<status value="active" /> <publisher value="Nictiz" /> <contact> <name value="Nictiz" /> <telecom> <system value="url" /> <value value="https://www.nictiz.nl" /> <use value="work" /> </telecom> </contact> <description value="An administration agreement contains the instructions for the use or administration of medication given by the supplier to the patient, their representative or administrator. With this, the medication agreement is specified in concrete terms." /> <purpose value="This MedicationDispense resource represents the AdministrationAgreement building block for implementations following the information standard [MP9](https://informatiestandaarden.nictiz.nl/wiki/Landingspagina_Medicatieproces). This profile is based on the Dutch zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) AdministrationAgreement, but has no dependency on the corresponding nl-core profile because it contains non-compatible changes. Where compatible, mappings to zib concepts are defined. Additional concepts or concepts that are not compatible with their zib counterparts contain a mapping to the MP9 data set." /> <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." /> <fhirVersion value="4.0.1" /> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <uri value="https://zibs.nl/wiki/AdministrationAgreement-v1.0.3(2020EN)" /> <name value="zib AdministrationAgreement-v1.0.3(2020EN)" /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <uri value="https://zibs.nl/wiki/InstructionsForUse-v1.2.1(2020EN)" /> <name value="zib InstructionsForUse-v1.2.1(2020EN)" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <uri value="https://decor.nictiz.nl/pub/medicatieproces/mp-html-20250522T132618/ds-2.16.840.1.113883.2.4.3.11.60.20.77.1.4-2022-06-30T000000.html" /> <name value="ART-DECOR Dataset MP9 3.0.0-rc.1 20250522" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <uri value="https://decor.nictiz.nl/pub/medicatieproces/mp-html-20260213T112547/ds-2.16.840.1.113883.2.4.3.11.60.20.77.1.4-2022-06-30T000000.html" /> <name value="ART-DECOR Dataset MP9 3.0.0-rc.2 20260213" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="MedicationDispense" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" /> <derivation value="constraint" /> <differential> <element id="MedicationDispense"> <path value="MedicationDispense" /> <short value="AdministrationAgreement" /> <alias value="Toedieningsafspraak" /> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.20132" /> <comment value="AdministrationAgreement" /> </mapping> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22098" /> <comment value="InstructionsForUse" /> </mapping> </element> <element id="MedicationDispense.extension:additionalInformation"> <path value="MedicationDispense.extension" /> <sliceName value="additionalInformation" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-AdministrationAgreement.AdditionalInformation" /> </type> </element> <element id="MedicationDispense.extension:additionalInformation.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-342" /> <comment value="AdministrationAgreementAdditionalInformation" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-342" /> <comment value="AdministrationAgreementAdditionalInformation" /> </mapping> </element> <element id="MedicationDispense.extension:reasonModificationOrDiscontinuation"> <path value="MedicationDispense.extension" /> <sliceName value="reasonModificationOrDiscontinuation" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-AdministrationAgreement.ReasonModificationOrDiscontinuation" /> </type> </element> <element id="MedicationDispense.extension:reasonModificationOrDiscontinuation.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-333" /> <comment value="AdministrationAgreementReasonModificationOrDiscontinuation" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-333" /> <comment value="AdministrationAgreementReasonModificationOrDiscontinuation" /> </mapping> </element> <element id="MedicationDispense.extension:administrationAgreementDateTime"> <path value="MedicationDispense.extension" /> <sliceName value="administrationAgreementDateTime" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-AdministrationAgreement.AdministrationAgreementDateTime" /> </type> </element> <element id="MedicationDispense.extension:administrationAgreementDateTime.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.20133" /> <comment value="AdministrationAgreementDateTime" /> </mapping> </element> <element id="MedicationDispense.extension:renderedDosageInstruction"> <path value="MedicationDispense.extension" /> <sliceName value="renderedDosageInstruction" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction" /> </type> </element> <element id="MedicationDispense.extension:renderedDosageInstruction.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.9581" /> <comment value="Description" /> </mapping> </element> <element id="MedicationDispense.extension:periodOfUse"> <path value="MedicationDispense.extension" /> <sliceName value="periodOfUse" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TimeInterval.Period" /> </type> </element> <element id="MedicationDispense.extension:periodOfUse.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <short value="PeriodOfUse" /> <definition value="**Start date**: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original administration agreement. The end date indicates from when the medication is to be discontinued. **Duration**: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days. **End date**: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date. With medication for an indefinite period only a start date is indicated." /> <alias value="Gebruiksperiode" /> <type> <code value="Period" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-TimeInterval" /> </type> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22660" /> <comment value="PeriodOfUse" /> </mapping> </element> <element id="MedicationDispense.extension:periodOfUse.value[x].extension:condition"> <path value="MedicationDispense.extension.value[x].extension" /> <sliceName value="condition" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-PeriodOfUse.Condition" /> </type> <isModifier value="false" /> </element> <element id="MedicationDispense.extension:periodOfUse.value[x].extension:condition.value[x]"> <path value="MedicationDispense.extension.value[x].extension.value[x]" /> <definition value="Element to indicate that the start or end date is uncertain. In certain situations the start or end date can depend on another piece of information. This is, for example, the case when a patient has to start or stop medication a few days before hospital admission. In that case this element is used to indicate (in free text): ‘start X days before hospital admission’ or ‘stop X days before hospital admission’. By doing this, it is clear that the entered start or end date is uncertain when the AdministrationAgreement is being exchanged." /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1484" /> <comment value="Condition" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1484" /> <comment value="Condition" /> </mapping> </element> <element id="MedicationDispense.extension:copyIndicator"> <path value="MedicationDispense.extension" /> <sliceName value="copyIndicator" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-CopyIndicator" /> </type> </element> <element id="MedicationDispense.extension:copyIndicator.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-345" /> <comment value="CopyIndicator" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-345" /> <comment value="CopyIndicator" /> </mapping> </element> <element id="MedicationDispense.extension:pharmaceuticalTreatmentIdentifier"> <path value="MedicationDispense.extension" /> <sliceName value="pharmaceuticalTreatmentIdentifier" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier" /> </type> </element> <element id="MedicationDispense.extension:pharmaceuticalTreatmentIdentifier.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-42" /> <comment value="Identification" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-42" /> <comment value="Identification" /> </mapping> </element> <element id="MedicationDispense.extension:distributionForm"> <path value="MedicationDispense.extension" /> <sliceName value="distributionForm" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-MedicationDispense.DistributionForm" /> </type> </element> <element id="MedicationDispense.extension:distributionForm.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1371" /> <comment value="DistributionForm" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1371" /> <comment value="DistributionForm" /> </mapping> </element> <element id="MedicationDispense.extension:relationAdministrationAgreement"> <path value="MedicationDispense.extension" /> <sliceName value="relationAdministrationAgreement" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-RelationAdministrationAgreement" /> </type> </element> <element id="MedicationDispense.extension:relationAdministrationAgreement.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1380" /> <comment value="RelationAdministrationAgreement" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1380" /> <comment value="RelationAdministrationAgreement" /> </mapping> </element> <element id="MedicationDispense.extension:registrationDateTime"> <path value="MedicationDispense.extension" /> <sliceName value="registrationDateTime" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-RegistrationDateTime" /> </type> </element> <element id="MedicationDispense.extension:registrationDateTime.value[x]"> <path value="MedicationDispense.extension.value[x]" /> <definition value="The date and time when the AdministrationAgreement was recorded. RegistrationDateTime is used to accurately determine the chronological order of agreements. Therefore, the date and time are mandatory. These values are immutable. When consulting or receiving this AdministrationAgreement, the original RegistrationDateTime remains unchanged. Note: This data element differs from the data element RegistrationDateTime in zib RegistratieGegevens-v1.1.1 (2024NL). In zib RegistratieGegevens-v1.1.1 (2024NL), RegistrationDateTime refers to the date and time when the data was recorded. This may be the initial registration or the date and time when data was transferred. The zib concept RegistrationDateTime is not applied in MP9." /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1481" /> <comment value="RegistrationDateTime" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1481" /> <comment value="RegistrationDateTime" /> </mapping> </element> <element id="MedicationDispense.modifierExtension:stopType"> <path value="MedicationDispense.modifierExtension" /> <sliceName value="stopType" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-StopType" /> </type> </element> <element id="MedicationDispense.modifierExtension:stopType.value[x]"> <path value="MedicationDispense.modifierExtension.value[x]" /> <short value="AdministrationAgreementStopType" /> <alias value="ToedieningsafspraakStopType" /> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22498" /> <comment value="AdministrationAgreementStopType [DEPRECATED]" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-340" /> <comment value="AdministrationAgreementStopType" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-340" /> <comment value="AdministrationAgreementStopType" /> </mapping> </element> <element id="MedicationDispense.modifierExtension:repeatPeriodCyclicalSchedule"> <path value="MedicationDispense.modifierExtension" /> <sliceName value="repeatPeriodCyclicalSchedule" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule" /> </type> </element> <element id="MedicationDispense.modifierExtension:repeatPeriodCyclicalSchedule.value[x]"> <path value="MedicationDispense.modifierExtension.value[x]" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22505" /> <comment value="RepeatPeriodCyclicalSchedule" /> </mapping> </element> <element id="MedicationDispense.identifier"> <path value="MedicationDispense.identifier" /> <short value="Identification" /> <alias value="Identificatie" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-344" /> <comment value="Identification" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-344" /> <comment value="Identification" /> </mapping> </element> <element id="MedicationDispense.status"> <path value="MedicationDispense.status" /> <definition value="A code specifying the state of the set of dispense events. In the event of an error correction, the value is set to _entered-in-error_." /> <comment value="The AdministrationAgreement building block does not provide much information on the logistical status as is intended by the ValueSet binding on this element. Therefore, if a system is unable to infer the status, `.status` will usually be set to _unknown_." /> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.23034" /> <comment value="CanceledIndicator [DEPRECATED]" /> </mapping> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22660" /> <comment value="PeriodOfUse (implicit, main mapping is on the extensions ext-TimeInterval.Period and ext-TimeInterval.Duration) [DEPRECATED]" /> </mapping> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22498" /> <comment value="AdministrationAgreementStopType (implicit, main mapping is on the modifier extension ext-StopType) [DEPRECATED]" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-340" /> <comment value="AdministrationAgreementStopType (implicit, main mapping is on the modifier extension ext-StopType)" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-340" /> <comment value="AdministrationAgreementStopType (implicit, main mapping is on the modifier extension ext-StopType)" /> </mapping> </element> <element id="MedicationDispense.category"> <path value="MedicationDispense.category" /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="422037009" /> </coding> </patternCodeableConcept> </element> <element id="MedicationDispense.category.extension:additionalCategory"> <path value="MedicationDispense.category.extension" /> <sliceName value="additionalCategory" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-AdditionalCategory" /> </type> </element> <element id="MedicationDispense.category.extension:additionalCategory.value[x]"> <path value="MedicationDispense.category.extension.value[x]" /> <short value="Type of medication dispense" /> <definition value="Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient))" /> <binding> <strength value="preferred" /> <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-category" /> </binding> </element> <element id="MedicationDispense.medication[x]"> <path value="MedicationDispense.medication[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="MedicationDispense.medication[x]:medicationReference"> <path value="MedicationDispense.medication[x]" /> <sliceName value="medicationReference" /> <short value="MedicineForAdministrationAgreement" /> <definition value="Medicine in the AdministrationAgreement." /> <alias value="GeneesmiddelBijToedieningsafspraak" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/mp-PharmaceuticalProduct" /> </type> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.20237" /> <comment value="MedicineForAdministrationAgreement" /> </mapping> </element> <element id="MedicationDispense.subject"> <path value="MedicationDispense.subject" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" /> </type> </element> <element id="MedicationDispense.performer"> <path value="MedicationDispense.performer" /> <max value="1" /> </element> <element id="MedicationDispense.performer.actor"> <path value="MedicationDispense.performer.actor" /> <short value="Supplier" /> <definition value="The supplier (pharmacist) that entered the administration agreement." /> <comment value="The 'Supplier' concept of zib AdministrationAgreement is mapped to both `.performer.actor` and `.location`. This is a Reference to an instance of nl-core-HealthcareProvider-Organization instead of to an instance of nl-core-HealthcareProfessional, because individuals who enter the administration agreement are not recorded." /> <alias value="Verstrekker" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization" /> </type> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22097" /> <comment value="Supplier" /> </mapping> </element> <element id="MedicationDispense.location"> <path value="MedicationDispense.location" /> <short value="Supplier" /> <definition value="The supplier (pharmacist) that entered the administration agreement." /> <comment value="The 'Supplier' concept of zib AdministrationAgreement is mapped to both `.performer.actor` and `.location`. Details of the physical location of the supplier of the administration agreement can be referenced here." /> <alias value="Verstrekker" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider" /> </type> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22097" /> <comment value="Supplier" /> </mapping> </element> <element id="MedicationDispense.authorizingPrescription"> <path value="MedicationDispense.authorizingPrescription" /> <short value="MedicationAgreement" /> <definition value="Relationship to the medication agreement on which the administration agreement is based." /> <alias value="Medicatieafspraak" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/mp-MedicationAgreement" /> </type> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22394" /> <comment value="MedicationAgreement" /> </mapping> </element> <element id="MedicationDispense.note"> <path value="MedicationDispense.note" /> <max value="1" /> </element> <element id="MedicationDispense.note.text"> <path value="MedicationDispense.note.text" /> <short value="Comment" /> <definition value="Comments on the administration agreement." /> <alias value="Toelichting" /> <mapping> <identity value="zib-administrationagreement-v1.0.3-2020EN" /> <map value="NL-CM:9.8.22275" /> <comment value="Comment" /> </mapping> </element> <element id="MedicationDispense.dosageInstruction"> <path value="MedicationDispense.dosageInstruction" /> <short value="DosingInstructions / InstructionsForUse" /> <definition value="Instructions for administering the medication, e.g. dose and route of administration." /> <alias value="Gebruiksinstructie" /> <type> <code value="Dosage" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/mp-InstructionsForUse.DosageInstructions" /> </type> </element> </differential> </StructureDefinition>