MII IG Medikation v2025

Extension: Wirkstofftyp

MII EX Medikation Wirkstofftyp

Beschreibung

Durch die Extension KANN bei der Berechnung der Dosisangaben zwischen dem genauen Wirkstoff (der ein Salz, Ester etc. sein kann) und dem reinen Wirkstoff unterschieden werden, um anzugeben, ob die Berechnung auf dem Derivat (seltener) oder der reinen/"allgemeinen" Substanz (meist) beruht. Aus diesem Grund wurde eine Extension definiert, welche zusätzlich zur Wirkstoffcodierung angegeben werden KANN. Diese Extension verweist auf ein ValueSet mit Codes für:

IN (ingredient - allgemeiner Wirkstoff),
PIN (precise ingredient - genauer Wirkstoff),
oder MIN (multiple ingredients - Kombinationscode für mehrere Wirkstoffe).

Siehe auch Terminologien

Name	Status	Version	Lizenz	Canonical	Basis
MII_EX_Medikation_Wirkstofftyp	active	2025.0.0	CC-BY-4.0	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp	http://hl7.org/fhir/StructureDefinition/Extension

Inhalt

MII_EX_Medikation_Wirkstofftyp (Extension)	I		Extension	There are no (further) constraints on this element Element id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Extension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding MII_VS_Medikation_Wirkstofftyp (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCoding			Coding	Data type Coding
id		0..1	string	There are no (further) constraints on this element Element id Extension.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Extension.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Extension.value[x].version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Extension.value[x].code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Extension.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Extension.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

Extension zur Differenzierung des Wirkstofftyps in allgemeinen, genauen oder Kombinationswirkstoff.

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="mii-ex-medikation-wirkstofftyp" />
    <extension url="https://www.medizininformatik-initiative.de/fhir/modul-meta/StructureDefinition/mii-ex-meta-license-codeable">
        <valueCodeableConcept>
            <coding>
                <system value="http://hl7.org/fhir/spdx-license" />
                <code value="CC-BY-4.0" />
                <display value="Creative Commons Attribution 4.0 International" />
            </coding>
        </valueCodeableConcept>
    </extension>
    <url value="https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp" />
    <version value="2025.0.0" />
    <name value="MII_EX_Medikation_Wirkstofftyp">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="MII_EX_Medikation_IngredientType" />
            </extension>
        </extension>
    </name>
    <title value="MII EX Medikation Wirkstofftyp">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="MII EX Medikation Ingredient Type" />
            </extension>
        </extension>
    </title>
    <status value="active" />
    <experimental value="false" />
    <date value="2024-11-14" />
    <publisher value="Medizininformatik Initiative" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="https://www.medizininformatik-initiative.de" />
        </telecom>
    </contact>
    <description value="Extension zur Differenzierung des Wirkstofftyps in allgemeinen, genauen oder Kombinationswirkstoff.">
        <extension url="http://hl7.org/fhir/StructureDefinition/translation">
            <extension url="lang">
                <valueCode value="en-US" />
            </extension>
            <extension url="content">
                <valueString value="Extension to differentiate the type of ingredient into general, exact or combination ingredient." />
            </extension>
        </extension>
    </description>
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Medication.ingredient" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension.extension">
            <path value="Extension.extension" />
            <max value="0" />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <min value="1" />
            <type>
                <code value="Coding" />
            </type>
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/ValueSet/wirkstofftyp" />
            </binding>
        </element>
        <element id="Extension.value[x].system">
            <path value="Extension.value[x].system" />
            <min value="1" />
            <fixedUri value="https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp" />
        </element>
        <element id="Extension.value[x].code">
            <path value="Extension.value[x].code" />
            <min value="1" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "mii-ex-medikation-wirkstofftyp",
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/modul-meta/StructureDefinition/mii-ex-meta-license-codeable",
            "valueCodeableConcept": {
                "coding":  [
                    {
                        "code": "CC-BY-4.0",
                        "system": "http://hl7.org/fhir/spdx-license",
                        "display": "Creative Commons Attribution 4.0 International"
                    }
                ]
            }
        }
    ],
    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp",
    "version": "2025.0.0",
    "name": "MII_EX_Medikation_Wirkstofftyp",
    "_name": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "MII_EX_Medikation_IngredientType"
                    }
                ]
            }
        ]
    },
    "title": "MII EX Medikation Wirkstofftyp",
    "_title": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "MII EX Medikation Ingredient Type"
                    }
                ]
            }
        ]
    },
    "status": "active",
    "experimental": false,
    "date": "2024-11-14",
    "publisher": "Medizininformatik Initiative",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "https://www.medizininformatik-initiative.de"
                }
            ]
        }
    ],
    "description": "Extension zur Differenzierung des Wirkstofftyps in allgemeinen, genauen oder Kombinationswirkstoff.",
    "_description": {
        "extension":  [
            {
                "url": "http://hl7.org/fhir/StructureDefinition/translation",
                "extension":  [
                    {
                        "url": "lang",
                        "valueCode": "en-US"
                    },
                    {
                        "url": "content",
                        "valueString": "Extension to differentiate the type of ingredient into general, exact or combination ingredient."
                    }
                ]
            }
        ]
    },
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Medication.ingredient"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension.extension",
                "path": "Extension.extension",
                "max": "0"
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/ValueSet/wirkstofftyp"
                }
            },
            {
                "id": "Extension.value[x].system",
                "path": "Extension.value[x].system",
                "min": 1,
                "fixedUri": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp"
            },
            {
                "id": "Extension.value[x].code",
                "path": "Extension.value[x].code",
                "min": 1
            }
        ]
    }
}

MII EX Medikation Wirkstofftyp

Beispiele

Beispiel

Beispiel Medication-Ressource mit Liste von Wirkstoffen in Medication.ingredient und Klassifizierung jedes Wirkstofftyps mittels Extension:

{
    "resourceType": "Medication",
    "id": "mii-exa-medikation-medication-calcium",
    "meta": {
        "security":  [
            {
                "code": "HTEST",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
                "display": "test health data"
            }
        ],
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/Medication"
        ]
    },
    "code": {
        "coding":  [
            {
                "code": "00169644",
                "system": "http://fhir.de/CodeSystem/ifa/pzn",
                "display": "CALCIUM SANDOZ forte Brausetabletten"
            },
            {
                "code": "A12AA20",
                "system": "http://fhir.de/CodeSystem/bfarm/atc",
                "version": "2023",
                "display": "Calcium (verschiedene Salze in Kombination)"
            },
            {
                "code": "A12AA20",
                "system": "http://www.whocc.no/atc",
                "version": "2023",
                "display": "calcium (different salts in combination)"
            }
        ]
    },
    "form": {
        "coding":  [
            {
                "code": "10222000",
                "system": "http://standardterms.edqm.eu",
                "display": "Effervescent tablet"
            }
        ]
    },
    "ingredient":  [
        {
            "id": "ing_1",
            "extension":  [
                {
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp",
                    "valueCoding": {
                        "code": "PIN",
                        "system": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp"
                    }
                }
            ],
            "itemCodeableConcept": {
                "coding":  [
                    {
                        "code": "472LWJ3Y9N",
                        "system": "http://fdasis.nlm.nih.gov",
                        "display": "CALCIUM LACTATE GLUCONATE"
                    },
                    {
                        "code": "11116-97-5",
                        "system": "http://terminology.hl7.org/CodeSystem/CAS",
                        "display": "Calcium lactate gluconate"
                    },
                    {
                        "code": "422232005",
                        "system": "http://snomed.info/sct",
                        "version": "http://snomed.info/sct/900000000000207008/version/20230731",
                        "display": "Calcium lactate gluconate (substance)"
                    }
                ]
            },
            "strength": {
                "numerator": {
                    "value": 2945.15,
                    "code": "mg",
                    "system": "http://unitsofmeasure.org",
                    "unit": "milligram"
                },
                "denominator": {
                    "value": 1,
                    "code": "10222000",
                    "system": "http://standardterms.edqm.eu",
                    "unit": "Effervescent tablet"
                }
            }
        },
        {
            "id": "ing_2",
            "extension":  [
                {
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp",
                    "valueCoding": {
                        "code": "PIN",
                        "system": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp"
                    }
                }
            ],
            "itemCodeableConcept": {
                "coding":  [
                    {
                        "code": "H0G9379FGK",
                        "system": "http://fdasis.nlm.nih.gov",
                        "display": "CALCIUM CARBONATE"
                    },
                    {
                        "code": "471-34-1",
                        "system": "http://terminology.hl7.org/CodeSystem/CAS",
                        "display": "Calcium carbonate"
                    },
                    {
                        "code": "387307005",
                        "system": "http://snomed.info/sct",
                        "version": "http://snomed.info/sct/900000000000207008/version/20230731",
                        "display": "Calcium carbonate (substance)"
                    }
                ]
            },
            "strength": {
                "numerator": {
                    "value": 300,
                    "code": "mg",
                    "system": "http://unitsofmeasure.org",
                    "unit": "milligram"
                },
                "denominator": {
                    "value": 1,
                    "code": "10222000",
                    "system": "http://standardterms.edqm.eu",
                    "unit": "Effervescent tablet"
                }
            }
        },
        {
            "id": "ing_3",
            "extension":  [
                {
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp",
                    "valueCoding": {
                        "code": "IN",
                        "system": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp"
                    }
                },
                {
                    "extension":  [
                        {
                            "url": "ingredientUri",
                            "valueUri": "#ing_1"
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstoffrelation"
                },
                {
                    "extension":  [
                        {
                            "url": "ingredientUri",
                            "valueUri": "#ing_2"
                        }
                    ],
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstoffrelation"
                }
            ],
            "itemCodeableConcept": {
                "coding":  [
                    {
                        "code": "2M83C4R6ZB",
                        "system": "http://fdasis.nlm.nih.gov",
                        "display": "CALCIUM CATION"
                    },
                    {
                        "code": "14127-61-8",
                        "system": "http://terminology.hl7.org/CodeSystem/CAS",
                        "display": "Calcium cation"
                    },
                    {
                        "code": "5540006",
                        "system": "http://snomed.info/sct",
                        "version": "http://snomed.info/sct/900000000000207008/version/20230731",
                        "display": "Calcium (substance)"
                    }
                ]
            },
            "strength": {
                "numerator": {
                    "value": 500.54,
                    "code": "mg",
                    "system": "http://unitsofmeasure.org",
                    "unit": "milligram"
                },
                "denominator": {
                    "value": 1,
                    "code": "10222000",
                    "system": "http://standardterms.edqm.eu",
                    "unit": "Effervescent tablet"
                }
            }
        }
    ]
}