieses Profil ermöglicht die Abbildung der Verabreichung von Medikamenten für einen Patienten in ISiK Szenarien. Hinweis zur Auswahl des Profils: In Abgrenzung zu ISiKMedikationsInformation (MedicationStatement) wird mittels des vorliegenden Profils die Verabreichung eines Medikaments an einen Patienten mit einer Zeitpunkt-genauen Angabe abgebildet (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der FHIR-Core Vorgabe). D.h. die lediglich Datums-genaue Angabe ist im vorliegenden Profil nicht erlaubt. Das Profil ISiKMedikationsInformation (MedicationStatement) kann ebenfalls für die Abbildung der Verabreichung von Medikamenten für einen Patienten verwendet werden, wenn keine Zeitpunkt-genauen Angaben zur Verabreichung vorliegen, sondern lediglich Datums-genaue Angaben (einschließlich Granularität Jahr, Monat oder Tag).

Begründung zur Profil- und Nutzungsdifferenzierung: Handelt es sich bei Erfassung um eine medizinische Verabreichungsdokumentation, dann ist ein genauer Zeitstempel zwingend. Die medizinische Verabreichungsdokumentation muss durch medizinisches Personal erfolgen. Angaben von Patienten und Angehörigen sind grundsätzlich keine medizinische Verabreichungsdokumentation und daher als MedicationStament zu erfassen('report that such a sequence (or at least a part of it) did take place').

Bestätigungsrelevanz

Verbindlichkeit	SHALL

Metadaten

Canonical	https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung
Status	active
Version	4.0.3
Basis	http://hl7.org/fhir/StructureDefinition/MedicationAdministration

Inhalt

ISiKMedikationsVerabreichung (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().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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 workflow: Event rim: SubstanceAdministration
id	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
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 it's 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 A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id MedicationAdministration.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and 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 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		0..*	Resource	There are no (further) constraints on this element Element id MedicationAdministration.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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	?! 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. 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..*	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
instantiates	Σ	0..*	uri	There are no (further) constraints on this element Element id MedicationAdministration.instantiates Short description Instantiates protocol or definition Definition A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiates rim: .outboundRelationship[typeCode=DEFN].target[classCode=unspecified]
partOf	Σ	0..*	Reference(MedicationAdministration \| Procedure)	There are no (further) constraints on this element Element id MedicationAdministration.partOf Short description Part of referenced event Definition A larger event of which this particular event is a component or step. Data type Reference(MedicationAdministration \| Procedure) 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	S Σ ?!	1..1	codeBinding	Element id MedicationAdministration.status Short description Status der Verabreichungsinformation 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 Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard Data type code Binding A set of codes indicating the current status of a MedicationAdministration. MedicationAdministration Status Codes (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..*	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	There are no (further) constraints on this element Element id MedicationAdministration.category Short description Type of medication usage Definition Indicates where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A coded concept describing where the medication administered is expected to occur. MedicationAdministration Category Codes (preferred) 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[x]	Σ	1..1		Element id MedicationAdministration.medication[x] Short description What was administered Definition Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. Comments If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. Sliced: Unordered, Open, by $this(Type) 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]
medicationCodeableConcept	S Σ	0..1	CodeableConcept	Element id MedicationAdministration.medication[x]:medicationCodeableConcept Short description Medikament in codierter Form oder ggf. als Freitext 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 Begründung des Must-Support: Basisinformation Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren. Data type CodeableConcept 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	string	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationCodeableConcept.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.medication[x]:medicationCodeableConcept.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
coding	S Σ	0..*	Coding	Element id MedicationAdministration.medication[x]:medicationCodeableConcept.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
PZN	S Σ	0..1	ISiKPZNCodingPattern	Element id MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKPZNCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://fhir.de/CodeSystem/ifa/pzn" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
ATC-DE	S Σ	0..1	ISiKATCCodingPattern	Element id MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKATCCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://fhir.de/CodeSystem/bfarm/atc" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
SCT	S Σ	0..1	ISiKSnomedCTCodingPattern	Element id MedicationAdministration.medication[x]:medicationCodeableConcept.coding:SCT Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKSnomedCTCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationCodeableConcept.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
medicationReference	S Σ	0..1	Reference(Medication)	Element id MedicationAdministration.medication[x]:medicationReference Short description Referenz auf das Medikament (Medication-Ressource) 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 Begründung des Must-Support: Basisinformation Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen Data type Reference(Medication) 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	string	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationReference.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.medication[x]:medicationReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationReference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationReference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationReference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.medication[x]:medicationReference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
subject	S Σ	1..1	Reference(Patient)	Element id MedicationAdministration.subject Short description Referenz auf den Patienten Definition The person or animal or group receiving the medication. Comments Begründung des Must-Support: Basisinformation Data type Reference(Patient) 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] w5: FiveWs.subject
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.subject.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.subject.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationAdministration.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationAdministration.subject.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.subject.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
context	S	0..1	Reference(Encounter \| EpisodeOfCare)	Element id MedicationAdministration.context Short description Referenz auf den Abteilungskontakt Definition The visit, admission, or other contact between patient and health care provider during which the medication administration was performed. Comments Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext Data type Reference(Encounter \| EpisodeOfCare) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.context w5: FiveWs.context v2: PV1-19-Visit Number rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.context.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.context.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationAdministration.context.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationAdministration.context.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.context.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.context.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
supportingInformation		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationAdministration.supportingInformation Short description Additional information to support administration Definition Additional information (for example, patient height and weight) that supports the administration of the medication. 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)]
effective[x]	Σ	1..1		Element id MedicationAdministration.effective[x] Short description Start and end time of administration Definition A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Sliced: Unordered, Open, by $this(Type) 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
effectiveDateTime	S Σ	0..1	dateTime	Element id MedicationAdministration.effective[x]:effectiveDateTime Short description Zeitpunkt der Verabreichung Definition A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Comments Begründung des Must-Support: Basisinformation Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der FHIR-Core Vorgabe) MUSS hier seitens eines bestätigungsrelevanten Systems unterstützt werden. Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden. Data type dateTime 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
effectivePeriod	S Σ	0..1	Period	Element id MedicationAdministration.effective[x]:effectivePeriod Short description Zeitraum der Verabreichung Definition A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate. Comments Begründung des Must-Support: Basisinformation Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der FHIR-Core Vorgabe) MUSS hier seitens eines bestätigungsrelevanten Systems unterstützt werden. Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden. Data type Period 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.effective[x]:effectivePeriod.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.effective[x]:effectivePeriod.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
start	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id MedicationAdministration.effective[x]:effectivePeriod.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.1 rim: ./low
end	S Σ I	0..1	dateTime	There are no (further) constraints on this element Element id MedicationAdministration.effective[x]:effectivePeriod.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: DR.2 rim: ./high
performer	S Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id MedicationAdministration.performer Short description Who performed the medication administration and what they did Definition Indicates who or what performed the medication administration and how they were involved. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. MedicationAdministration Performer Function Codes (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	S Σ	1..1	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Device)	Element id MedicationAdministration.performer.actor Short description Referenz auf die verabreichende Person Definition Indicates who or what performed the medication administration. Comments Begründung des Must-Support: Nachvollziehbarkeit Data type Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Device) 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.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.actor.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.performer.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
reasonCode	S	0..*	CodeableConcept	Element id MedicationAdministration.reasonCode Short description Grund der Medikation (Referenz) Definition A code indicating why the medication was given. Comments Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können. Data type CodeableConcept 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.reasonCode v2: RXE-27 Give Indication rim: .reasonCode
reasonReference	S	0..*	Reference(Condition \| Observation \| DiagnosticReport)	Element id MedicationAdministration.reasonReference Short description Grund der Medikation (Referenz) Definition Condition or observation that supports why the medication was administered. Comments Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können. Data type Reference(Condition \| Observation \| DiagnosticReport) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference w5: FiveWs.why[x] rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use ASSERTION"].value w3c.prov: no mapping
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.reasonReference.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.reasonReference.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id MedicationAdministration.reasonReference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id MedicationAdministration.reasonReference.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id MedicationAdministration.reasonReference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.reasonReference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
request		0..1	Reference(MedicationRequest)	There are no (further) constraints on this element 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(MedicationRequest) 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..*	Reference(Device)	There are no (further) constraints on this element Element id MedicationAdministration.device Short description Device used to administer Definition The device used in administering the medication to the patient. For example, a particular infusion pump. Data type Reference(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	S	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
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.note.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.note.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
author[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationAdministration.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationAdministration.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Act.effectiveTime
text	S Σ	1..1	markdown	Element id MedicationAdministration.note.text Short description Freitext-Notiz Definition The text of the annotation in markdown format. Comments Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Act.text
dosage	S I	0..1	BackboneElement	Element id MedicationAdministration.dosage Short description Dosierungsangaben Definition Describes the medication dosage information details e.g. dose, rate, site, route, etc. Comments Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] `dose.exists() or rate.exists()` Mappings rim: 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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	S	0..1	string	Element id MedicationAdministration.dosage.text Short description Freitext-Dosierungsangabe Definition Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Comments Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden. Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten. Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://simplifier.net/guide/isik-basis-401/Einfuehrung/UebergreifendeFestlegungen/UebergreifendeFestlegungen_Must-Support-Flags.page.md?version=current): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.' Zum Beispiel kann die textuelle Information '1L Infusion mit Rate 50ml/h' in eine entsprechende, strukturierte Form überführt werden - d.h. in die Angabe von 'dose' und 'rateQuantity'. 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	S	0..1	CodeableConcept	Element id MedicationAdministration.dosage.site Short description Körperstelle der Verabreichung 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 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. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (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
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.site.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.site.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
coding	S Σ	0..*	Coding	Element id MedicationAdministration.dosage.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
SNOMED-CT	S Σ	0..1	ISiKSnomedCTCodingPattern	Element id MedicationAdministration.dosage.site.coding:SNOMED-CT Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKSnomedCTCoding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
route	S	0..1	CodeableConcept	Element id MedicationAdministration.dosage.route Short description 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. 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.route.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.route.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
coding	S Σ	0..*	Coding	Element id MedicationAdministration.dosage.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EDQM	S Σ	0..1	ISiKCodingBindingPattern	Element id MedicationAdministration.dosage.route.coding:EDQM Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKCoding Binding MedicineRouteOfAdministrationUvIps (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://standardterms.edqm.eu" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
SNOMED-CT	S Σ	0..1	ISiKSnomedCTCodingBindingPattern	Element id MedicationAdministration.dosage.route.coding:SNOMED-CT Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type ISiKSnomedCTCoding Binding SctRouteOfAdministration (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://snomed.info/sct" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
method		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationAdministration.dosage.method Short description How drug was administered Definition A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. Comments One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) 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	S I	0..1	MedicationQuantity	Element id MedicationAdministration.dosage.dose Short description verabreichte Dosis Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: RXA-6 Administered Amount / RXA-7 Administered Units rim: .doseQuantity rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
rate[x]		0..1		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. Sliced: Unordered, Open, by $this(Type) 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	S	0..1	Ratio	Element id MedicationAdministration.dosage.rate[x]:rateRatio Short description Verabreichungs-Rate (Verhältnis) 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 Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können. Data type Ratio 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationAdministration.dosage.rate[x]:rateRatio.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.rate[x]:rateRatio.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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
numerator	S Σ I	1..1	MedicationQuantity	Element id MedicationAdministration.dosage.rate[x]:rateRatio.numerator Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: .numerator rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
denominator	S Σ I	1..1	MedicationQuantity	Element id MedicationAdministration.dosage.rate[x]:rateRatio.denominator Short description A fixed quantity (no comparator) Definition The comparator is not used on a SimpleQuantity Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: .denominator rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
rateQuantity	S I	0..1	MedicationQuantity	Element id MedicationAdministration.dosage.rate[x]:rateQuantity Short description Verabreichungs-Rate Definition The comparator is not used on a SimpleQuantity Comments Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können. Data type MedicationQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings v2: RXA-12-Administered Per (Time Unit) rim: .rateQuantity rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationAdministration.eventHistory Short description A list of events of interest in the lifecycle Definition A summary of the events of interest that have occurred, such as when the administration was verified. Comments This 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]

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="ISiKMedikationsVerabreichung" />
    <url value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung" />
    <version value="4.0.3" />
    <name value="ISiKMedikationsVerabreichung" />
    <status value="active" />
    <experimental value="false" />
    <date value="2025-03-17" />
    <publisher value="gematik GmbH" />
    <description value="Dieses Profil erm&#246;glicht die Abbildung der Verabreichung von Medikamenten f&#252;r einen Patienten in ISiK Szenarien. \nHinweis zur Auswahl des Profils: In Abgrenzung zu ISiKMedikationsInformation (MedicationStatement) wird mittels des vorliegenden Profils die Verabreichung eines Medikaments an einen Patienten mit einer Zeitpunkt-genauen Angabe abgebildet (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gem&#228;&#223; der [FHIR-Core Vorgabe](https://hl7.org/fhir/R4/datatypes.html#dateTime)). D.h. die lediglich Datums-genaue Angabe  ist im vorliegenden Profil nicht erlaubt. \nDas Profil ISiKMedikationsInformation (MedicationStatement) kann ebenfalls f&#252;r  die Abbildung der Verabreichung von Medikamenten f&#252;r einen Patienten verwendet werden, wenn keine Zeitpunkt-genauen Angaben zur Verabreichung vorliegen, sondern lediglich Datums-genaue Angaben (einschlie&#223;lich Granularit&#228;t Jahr, Monat oder Tag).\n\nBegr&#252;ndung zur Profil- und Nutzungsdifferenzierung:\nHandelt es sich bei Erfassung um eine medizinische Verabreichungsdokumentation, dann ist ein genauer Zeitstempel zwingend. Die medizinische Verabreichungsdokumentation muss durch medizinisches Personal erfolgen. Angaben von Patienten und Angeh&#246;rigen sind grunds&#228;tzlich keine medizinische Verabreichungsdokumentation und daher als MedicationStament zu erfassen([&#39;report that such a sequence (or at least a part of it) did take place&#39;](https://hl7.org/fhir/R4/medicationstatement.html))." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationAdministration" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationAdministration.status">
            <path value="MedicationAdministration.status" />
            <short value="Status der Verabreichungsinformation" />
            <comment value="Begr&#252;ndung des Must-Support: Erforderliche Angabe im FHIR-Standard" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]">
            <path value="MedicationAdministration.medication[x]" />
            <slicing>
                <discriminator>
                    <type value="type" />
                    <path value="$this" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="MedicationAdministration.medication[x]:medicationCodeableConcept">
            <path value="MedicationAdministration.medication[x]" />
            <sliceName value="medicationCodeableConcept" />
            <short value="Medikament in codierter Form oder ggf. als Freitext" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation\n\n  Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]:medicationCodeableConcept.coding">
            <path value="MedicationAdministration.medication[x].coding" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="$this" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN">
            <path value="MedicationAdministration.medication[x].coding" />
            <sliceName value="PZN" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKPZNCoding" />
            </type>
            <patternCoding>
                <system value="http://fhir.de/CodeSystem/ifa/pzn" />
            </patternCoding>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE">
            <path value="MedicationAdministration.medication[x].coding" />
            <sliceName value="ATC-DE" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKATCCoding" />
            </type>
            <patternCoding>
                <system value="http://fhir.de/CodeSystem/bfarm/atc" />
            </patternCoding>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]:medicationCodeableConcept.coding:SCT">
            <path value="MedicationAdministration.medication[x].coding" />
            <sliceName value="SCT" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding" />
            </type>
            <patternCoding>
                <system value="http://snomed.info/sct" />
            </patternCoding>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]:medicationReference">
            <path value="MedicationAdministration.medication[x]" />
            <sliceName value="medicationReference" />
            <short value="Referenz auf das Medikament (Medication-Ressource)" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation\n\n  Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.medication[x]:medicationReference.reference">
            <path value="MedicationAdministration.medication[x].reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.subject">
            <path value="MedicationAdministration.subject" />
            <short value="Referenz auf den Patienten" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.subject.reference">
            <path value="MedicationAdministration.subject.reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.context">
            <path value="MedicationAdministration.context" />
            <short value="Referenz auf den Abteilungskontakt" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation im Krankenhaus-Kontext" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.context.reference">
            <path value="MedicationAdministration.context.reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.effective[x]">
            <path value="MedicationAdministration.effective[x]" />
            <slicing>
                <discriminator>
                    <type value="type" />
                    <path value="$this" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="MedicationAdministration.effective[x]:effectiveDateTime">
            <path value="MedicationAdministration.effective[x]" />
            <sliceName value="effectiveDateTime" />
            <short value="Zeitpunkt der Verabreichung" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation\n  \n  Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gem&#228;&#223; der [FHIR-Core Vorgabe](https://hl7.org/fhir/R4/datatypes.html#dateTime)) MUSS hier seitens eines best&#228;tigungsrelevanten Systems unterst&#252;tzt werden.\n\n  F&#252;r grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="dateTime" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.effective[x]:effectivePeriod">
            <path value="MedicationAdministration.effective[x]" />
            <sliceName value="effectivePeriod" />
            <short value="Zeitraum der Verabreichung" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation\n  \n  Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gem&#228;&#223; der [FHIR-Core Vorgabe](https://hl7.org/fhir/R4/datatypes.html#dateTime)) MUSS hier seitens eines best&#228;tigungsrelevanten Systems unterst&#252;tzt werden.\n  F&#252;r grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Period" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.effective[x]:effectivePeriod.start">
            <path value="MedicationAdministration.effective[x].start" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.effective[x]:effectivePeriod.end">
            <path value="MedicationAdministration.effective[x].end" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.performer">
            <path value="MedicationAdministration.performer" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.performer.actor">
            <path value="MedicationAdministration.performer.actor" />
            <short value="Referenz auf die verabreichende Person" />
            <comment value="Begr&#252;ndung des Must-Support: Nachvollziehbarkeit" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.performer.actor.reference">
            <path value="MedicationAdministration.performer.actor.reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.reasonCode">
            <path value="MedicationAdministration.reasonCode" />
            <short value="Grund der Medikation (Referenz)" />
            <comment value="Festlegung zum MS: Die Elemente .reasonCode und .reasonReference M&#220;SSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden k&#246;nnen. Weiterhin M&#220;SSEN beide Elemente interpretiert werden k&#246;nnen." />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.reasonReference">
            <path value="MedicationAdministration.reasonReference" />
            <short value="Grund der Medikation (Referenz)" />
            <comment value="Festlegung zum MS: Die Elemente .reasonCode und .reasonReference M&#220;SSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden k&#246;nnen. Weiterhin M&#220;SSEN beide Elemente interpretiert werden k&#246;nnen." />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.reasonReference.reference">
            <path value="MedicationAdministration.reasonReference.reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.note">
            <path value="MedicationAdministration.note" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.note.text">
            <path value="MedicationAdministration.note.text" />
            <short value="Freitext-Notiz" />
            <comment value="Begr&#252;ndung des Must-Support: Angabe zus&#228;tzlicher Informationen kann fachlich relevant sein" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage">
            <path value="MedicationAdministration.dosage" />
            <short value="Dosierungsangaben" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation. Zur vollst&#228;ndig strukturierten Abbildung der zahlreichen M&#246;glichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gem&#228;&#223; Konsens der ISiK AG Medikation" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.text">
            <path value="MedicationAdministration.dosage.text" />
            <short value="Freitext-Dosierungsangabe" />
            <comment value="Festlegung zum Must-Support: Die Verarbeitung MUSS unterst&#252;tzt werden, indem empfangende Systeme  die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.\n        \n    Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfl&#228;che anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.\n    \n    Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://simplifier.net/guide/isik-basis-401/Einfuehrung/UebergreifendeFestlegungen/UebergreifendeFestlegungen_Must-Support-Flags.page.md?version=current): &#39;Systeme K&#214;NNEN es dar&#252;ber hinaus erm&#246;glichen, dass die jeweiligen Informationen vom Anwender erg&#228;nzt oder editiert werden.&#39; \n    \n    Zum Beispiel kann die textuelle Information &#39;1L Infusion mit Rate 50ml/h&#39; in eine entsprechende, strukturierte Form &#252;berf&#252;hrt werden - d.h. in die Angabe von &#39;dose&#39; und &#39;rateQuantity&#39;." />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.site">
            <path value="MedicationAdministration.dosage.site" />
            <short value="K&#246;rperstelle der Verabreichung" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.site.coding">
            <path value="MedicationAdministration.dosage.site.coding" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="$this" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.site.coding:SNOMED-CT">
            <path value="MedicationAdministration.dosage.site.coding" />
            <sliceName value="SNOMED-CT" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding" />
            </type>
            <patternCoding>
                <system value="http://snomed.info/sct" />
            </patternCoding>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.site.text">
            <path value="MedicationAdministration.dosage.site.text" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.route">
            <path value="MedicationAdministration.dosage.route" />
            <short value="Route" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.route.coding">
            <path value="MedicationAdministration.dosage.route.coding" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="$this" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.route.coding:EDQM">
            <path value="MedicationAdministration.dosage.route.coding" />
            <sliceName value="EDQM" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKCoding" />
            </type>
            <patternCoding>
                <system value="http://standardterms.edqm.eu" />
            </patternCoding>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration" />
            </binding>
        </element>
        <element id="MedicationAdministration.dosage.route.coding:SNOMED-CT">
            <path value="MedicationAdministration.dosage.route.coding" />
            <sliceName value="SNOMED-CT" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Coding" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding" />
            </type>
            <patternCoding>
                <system value="http://snomed.info/sct" />
            </patternCoding>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration" />
            </binding>
        </element>
        <element id="MedicationAdministration.dosage.route.text">
            <path value="MedicationAdministration.dosage.route.text" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.dose">
            <path value="MedicationAdministration.dosage.dose" />
            <short value="verabreichte Dosis" />
            <type>
                <code value="Quantity" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.rate[x]">
            <path value="MedicationAdministration.dosage.rate[x]" />
            <slicing>
                <discriminator>
                    <type value="type" />
                    <path value="$this" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="MedicationAdministration.dosage.rate[x]:rateRatio">
            <path value="MedicationAdministration.dosage.rate[x]" />
            <sliceName value="rateRatio" />
            <short value="Verabreichungs-Rate (Verh&#228;ltnis)" />
            <comment value="Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden k&#246;nnen. Beim Empfang und Verarbeitung der eingehenden Daten m&#252;ssen dagegen beide Datentypen interpretiert werden k&#246;nnen." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Ratio" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.rate[x]:rateRatio.numerator">
            <path value="MedicationAdministration.dosage.rate[x].numerator" />
            <min value="1" />
            <type>
                <code value="Quantity" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.rate[x]:rateRatio.denominator">
            <path value="MedicationAdministration.dosage.rate[x].denominator" />
            <min value="1" />
            <type>
                <code value="Quantity" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationAdministration.dosage.rate[x]:rateQuantity">
            <path value="MedicationAdministration.dosage.rate[x]" />
            <sliceName value="rateQuantity" />
            <short value="Verabreichungs-Rate" />
            <comment value="Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden k&#246;nnen. Beim Empfang und Verarbeitung der eingehenden Daten m&#252;ssen dagegen beide Datentypen interpretiert werden k&#246;nnen." />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Quantity" />
                <profile value="https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity" />
            </type>
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "ISiKMedikationsVerabreichung",
    "url": "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung",
    "version": "4.0.3",
    "name": "ISiKMedikationsVerabreichung",
    "status": "active",
    "experimental": false,
    "date": "2025-03-17",
    "publisher": "gematik GmbH",
    "description": "Dieses Profil ermöglicht die Abbildung der Verabreichung von Medikamenten für einen Patienten in ISiK Szenarien. \nHinweis zur Auswahl des Profils: In Abgrenzung zu ISiKMedikationsInformation (MedicationStatement) wird mittels des vorliegenden Profils die Verabreichung eines Medikaments an einen Patienten mit einer Zeitpunkt-genauen Angabe abgebildet (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der [FHIR-Core Vorgabe](https://hl7.org/fhir/R4/datatypes.html#dateTime)). D.h. die lediglich Datums-genaue Angabe  ist im vorliegenden Profil nicht erlaubt. \nDas Profil ISiKMedikationsInformation (MedicationStatement) kann ebenfalls für  die Abbildung der Verabreichung von Medikamenten für einen Patienten verwendet werden, wenn keine Zeitpunkt-genauen Angaben zur Verabreichung vorliegen, sondern lediglich Datums-genaue Angaben (einschließlich Granularität Jahr, Monat oder Tag).\n\nBegründung zur Profil- und Nutzungsdifferenzierung:\nHandelt es sich bei Erfassung um eine medizinische Verabreichungsdokumentation, dann ist ein genauer Zeitstempel zwingend. Die medizinische Verabreichungsdokumentation muss durch medizinisches Personal erfolgen. Angaben von Patienten und Angehörigen sind grundsätzlich keine medizinische Verabreichungsdokumentation und daher als MedicationStament zu erfassen(['report that such a sequence (or at least a part of it) did take place'](https://hl7.org/fhir/R4/medicationstatement.html)). ",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "MedicationAdministration",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationAdministration.status",
                "path": "MedicationAdministration.status",
                "short": "Status der Verabreichungsinformation",
                "comment": "Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]",
                "path": "MedicationAdministration.medication[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationCodeableConcept",
                "path": "MedicationAdministration.medication[x]",
                "sliceName": "medicationCodeableConcept",
                "short": "Medikament in codierter Form oder ggf. als Freitext",
                "comment": "Begründung des Must-Support: Basisinformation\n\n  Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding",
                "path": "MedicationAdministration.medication[x].coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN",
                "path": "MedicationAdministration.medication[x].coding",
                "sliceName": "PZN",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/ISiKPZNCoding"
                        ]
                    }
                ],
                "patternCoding": {
                    "system": "http://fhir.de/CodeSystem/ifa/pzn"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE",
                "path": "MedicationAdministration.medication[x].coding",
                "sliceName": "ATC-DE",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/ISiKATCCoding"
                        ]
                    }
                ],
                "patternCoding": {
                    "system": "http://fhir.de/CodeSystem/bfarm/atc"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:SCT",
                "path": "MedicationAdministration.medication[x].coding",
                "sliceName": "SCT",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding"
                        ]
                    }
                ],
                "patternCoding": {
                    "system": "http://snomed.info/sct"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationReference",
                "path": "MedicationAdministration.medication[x]",
                "sliceName": "medicationReference",
                "short": "Referenz auf das Medikament (Medication-Ressource)",
                "comment": "Begründung des Must-Support: Basisinformation\n\n  Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Medication"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.medication[x]:medicationReference.reference",
                "path": "MedicationAdministration.medication[x].reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.subject",
                "path": "MedicationAdministration.subject",
                "short": "Referenz auf den Patienten",
                "comment": "Begründung des Must-Support: Basisinformation",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.subject.reference",
                "path": "MedicationAdministration.subject.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.context",
                "path": "MedicationAdministration.context",
                "short": "Referenz auf den Abteilungskontakt",
                "comment": "Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.context.reference",
                "path": "MedicationAdministration.context.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.effective[x]",
                "path": "MedicationAdministration.effective[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "MedicationAdministration.effective[x]:effectiveDateTime",
                "path": "MedicationAdministration.effective[x]",
                "sliceName": "effectiveDateTime",
                "short": "Zeitpunkt der Verabreichung",
                "comment": "Begründung des Must-Support: Basisinformation\n  \n  Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der [FHIR-Core Vorgabe](https://hl7.org/fhir/R4/datatypes.html#dateTime)) MUSS hier seitens eines bestätigungsrelevanten Systems unterstützt werden.\n\n  Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden.\n  ",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.effective[x]:effectivePeriod",
                "path": "MedicationAdministration.effective[x]",
                "sliceName": "effectivePeriod",
                "short": "Zeitraum der Verabreichung",
                "comment": "Begründung des Must-Support: Basisinformation\n  \n  Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der [FHIR-Core Vorgabe](https://hl7.org/fhir/R4/datatypes.html#dateTime)) MUSS hier seitens eines bestätigungsrelevanten Systems unterstützt werden.\n  Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden.\n  ",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Period"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.effective[x]:effectivePeriod.start",
                "path": "MedicationAdministration.effective[x].start",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.effective[x]:effectivePeriod.end",
                "path": "MedicationAdministration.effective[x].end",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.performer",
                "path": "MedicationAdministration.performer",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.performer.actor",
                "path": "MedicationAdministration.performer.actor",
                "short": "Referenz auf die verabreichende Person",
                "comment": "Begründung des Must-Support: Nachvollziehbarkeit",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.performer.actor.reference",
                "path": "MedicationAdministration.performer.actor.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.reasonCode",
                "path": "MedicationAdministration.reasonCode",
                "short": "Grund der Medikation (Referenz)",
                "comment": "  Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.reasonReference",
                "path": "MedicationAdministration.reasonReference",
                "short": "Grund der Medikation (Referenz)",
                "comment": "  Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.reasonReference.reference",
                "path": "MedicationAdministration.reasonReference.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.note",
                "path": "MedicationAdministration.note",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.note.text",
                "path": "MedicationAdministration.note.text",
                "short": "Freitext-Notiz",
                "comment": "Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage",
                "path": "MedicationAdministration.dosage",
                "short": "Dosierungsangaben",
                "comment": "Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.text",
                "path": "MedicationAdministration.dosage.text",
                "short": "Freitext-Dosierungsangabe",
                "comment": "Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme  die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.\n        \n    Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.\n    \n    Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://simplifier.net/guide/isik-basis-401/Einfuehrung/UebergreifendeFestlegungen/UebergreifendeFestlegungen_Must-Support-Flags.page.md?version=current): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.' \n    \n    Zum Beispiel kann die textuelle Information '1L Infusion mit Rate 50ml/h' in eine entsprechende, strukturierte Form überführt werden - d.h. in die Angabe von 'dose' und 'rateQuantity'.",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.site",
                "path": "MedicationAdministration.dosage.site",
                "short": "Körperstelle der Verabreichung",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.site.coding",
                "path": "MedicationAdministration.dosage.site.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT",
                "path": "MedicationAdministration.dosage.site.coding",
                "sliceName": "SNOMED-CT",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding"
                        ]
                    }
                ],
                "patternCoding": {
                    "system": "http://snomed.info/sct"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.site.text",
                "path": "MedicationAdministration.dosage.site.text",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.route",
                "path": "MedicationAdministration.dosage.route",
                "short": "Route",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.route.coding",
                "path": "MedicationAdministration.dosage.route.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                },
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.route.coding:EDQM",
                "path": "MedicationAdministration.dosage.route.coding",
                "sliceName": "EDQM",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/ISiKCoding"
                        ]
                    }
                ],
                "patternCoding": {
                    "system": "http://standardterms.edqm.eu"
                },
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration"
                }
            },
            {
                "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT",
                "path": "MedicationAdministration.dosage.route.coding",
                "sliceName": "SNOMED-CT",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Coding",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/ISiKSnomedCTCoding"
                        ]
                    }
                ],
                "patternCoding": {
                    "system": "http://snomed.info/sct"
                },
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration"
                }
            },
            {
                "id": "MedicationAdministration.dosage.route.text",
                "path": "MedicationAdministration.dosage.route.text",
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.dose",
                "path": "MedicationAdministration.dosage.dose",
                "short": "verabreichte Dosis",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.rate[x]",
                "path": "MedicationAdministration.dosage.rate[x]",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "type",
                            "path": "$this"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "MedicationAdministration.dosage.rate[x]:rateRatio",
                "path": "MedicationAdministration.dosage.rate[x]",
                "sliceName": "rateRatio",
                "short": "Verabreichungs-Rate (Verhältnis)",
                "comment": "Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Ratio"
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator",
                "path": "MedicationAdministration.dosage.rate[x].numerator",
                "min": 1,
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator",
                "path": "MedicationAdministration.dosage.rate[x].denominator",
                "min": 1,
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationAdministration.dosage.rate[x]:rateQuantity",
                "path": "MedicationAdministration.dosage.rate[x]",
                "sliceName": "rateQuantity",
                "short": "Verabreichungs-Rate",
                "comment": "Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "https://gematik.de/fhir/isik/StructureDefinition/MedicationQuantity"
                        ]
                    }
                ],
                "mustSupport": true
            }
        ]
    }
}

ISiKMedikationsVerabreichung

Constraints/Invarianten

Terminology-Bindings

Element	Staerke	ValueSet
MedicationAdministration.dosage.route.coding:EDQM	required	http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration
MedicationAdministration.dosage.route.coding:SNOMED-CT	required	https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration

Anmerkungen zu Must-Support-Feldern

Feldname	Kurzbeschreibung	Hinweise
MedicationAdministration.status	Status der Verabreichungsinformation	Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard
MedicationAdministration.medication[x]:medicationCodeableConcept	Medikament in codierter Form oder ggf. als Freitext	Begründung des Must-Support: Basisinformation Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.
MedicationAdministration.medication[x]:medicationCodeableConcept.coding
MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN
MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE
MedicationAdministration.medication[x]:medicationCodeableConcept.coding:SCT
MedicationAdministration.medication[x]:medicationReference	Referenz auf das Medikament (Medication-Ressource)	Begründung des Must-Support: Basisinformation Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen
MedicationAdministration.medication[x]:medicationReference.reference
MedicationAdministration.subject	Referenz auf den Patienten	Begründung des Must-Support: Basisinformation
MedicationAdministration.subject.reference
MedicationAdministration.context	Referenz auf den Abteilungskontakt	Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext
MedicationAdministration.context.reference
MedicationAdministration.effective[x]:effectiveDateTime	Zeitpunkt der Verabreichung	Begründung des Must-Support: Basisinformation Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der FHIR-Core Vorgabe) MUSS hier seitens eines bestätigungsrelevanten Systems unterstützt werden. Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden.
MedicationAdministration.effective[x]:effectivePeriod	Zeitraum der Verabreichung	Begründung des Must-Support: Basisinformation Festlegung zur Nutzung: eine Zeitpunkt-genaue Angabe (.effectiveDateTime oder .effectivePeriod auf Sekundenebene gemäß der FHIR-Core Vorgabe) MUSS hier seitens eines bestätigungsrelevanten Systems unterstützt werden. Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden.
MedicationAdministration.effective[x]:effectivePeriod.start
MedicationAdministration.effective[x]:effectivePeriod.end
MedicationAdministration.performer
MedicationAdministration.performer.actor	Referenz auf die verabreichende Person	Begründung des Must-Support: Nachvollziehbarkeit
MedicationAdministration.performer.actor.reference
MedicationAdministration.reasonCode	Grund der Medikation (Referenz)	Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.
MedicationAdministration.reasonReference	Grund der Medikation (Referenz)	Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.
MedicationAdministration.reasonReference.reference
MedicationAdministration.note
MedicationAdministration.note.text	Freitext-Notiz	Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein
MedicationAdministration.dosage	Dosierungsangaben	Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation
MedicationAdministration.dosage.text	Freitext-Dosierungsangabe	Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden. `Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten. Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem ISiK Basismodul: 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.'` `Zum Beispiel kann die textuelle Information '1L Infusion mit Rate 50ml/h' in eine entsprechende, strukturierte Form überführt werden - d.h. in die Angabe von 'dose' und 'rateQuantity'.`
MedicationAdministration.dosage.site	Körperstelle der Verabreichung
MedicationAdministration.dosage.site.coding
MedicationAdministration.dosage.site.coding:SNOMED-CT
MedicationAdministration.dosage.site.text
MedicationAdministration.dosage.route	Route
MedicationAdministration.dosage.route.coding
MedicationAdministration.dosage.route.coding:EDQM
MedicationAdministration.dosage.route.coding:SNOMED-CT
MedicationAdministration.dosage.route.text
MedicationAdministration.dosage.dose	verabreichte Dosis
MedicationAdministration.dosage.rate[x]:rateRatio	Verabreichungs-Rate (Verhältnis)	Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.
MedicationAdministration.dosage.rate[x]:rateRatio.numerator
MedicationAdministration.dosage.rate[x]:rateRatio.denominator
MedicationAdministration.dosage.rate[x]:rateQuantity	Verabreichungs-Rate	Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

Interaktionen

Interaktion	Verbindlichkeit
create	SHALL
read	SHALL
update	SHALL
search-type	SHALL

Parameter	Typ	Verbindlichkeit
_id	token	SHALL
code	token	SHALL
context	reference	SHALL
effective-time	date	SHALL
medication	reference	SHALL
patient	reference	SHALL
performer	reference	SHALL
status	token	SHALL

(Reverse-)Include

Include
MedicationAdministration:medication; MedicationAdministration:patient; MedicationAdministration:context; MedicationAdministration:performer

CapabilityStatements

Für die Ressource MedicationAdministration MÜSSEN die REST-Interaktionen "READ", "CREATE" und "UPDATE" implementiert werden.

Folgende Suchparameter sind für das Bestätigungsverfahren relevant, auch in Kombination:

Der Suchparameter "_id" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?_id=103270

Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "code" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?code=http://fhir.de/CodeSystem/bfarm/atc|V03AB23

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "context" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?context=Encounter/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "context.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?context.identifier=http://mein-krankenhaus.example/fhir/sid/fallnummern|7567867

GET [base]/MedicationAdministration?context.identifier=7567867

Use Case Zusammenhang: Um bei einem wiederkehrenden Patienten eine Verwechslung des Falls und damit eine falsche Verabreichung zu vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "effective-time" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?effective-time=2022-03-23

Anwendungshinweise: Weitere Informationen zur Suche nach Date-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Date".
Der Suchparameter "medication" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?medication=Medication/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "medication.code" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?medication.code=http://fhir.de/CodeSystem/bfarm/atc|V03AB23

Use Case Zusammenhang: Um eine Kontraindikation bei der Verabreichung auf Basis des Wirkstoffes zu vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "patient" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?patient=Patient/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "patient.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?patient.identifier=http://mein-krankenhaus.example/fhir/sid/patienten|1032702

GET [base]/MedicationAdministration?patient.identifier=1032702

Use Case Zusammenhang: Um bei der Verabreichung eine Verwechslung zwischen verschiedenen Patienten vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "performer" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?performer=Practitioner/101112

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "performer.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationAdministration?performer.identifier=http://fhir.de/sid/bundesaerztekammer/efn|123456789123456

GET [base]/MedicationAdministration?performer.identifier=123456789123456

Use Case Zusammenhang: Um mich als Heilberufler über die Historie meiner Medikationsverabreichungen zur informieren.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "status" MUSS unterstützt werden:

Beispiele:

GET [base]/MedicationRequest?status=completed

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Beispiele

ExampleISiKMedikationsVerabreichung

Einfache Einnahme:

MedicationAdministration

id : ExampleISiKMedikationsVerabreichung

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung

status : completed

medication

reference : Medication/ExampleISiKMedikament1

subject

reference : Patient/PatientinMusterfrau

context

reference : Encounter/Fachabteilungskontakt

effective : 2021-07-01

dosage

dose

value : 1

unit : Tablette

system : http://unitsofmeasure.org

code : 1

<MedicationAdministration xmlns="http://hl7.org/fhir">
    <id value="ExampleISiKMedikationsVerabreichung" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung" />
    </meta>
    <status value="completed" />
    <medicationReference>
        <reference value="Medication/ExampleISiKMedikament1" />
    </medicationReference>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <context>
        <reference value="Encounter/Fachabteilungskontakt" />
    </context>
    <effectiveDateTime value="2021-07-01" />
    <dosage>
        <dose>
            <value value="1" />
            <unit value="Tablette" />
            <system value="http://unitsofmeasure.org" />
            <code value="1" />
        </dose>
    </dosage>
</MedicationAdministration>

{
    "resourceType": "MedicationAdministration",
    "id": "ExampleISiKMedikationsVerabreichung",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung"
        ]
    },
    "dosage": {
        "dose": {
            "system": "http://unitsofmeasure.org",
            "value": 1,
            "unit": "Tablette",
            "code": "1"
        }
    },
    "status": "completed",
    "medicationReference": {
        "reference": "Medication/ExampleISiKMedikament1"
    },
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "context": {
        "reference": "Encounter/Fachabteilungskontakt"
    },
    "effectiveDateTime": "2021-07-01"
}

Medication administration for Patient/PatientinMusterfrau

ExampleISiKMedikationsVerabreichung2

Zytostatika-Infusion:

MedicationAdministration

id : ExampleISiKMedikationsVerabreichung2

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung

status : completed

medication

reference : Medication/ExampleISiKMedikament9

subject

reference : Patient/PatientinMusterfrau

context

reference : Encounter/Fachabteilungskontakt

effective : 2024-01-22

dosage

dose

value : 1

unit : Beutel

system : http://unitsofmeasure.org

code : 1

<MedicationAdministration xmlns="http://hl7.org/fhir">
    <id value="ExampleISiKMedikationsVerabreichung2" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung" />
    </meta>
    <status value="completed" />
    <medicationReference>
        <reference value="Medication/ExampleISiKMedikament9" />
    </medicationReference>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <context>
        <reference value="Encounter/Fachabteilungskontakt" />
    </context>
    <effectiveDateTime value="2024-01-22" />
    <dosage>
        <dose>
            <value value="1" />
            <unit value="Beutel" />
            <system value="http://unitsofmeasure.org" />
            <code value="1" />
        </dose>
    </dosage>
</MedicationAdministration>

{
    "resourceType": "MedicationAdministration",
    "id": "ExampleISiKMedikationsVerabreichung2",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung"
        ]
    },
    "dosage": {
        "dose": {
            "system": "http://unitsofmeasure.org",
            "value": 1,
            "unit": "Beutel",
            "code": "1"
        }
    },
    "status": "completed",
    "medicationReference": {
        "reference": "Medication/ExampleISiKMedikament9"
    },
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "context": {
        "reference": "Encounter/Fachabteilungskontakt"
    },
    "effectiveDateTime": "2024-01-22"
}

Medication administration for Patient/PatientinMusterfrau

ExampleISiKMedikationsVerabreichung3

Verabreichung einer Infusion mit Angabe der Dosierungs-Rate in zwei Varianten (Quantity und Ratio):

MedicationAdministration

id : ExampleISiKMedikationsVerabreichung3

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung

status : completed

medication

reference : Medication/ExampleISiKMedikament9

subject

reference : Patient/PatientinMusterfrau

context

reference : Encounter/Fachabteilungskontakt

identifier

value : 0123456789

effective : 2021-07-01

note

text : Testnotiz

dosage

text : 1L Infusion mit Rate 50ml/h

site

coding

system : http://snomed.info/sct

code : 6073002

display : Structure of ligament of left superior vena cava

route

coding

system : http://standardterms.edqm.eu

code : 20045000

display : Intravenous use

dose

value : 1000

unit : mL

system : http://unitsofmeasure.org

code : mL

rate

value : 50

unit : mL/h

system : http://unitsofmeasure.org

code : mL/h

<MedicationAdministration xmlns="http://hl7.org/fhir">
    <id value="ExampleISiKMedikationsVerabreichung3" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung" />
    </meta>
    <status value="completed" />
    <medicationReference>
        <reference value="Medication/ExampleISiKMedikament9" />
    </medicationReference>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <context>
        <reference value="Encounter/Fachabteilungskontakt" />
        <identifier>
            <value value="0123456789" />
        </identifier>
    </context>
    <effectiveDateTime value="2021-07-01" />
    <note>
        <text value="Testnotiz" />
    </note>
    <dosage>
        <text value="1L Infusion mit Rate 50ml/h" />
        <site>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="6073002" />
                <display value="Structure of ligament of left superior vena cava" />
            </coding>
        </site>
        <route>
            <coding>
                <system value="http://standardterms.edqm.eu" />
                <code value="20045000" />
                <display value="Intravenous use" />
            </coding>
        </route>
        <dose>
            <value value="1000" />
            <unit value="mL" />
            <system value="http://unitsofmeasure.org" />
            <code value="mL" />
        </dose>
        <rateQuantity>
            <value value="50" />
            <unit value="mL/h" />
            <system value="http://unitsofmeasure.org" />
            <code value="mL/h" />
        </rateQuantity>
    </dosage>
</MedicationAdministration>

{
    "resourceType": "MedicationAdministration",
    "id": "ExampleISiKMedikationsVerabreichung3",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung"
        ]
    },
    "dosage": {
        "dose": {
            "system": "http://unitsofmeasure.org",
            "value": 1000,
            "unit": "mL",
            "code": "mL"
        },
        "rateQuantity": {
            "system": "http://unitsofmeasure.org",
            "value": 50,
            "unit": "mL/h",
            "code": "mL/h"
        },
        "text": "1L Infusion mit Rate 50ml/h",
        "site": {
            "coding":  [
                {
                    "code": "6073002",
                    "system": "http://snomed.info/sct",
                    "display": "Structure of ligament of left superior vena cava"
                }
            ]
        },
        "route": {
            "coding":  [
                {
                    "code": "20045000",
                    "system": "http://standardterms.edqm.eu",
                    "display": "Intravenous use"
                }
            ]
        }
    },
    "status": "completed",
    "medicationReference": {
        "reference": "Medication/ExampleISiKMedikament9"
    },
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "context": {
        "reference": "Encounter/Fachabteilungskontakt",
        "identifier": {
            "value": "0123456789"
        }
    },
    "effectiveDateTime": "2021-07-01",
    "note":  [
        {
            "text": "Testnotiz"
        }
    ]
}

Medication administration for Patient/PatientinMusterfrau

ExampleISiKMedikationsVerabreichung4

MedicationAdministration

id : ExampleISiKMedikationsVerabreichung4

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung

status : completed

medication

reference : Medication/ExampleISiKMedikament2

subject

reference : Patient/PatientinMusterfrau

context

reference : Encounter/Fachabteilungskontakt

identifier

value : 0123456789

effective : 2021-07-01

note

text : Testnotiz

dosage

text : 1L Infusion mit Rate 50ml/h

site

coding

system : http://snomed.info/sct

code : 6073002

display : Structure of ligament of left superior vena cava

route

coding

system : http://standardterms.edqm.eu

code : 20045000

display : Intravenous use

dose

value : 1000

unit : mL

system : http://unitsofmeasure.org

code : mL

rate

numerator

value : 50

unit : mL

system : http://unitsofmeasure.org

code : mL

denominator

value : 1

unit : h

system : http://unitsofmeasure.org

code : h

<MedicationAdministration xmlns="http://hl7.org/fhir">
    <id value="ExampleISiKMedikationsVerabreichung4" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung" />
    </meta>
    <status value="completed" />
    <medicationReference>
        <reference value="Medication/ExampleISiKMedikament2" />
    </medicationReference>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <context>
        <reference value="Encounter/Fachabteilungskontakt" />
        <identifier>
            <value value="0123456789" />
        </identifier>
    </context>
    <effectiveDateTime value="2021-07-01" />
    <note>
        <text value="Testnotiz" />
    </note>
    <dosage>
        <text value="1L Infusion mit Rate 50ml/h" />
        <site>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="6073002" />
                <display value="Structure of ligament of left superior vena cava" />
            </coding>
        </site>
        <route>
            <coding>
                <system value="http://standardterms.edqm.eu" />
                <code value="20045000" />
                <display value="Intravenous use" />
            </coding>
        </route>
        <dose>
            <value value="1000" />
            <unit value="mL" />
            <system value="http://unitsofmeasure.org" />
            <code value="mL" />
        </dose>
        <rateRatio>
            <numerator>
                <value value="50" />
                <unit value="mL" />
                <system value="http://unitsofmeasure.org" />
                <code value="mL" />
            </numerator>
            <denominator>
                <value value="1" />
                <unit value="h" />
                <system value="http://unitsofmeasure.org" />
                <code value="h" />
            </denominator>
        </rateRatio>
    </dosage>
</MedicationAdministration>

{
    "resourceType": "MedicationAdministration",
    "id": "ExampleISiKMedikationsVerabreichung4",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsVerabreichung"
        ]
    },
    "dosage": {
        "dose": {
            "system": "http://unitsofmeasure.org",
            "value": 1000,
            "unit": "mL",
            "code": "mL"
        },
        "rateRatio": {
            "numerator": {
                "system": "http://unitsofmeasure.org",
                "value": 50,
                "unit": "mL",
                "code": "mL"
            },
            "denominator": {
                "system": "http://unitsofmeasure.org",
                "value": 1,
                "unit": "h",
                "code": "h"
            }
        },
        "text": "1L Infusion mit Rate 50ml/h",
        "site": {
            "coding":  [
                {
                    "code": "6073002",
                    "system": "http://snomed.info/sct",
                    "display": "Structure of ligament of left superior vena cava"
                }
            ]
        },
        "route": {
            "coding":  [
                {
                    "code": "20045000",
                    "system": "http://standardterms.edqm.eu",
                    "display": "Intravenous use"
                }
            ]
        }
    },
    "status": "completed",
    "medicationReference": {
        "reference": "Medication/ExampleISiKMedikament2"
    },
    "subject": {
        "reference": "Patient/PatientinMusterfrau"
    },
    "context": {
        "reference": "Encounter/Fachabteilungskontakt",
        "identifier": {
            "value": "0123456789"
        }
    },
    "effectiveDateTime": "2021-07-01",
    "note":  [
        {
            "text": "Testnotiz"
        }
    ]
}

Medication administration for Patient/PatientinMusterfrau