Implementierungsleitfaden ISiK-Medikation

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

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

MedicationAdministration Category Codes (preferred)

Binding

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

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]

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.

Slicing

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

Element id

MedicationAdministration.medication[x]:medicationCodeableConcept

Short description

Medikament in codierter Form oder ggf. als Freitext

Definition

Comments

Begründung des Must-Support: Basisinformation

Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.

Data type

SNOMEDCTMedicationCodes (example)

Binding

Codes identifying substance or product that can be administered.

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]

0..1

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

Mappings

rim: n/a

extension

0..*

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

Data type

Slicing

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..*

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

Slicing

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: C*E.1-8, C*E.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

Conditions

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

Constraints

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

Pattern

{
  "system": "http://fhir.de/CodeSystem/ifa/pzn"
}

Mappings

v2: C*E.1-8, C*E.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

Conditions

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

Constraints

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

Pattern

{
  "system": "http://fhir.de/CodeSystem/bfarm/atc"
}

Mappings

v2: C*E.1-8, C*E.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

Conditions

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

Constraints

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

Pattern

{
  "system": "http://snomed.info/sct"
}

Mappings

v2: C*E.1-8, C*E.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

0..1

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

Constraints

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

Mappings

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

medicationReference

S Σ

0..1

Reference(Medication)

Element id

MedicationAdministration.medication[x]:medicationReference

Short description

Referenz auf das Medikament (Medication-Ressource)

Definition

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]

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

1..1

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

Conditions

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

Constraints

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

Mappings

rim: N/A

type

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

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

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

Mappings

rim: N/A

identifier

0..1

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

Constraints

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

Mappings

rim: .identifier

display

0..1

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

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.subject.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

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

Constraints

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

Mappings

rim: N/A

type

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.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

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

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.subject.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

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

Mappings

rim: .identifier

display

0..1

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

Constraints

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

Mappings

rim: N/A

context

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"]

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.context.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

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

Constraints

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

Mappings

rim: N/A

type

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.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

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

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.context.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

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

Mappings

rim: .identifier

display

0..1

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

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]

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.

Slicing

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

Element id

MedicationAdministration.effective[x]:effectiveDateTime

Short description

Zeitpunkt der Verabreichung

Definition

Comments

Begründung des Must-Support: Basisinformation

Für grobgranularere Angaben (z.B. nur Jahr, Monat oder Tag) SOLL das Profil ISiKMedikationsInformation (MedicationStatement) verwendet werden.

Data 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

effectivePeriod

S Σ

0..1

Period

Element id

MedicationAdministration.effective[x]:effectivePeriod

Short description

Zeitraum der Verabreichung

Definition

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

0..1

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

Conditions

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

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 C

0..1

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

Conditions

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

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..*

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

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]

0..1

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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

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 ?! C

0..*

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

Comments

Data type

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

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

MedicationAdministration Performer Function Codes (example)

Binding

A code describing the role an individual played in administering the medication.

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.performer.actor.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

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

Constraints

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

Mappings

rim: N/A

type

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.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

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

Mappings

rim: N/A

identifier

0..1

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

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

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

Mappings

rim: .identifier

display

0..1

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

Constraints

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

Mappings

rim: N/A

reasonCode

0..*

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

ReasonMedicationGivenCodes (example)

Binding

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

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

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

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

1..1

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonReference.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

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

Constraints

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

Mappings

rim: N/A

type

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.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

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

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationAdministration.reasonReference.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

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

Mappings

rim: .identifier

display

0..1

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

Reference(MedicationRequest)

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

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

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

0..1

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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationAdministration.note.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

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]

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

There are no (further) constraints on this element

Data type

authorReference

Reference(Practitioner | Patient | RelatedPerson | Organization)

There are no (further) constraints on this element

Data type

Reference(Practitioner | Patient | RelatedPerson | Organization)

time

0..1

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

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 C

0..1

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

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

0..1

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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

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 ?! C

0..*

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

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

0..1

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

Constraints

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

Mappings

rim: .text

site

0..1

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

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)

Binding

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

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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..*

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

Data type

Slicing

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: C*E.1-8, C*E.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

Conditions

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

Constraints

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

Pattern

{
  "system": "http://snomed.info/sct"
}

Mappings

v2: C*E.1-8, C*E.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

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

Comments

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

Data type

Constraints

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

Mappings

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

route

0..1

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

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

0..1

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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

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..*

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

Data type

MedicineRouteOfAdministrationUvIps (required)

Slicing

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: C*E.1-8, C*E.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

Conditions

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

Constraints

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

Pattern

{
  "system": "http://standardterms.edqm.eu"
}

Mappings

v2: C*E.1-8, C*E.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)

Conditions

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

Constraints

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

Pattern

{
  "system": "http://snomed.info/sct"
}

Mappings

v2: C*E.1-8, C*E.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

There are no (further) constraints on this element

Element id

MedicationAdministration.dosage.route.text

Short description

Plain text representation of the concept

Definition

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

Requirements

Comments

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

Data type

Constraints

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

Mappings

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

method

0..1

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

SNOMEDCTAdministrationMethodCodes (example)

Binding

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

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 C

0..1

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

Conditions

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

Constraints

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

Slicing

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

0..1

Ratio

Element id

MedicationAdministration.dosage.rate[x]:rateRatio

Short description

Verabreichungs-Rate (Verhältnis)

Definition

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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 C

1..1

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

Conditions

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() 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 C

1..1

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

Conditions

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() 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 C

0..1

Element id

MedicationAdministration.dosage.rate[x]:rateQuantity

Short description

Verabreichungs-Rate

Definition

The comparator is not used on a SimpleQuantity

Comments

Data type

Conditions

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() 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]

<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="2025-04-08" />
<publisher value="gematik GmbH" />
<description value="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 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="Begründung 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="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="MedicationAdministration.medication[x]:medicationCodeableConcept">
<path value="MedicationAdministration.medication[x]" />
<sliceName value="medicationCodeableConcept" />
<short value="Medikament in codierter Form oder ggf. als Freitext" />
<comment value="Begründung des Must-Support: Basisinformation\n\n  Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren." />
<min value="0" />
<max value="1" />
<type>
<code value="CodeableConcept" />
</type>
<mustSupport value="true" />
</element>
<element id="MedicationAdministration.medication[x]:medicationCodeableConcept.coding">
<path value="MedicationAdministration.medication[x].coding" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="$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="Begründung 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="Begründung 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="Begründung 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="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." />
<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="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." />
<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="Begründung 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 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 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 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 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="Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein" />
<mustSupport value="true" />
</element>
<element id="MedicationAdministration.dosage">
<path value="MedicationAdministration.dosage" />
<short value="Dosierungsangaben" />
<comment value="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 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 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 value="true" />
</element>
<element id="MedicationAdministration.dosage.site">
<path value="MedicationAdministration.dosage.site" />
<short value="Körperstelle 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 (Verhältnis)" />
<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 können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können." />
<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 können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können." />
<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": "2025-04-08",
"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.",
"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.",
"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

<meta>

</meta>

</medicationReference>

</subject>

</context>

<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",

Medication administration for Patient/PatientinMusterfrau

"reference": "Medication/ExampleISiKMedikament1"

"subject": {

"reference": "Patient/PatientinMusterfrau"

"context": {

"reference": "Encounter/Fachabteilungskontakt"

"effectiveDateTime": "2021-07-01"

}

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

<meta>

</meta>

</medicationReference>

</subject>

</context>

<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",

Medication administration for Patient/PatientinMusterfrau

"reference": "Medication/ExampleISiKMedikament9"

"subject": {

"reference": "Patient/PatientinMusterfrau"

"context": {

"reference": "Encounter/Fachabteilungskontakt"

"effectiveDateTime": "2024-01-22"

}

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

<meta>

</meta>

</medicationReference>

</subject>

</identifier>

</context>

<note>

</note>

<site>

<system value="http://snomed.info/sct" />
<code value="6073002" />
<display value="Structure of ligament of left superior vena cava" />

</coding>

</site>

<route>

<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>

<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",

Medication administration for Patient/PatientinMusterfrau

"reference": "Medication/ExampleISiKMedikament9"

"subject": {

"reference": "Patient/PatientinMusterfrau"

"context": {

"reference": "Encounter/Fachabteilungskontakt",

"identifier": {

"value": "0123456789"

}

"effectiveDateTime": "2021-07-01",

"note": [

{

"text": "Testnotiz"

}

]

}

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

<meta>

</meta>

</medicationReference>

</subject>

</identifier>

</context>

<note>

</note>

<site>

<system value="http://snomed.info/sct" />
<code value="6073002" />
<display value="Structure of ligament of left superior vena cava" />

</coding>

</site>

<route>

<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>

<value value="50" />
<unit value="mL" />
<system value="http://unitsofmeasure.org" />
<code value="mL" />

</numerator>

<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",