<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="Instructions for the use or administration of the medication, e.g. dose and route of administration. In the medication building block MedicationUse, this is the pattern of use established by the patient or which the patient followed." /> <purpose value="This Dosage data type profile _mainly_ represents the DosingInstructions concept of the sub building block InstructionsForUse, 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) InstructionsForUse, 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. This profile also includes the concepts AdditionalInstructions and RouteOfAdministration. These concepts are placed on the same level as DosingInstructions in the zib, but are in FHIR part of the Dosage data type. As a consequence, these concepts may be duplicated if this Dosage profile is instantiated multiple times. This profile should be used in medication related resources that define dosage instructions and supplemented by the extensions [ext-RenderedDosageInstruction](http://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction) and [ext-InstructionsForUse.RepeatPeriodCyclicalSchedule](http://nictiz.nl/fhir/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule) to implement the remaining concepts Description and RepeatPeriodCyclicalSchedule." /> <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-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="zib-range-v1.0.1-2020EN" /> <uri value="https://zibs.nl/wiki/Range-v1.0.1(2020EN)" /> <name value="zib Range-v1.0.1(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="complex-type" /> <abstract value="false" /> <type value="Dosage" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Dosage" /> <derivation value="constraint" /> <differential> <element id="Dosage"> <path value="Dosage" /> <short value="DosingInstructions" /> <definition value="Indicates how the medication is/was taken or should be taken by the patient. Instructions for the administrator to administer the medication (the patient themselves, a nurse or other aid). When taking stock of medication use, the dosage describes the pattern of use established by the patient." /> <comment value="This element _mostly_ represents the DosingInstructions container from zib InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are **duplicated** in every repetition of this element, even though these concepts should be present just once according to the zib. This element does not contain a mapping to the Dosage container from zib InstructionsForUse. However, all child concepts of the Dosage concept are mapped. If an instance of zib container DosingInstructions contains multiple Dosage containers, each of these results in a separate instance of the FHIR Dosage data type conforming to this profile, wherein `.sequence` (zib concept SequenceNumber) and `.timing.repeat.bounds[x]:boundsDuration` (zib concept DoseDuration) are equal." /> <alias value="Doseerinstructie" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22095" /> <comment value="DosingInstructions" /> </mapping> </element> <element id="Dosage.extension:asNeeded"> <path value="Dosage.extension" /> <sliceName value="asNeeded" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-Dosage-AsNeededFor" /> </type> </element> <element id="Dosage.extension:asNeeded.value[x]"> <path value="Dosage.extension.value[x]" /> <short value="Condition" /> <definition value="The condition for administering medication can be: * a physiological measurement value (plasma glucose concentration, body temperature, blood pressure); * a symptom or other circumstance (in the event of a headache, or itch). Supplemental information from G-standard bst362 make up the list of values for coded entering of this concept. Also always include the textual description of that code. Physiological measurement values or other conditions that do not occur in bst362 do not need to be coded. These can be expressed in free text in the Description concept." /> <alias value="Criterium" /> <binding> <strength value="required" /> <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.4--20200901000000" /> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19945" /> <comment value="Condition" /> </mapping> </element> <element id="Dosage.sequence"> <path value="Dosage.sequence" /> <short value="SequenceNumber" /> <definition value="This indicates the sequence of the dosing instructions within the medication agreement." /> <alias value="Volgnummer" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22503" /> <comment value="SequenceNumber" /> </mapping> </element> <element id="Dosage.additionalInstruction"> <path value="Dosage.additionalInstruction" /> <short value="AdditionalInstructions" /> <definition value="The additional instructions contain extra information on the use of the current prescription. The additional instructions applies to the entire instructions for use and not to an individual dosage. This includes all instructions for use. The text can come from the original “paper" medication prescription, but can also be generated from the coded information. The instructions may not conflict with other components of the medication agreement/ administration agreement. The instructions can also refer to an existing protocol. In the case of an external dosing regimen (e.g., "according to thrombosis service regimen"), OTH is used. The texts in the G-standard that can support this attribute are included in table 362 where the texts from the general practitioner' standard 'NHG-Tabel 25-component b: 'aanvullende teksten’ ' are included. These texts can only be used when it is not possible to include this information in the other structured elements of the Instructions for Use. A free-text explanation of the Instructions for Use can be placed under code OTH if it is not possible to record it in a structured manner within the Instructions for Use." /> <comment value="Please note that in contrast to the zib, this AdditionalInstructions concept is grouped under the DosingInstructions concept. This `.additionalInstruction` element shall have the same value when there are multiple DosingInstructions." /> <alias value="AanvullendeInstructie" /> <binding> <strength value="required" /> <description value="WCIAv3 Tabel 25 B-codes subset voor aanvullende gebruiksinstructies" /> <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.9--20160407000000" /> </binding> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-51" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-51" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-649" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-649" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-300" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-300" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-368" /> <comment value="AdditionalInstructions" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-368" /> <comment value="AdditionalInstructions" /> </mapping> </element> <element id="Dosage.timing"> <path value="Dosage.timing" /> <short value="AdministeringSchedule" /> <definition value="Specifications of the times at which the medication is to be administered. This is indicated as follows: * Time(s) (16:00) or indications (“before meals”) at which the medication is to be taken each day. * A specific number of times the medication is to be taken each day ("3x a day"), indicated with the frequency. * A time interval between consecutive doses (“Every 2 hours”, “every 3 days”), indicated with the word Interval. * Combined periods with an interval and duration (“1 daily for three out of four weeks: the pill schedule”) If a certain medication is not to be taken daily, the aforementioned can be combined with daily indications: * One or more week days on which the medication is to be administered (e.g. “Monday, Wednesday, Friday”) * ”3x a week”, “2x a month”. The specified administration “infinite” is automatically to be repeated until: * The end date and time has been reached * The total administration duration has been reached (14 days) * A specific amount of administrations has been reached (“20 doses”), to be entered in the Frequency concept." /> <alias value="Toedieningsschema" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19948" /> <comment value="AdministeringSchedule" /> </mapping> </element> <element id="Dosage.timing.repeat.extension:timingExact"> <path value="Dosage.timing.repeat.extension" /> <sliceName value="timingExact" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/timing-exact" /> </type> </element> <element id="Dosage.timing.repeat.extension:timingExact.value[x]"> <path value="Dosage.timing.repeat.extension.value[x]" /> <definition value="Indicates that the timing as specified by `.frequency`, `.period` and `.periodUnit` should be strictly interpreted. This is the case when the zib concept Interval is expressed using these elements (as opposed to the zib concept Frequency). The times can be chosen freely, but distribution throughout the day is more precise, and the interval between times is important (e.g. in the case of antibiotics). In the case of Baxter packs and intramural care, such a prescription is used to draw up a (location-specific) outline for distribution times (logistics)." /> <comment value="Notes on the zib concepts Frequency and Interval: 1. An interval (in FHIR) is just a normal frequency of 1 (combined with a period based on the interval length) and is represented in FHIR as just another frequency using `.frequency` (set to 1), `.period` and `.periodUnit`. However, the zib differentiates between the two concepts in the timing precision (the Interval concept defines precise intervals while the Frequency concept defines approximate intervals). When the interval is precise, this is communicated using the extension in `.extension:timingExact`. 2. On the other hand, the zib Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * zib concept Frequency: * With time unit: * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * zib concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit` and `.extension:timingExact` (set to _true_)" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval (implicit, main mapping is on `.frequency`, `.period` and `.periodMax`)" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-271" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-271" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-672" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-672" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-580" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-580" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-412" /> <comment value="(negative of) IsFlexible" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-412" /> <comment value="(negative of) IsFlexible" /> </mapping> </element> <element id="Dosage.timing.repeat.bounds[x]"> <path value="Dosage.timing.repeat.bounds[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Dosage.timing.repeat.bounds[x]:boundsDuration"> <path value="Dosage.timing.repeat.bounds[x]" /> <sliceName value="boundsDuration" /> <short value="DoseDuration" /> <definition value="The intended time duration for these dosing instructions, e.g. 5 days or 8 weeks. In the case of medication for an indefinite period, the dosing duration is left empty in the last dosing instruction." /> <alias value="Doseerduur" /> <type> <code value="Duration" /> </type> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.22506" /> <comment value="DoseDuration" /> </mapping> </element> <element id="Dosage.timing.repeat.count"> <path value="Dosage.timing.repeat.count" /> <short value="Frequency / minimumValue / nominalValue" /> <definition value="Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by this `.count` element and optionally `.countMax` if a range should be represented." /> <comment value="Notes on the zib concept Frequency can be found in the comment of the `.frequency` element." /> <alias value="Frequentie" /> <alias value="nominaleWaarde" /> <alias value="minimumWaarde" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency (single use only)" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> </element> <element id="Dosage.timing.repeat.countMax"> <path value="Dosage.timing.repeat.countMax" /> <short value="Frequency / maximumValue" /> <definition value="Usually, frequency comprises both amount and time unit (3 times a day), but it can occur without the time unit (single use). This is represented by the `.count` element and optionally `.countMax` if a range should be represented." /> <comment value="Notes on the zib concept Frequency can be found in the comment of the `.frequency` element." /> <alias value="Frequentie" /> <alias value="maximumWaarde" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> </element> <element id="Dosage.timing.repeat.duration"> <path value="Dosage.timing.repeat.duration" /> <short value="DurationOfAdministration" /> <definition value="The duration of administration defines the length of time during which the drug is administered and is mainly used in the slow parenteral administration of fluids. The `durationUnit` defines the time unit." /> <alias value="Toedieningsduur" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.23141" /> <comment value="DurationOfAdministration" /> </mapping> </element> <element id="Dosage.timing.repeat.durationUnit"> <path value="Dosage.timing.repeat.durationUnit" /> <short value="DurationOfAdministration" /> <definition value="The units of time, in UCUM units, for the duration of administration of time during which the drug is administered." /> <alias value="Toedieningsduur" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.23141" /> <comment value="DurationOfAdministration" /> </mapping> </element> <element id="Dosage.timing.repeat.frequency"> <path value="Dosage.timing.repeat.frequency" /> <short value="Frequency / minimumValue / nominalValue / Interval" /> <definition value="The `.frequency` element indicates either the number of dose moments per time unit (zib concept Frequency) or the time between dose times (zib concept Interval). If `.frequencyMax` is present, this `.frequency` element indicates the lower bound of the allowed range of the frequency." /> <comment value="Notes on the zib concepts Frequency and Interval, The zib differentiates between the two concepts in the specific usage of the extension `.extension:timingExact` and the element `.timeOfDay` combined: 1. The zib Interval (in FHIR) is just a normal frequency of 1 (combined with a period based on the interval length) and is represented in FHIR as just another frequency using `.frequency` (set to 1), `.period`, `.periodUnit`, the extension `.extension:timingExact` set to _true_ and the absence of the element `.timeOfDay`. 2. The zib Frequency concept might be used to express a single-use, non-repeating series by omitting the time unit. In FHIR, this is _not_ represented as a frequency, but with the `.count` element. 3. Lastly, the Frequency concept may be used to express either a single nominal value or a range. The extension `.extension:timingExact` can be used to specify the precision of the timing of the administration (i.e. the element `.timeOfDay`). When this element is meant to convey the zib Frequency concept this can be, unlike the zib concept Interval, either _true_or _false_. A range is represented by respectively setting the minimum and maximum value to `.frequency` and `.frequencyMax`, or to `.count` and `.countMax` for single-use events as mentioned in the second point. A nominal value is expressed by setting its value to `.frequency` or to `.count` for single-use events, and leaving `.frequencyMax` and `.countMax` unpopulated. In summary: * zib concept Frequency: * With time unit (precision of the timing can be further specified with the extension `.extension:timingExact`): * Nominal value: `.frequency`, `.period` and `.periodUnit` * Range: `.frequency`, `.frequencyMax`, `.period` and `.periodUnit` * Without time unit: * Nominal value: `.count` * Range: `.count` and `.countMax` * zib concept Interval: `.frequency` (set to 1), `.period`, `.periodUnit`, `.extension:timingExact` (SHALL be set to _true_) and the absence of `.timeOfDay`." /> <alias value="Frequentie" /> <alias value="minimumWaarde" /> <alias value="nominaleWaarde" /> <alias value="Interval" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval" /> </mapping> </element> <element id="Dosage.timing.repeat.frequencyMax"> <path value="Dosage.timing.repeat.frequencyMax" /> <short value="Frequency / maximumValue" /> <comment value="Notes on the zib concept Frequency can be found in the comment of the `.frequency` element." /> <alias value="maximumWaarde" /> <alias value="Frequentie" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> </element> <element id="Dosage.timing.repeat.period"> <path value="Dosage.timing.repeat.period" /> <short value="Frequency / Interval" /> <definition value="Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If `.periodMax` is present, this element indicates the lower bound of the allowed range of the period length." /> <comment value="Notes on the zib concepts Frequency and Interval can be found in the comment of the `.frequency` element." /> <alias value="Frequentie" /> <alias value="Interval" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency" /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval" /> </mapping> </element> <element id="Dosage.timing.repeat.periodUnit"> <path value="Dosage.timing.repeat.periodUnit" /> <short value="Frequency / Interval" /> <definition value="The units of time for the period in UCUM units for Frequency and Interval." /> <comment value="Notes on the zib concepts Frequency and Interval can be found in the comment of the `.frequency` element." /> <alias value="Frequentie" /> <alias value="Interval" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19949" /> <comment value="Frequency. When frequency is used, set `.extension.timingExact` to false." /> </mapping> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19950" /> <comment value="Interval" /> </mapping> </element> <element id="Dosage.timing.repeat.dayOfWeek"> <path value="Dosage.timing.repeat.dayOfWeek" /> <short value="WeekDay" /> <definition value="WeekDay indicates a pattern of doses on fixed week days." /> <comment value="If no days are specified, the action is assumed to happen every day as otherwise specified." /> <alias value="Weekdag" /> <binding> <strength value="required" /> <description value="Use ConceptMap 'WeekdagCodelijst_to_DaysOfWeek' to translate zib terminology to profile terminology in ValueSet 'DaysOfWeek'" /> <valueSet value="http://hl7.org/fhir/ValueSet/days-of-week|4.0.1"> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueCanonical value="http://nictiz.nl/fhir/ConceptMap/WeekdagCodelijst-to-DaysOfWeek" /> </extension> </valueSet> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19952" /> <comment value="WeekDay" /> </mapping> </element> <element id="Dosage.timing.repeat.timeOfDay"> <path value="Dosage.timing.repeat.timeOfDay" /> <short value="AdministrationTime" /> <definition value="The time of administration is a specific time of day (on the clock). This time usually isn’t (intended to be) exact. There can be multiple administering times in one day. The ideal time of administration can also be entered as a time of day (morning, afternoon, evening, night-time). The administration time is then to be left empty, and the time of day can be entered in the TimeOfDay concept." /> <comment value="If there's a `.timeOfDay`, there cannot be a `.when`, or vice versa." /> <alias value="Toedientijd" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19951" /> <comment value="AdministrationTime" /> </mapping> </element> <element id="Dosage.timing.repeat.when"> <path value="Dosage.timing.repeat.when" /> <short value="TimeOfDay" /> <definition value="Time of day: morning, afternoon, evening, night." /> <comment value="If there's a `.timeOfDay`, there cannot be a `.when`, or vice versa." /> <alias value="Dagdeel" /> <binding> <strength value="required" /> <description value="Use ConceptMap 'DagdeelCodelijst_to_EventTiming' to translate zib terminology to profile terminology in ValueSet 'EventTiming'" /> <valueSet value="http://hl7.org/fhir/ValueSet/event-timing"> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueCanonical value="http://nictiz.nl/fhir/ConceptMap/DagdeelCodelijst-to-EventTiming" /> </extension> </valueSet> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19953" /> <comment value="TimeOfDay" /> </mapping> </element> <element id="Dosage.asNeeded[x]"> <path value="Dosage.asNeeded[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Dosage.asNeeded[x]:asNeededCodeableConcept"> <path value="Dosage.asNeeded[x]" /> <sliceName value="asNeededCodeableConcept" /> <short value="Condition" /> <definition value="Condition for administration of medication can be: *a measured physiological value (plasma glucose level, body temperature, blood pressure); *a symptom or other condition (headache, itching). Relevant “as needed” conditions from NHG Table 25 form the value list for transmitting this concept in coded form. The conditions supported in the G-standard are included in file 362. The textual description of that code must always be provided as well. Physiological measurements or other conditions that are not included in the “as needed” conditions of NHG Table 25 can be expressed in free text using the OTH code." /> <comment value="If only one 'asNeeded' concept is exchanged within a Dosage, use Dosage.asNeeded[x]. Otherwise use the extension Dosage.extension:asNeeded.value[x] for when multiple 'asNeeded' concepts are to be exchanged. Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed"." /> <alias value="Criterium" /> <type> <code value="CodeableConcept" /> </type> <binding> <strength value="required" /> <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.4--20200901000000" /> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19945" /> <comment value="Condition [DEPRECATED]" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-321" /> <comment value="Condition" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-72" /> <comment value="Condition" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-389" /> <comment value="Condition" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-676" /> <comment value="Condition" /> </mapping> </element> <element id="Dosage.asNeeded[x]:asNeededCodeableConcept.text"> <path value="Dosage.asNeeded[x].text" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-272" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-272" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-677" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-677" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-582" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-582" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-514" /> <comment value="Description" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-514" /> <comment value="Description" /> </mapping> </element> <element id="Dosage.route"> <path value="Dosage.route" /> <short value="RouteOfAdministration" /> <definition value="The route through which the medication is administered (oral, nasal, intravenous, etc.). The routes of administration supported in the G-standard are included in file 902, thesaurus number 7." /> <comment value="Please note that in contrast to the zib, this RouteOfAdministration concept is grouped under the DosingInstructions concept. This `.route` element shall have the same value when there are multiple DosingInstructions." /> <alias value="Toedieningsweg" /> <binding> <strength value="required" /> <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.1--20200901000000" /> </binding> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19941" /> <comment value="RouteOfAdministration [DEPRECATED]" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-303" /> <comment value="RouteOfAdministration" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-430" /> <comment value="RouteOfAdministration" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-54" /> <comment value="RouteOfAdministration" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-371" /> <comment value="RouteOfAdministration" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-648" /> <comment value="RouteOfAdministration" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]"> <path value="Dosage.doseAndRate.dose[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <short value="Dose" /> <definition value="The dose indicates the amount/unit per administration. The unit can be any unit that can occur with this particular medicine. For liquids and other divisible products, a volume measure (preferably "ml") will usually be used. In many cases, the prescriber may want to specify the dosage in units of weight of the active substance. If only the substance is indicated and not the product, then the amount of that substance is specified. For example, Paracetamol 1000 mg is equivalent to Paracetamol 500 mg tablets, 2 tablets (or units). The dosage is sometimes indicated in a calculation, which often uses the patient's body weight or body surface area as a parameter. However, the calculation remains nothing more than a tool to aid decision-making. In continuous administration, alongside the administration speed, the dose can be specified (e.g., 20 ml in a syringe or 500 ml in a bag), but it is often omitted. Even a general dosing recommendation such as 'Use according to protocol' or 'See instructions for use' can be adequate. Then, no dose is specified." /> <alias value="Keerdosis" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19940" /> <comment value="Dose [DEPRECATED]" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-316" /> <comment value="Dose" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-67" /> <comment value="Dose" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-384" /> <comment value="Dose" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-655" /> <comment value="Dose" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseRange" /> <type> <code value="Range" /> </type> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange.low"> <path value="Dosage.doseAndRate.dose[x].low" /> <short value="minimumValue" /> <definition value="The minimal value of the range. The boundary is inclusive." /> <alias value="minimumWaarde" /> <type> <code value="Quantity" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdSimpleQuantity" /> </type> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange.high"> <path value="Dosage.doseAndRate.dose[x].high" /> <short value="maximumValue" /> <definition value="The maximum value of the range. The boundary is inclusive." /> <alias value="maximumWaarde" /> <type> <code value="Quantity" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdSimpleQuantity" /> </type> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseQuantity"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseQuantity" /> <short value="nominalValue" /> <definition value="Amount of medication per dose. The nominal value of the quantity." /> <alias value="nominaleWaarde" /> <type> <code value="Quantity" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdSimpleQuantity" /> </type> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]"> <path value="Dosage.doseAndRate.rate[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <short value="AdministeringSpeed" /> <definition value="The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour, but can also be parametric with i.e. body weight or body surface area (in the case of a MedicationAgreement, VariableDosingRegimen or AdministrationAgreement). Entering an interval (such as 0-10 ml/hour) is also a commonly used option. For example, with an administering speed of 10ml/hour: * value = 10 * unit = ml/hour" /> <alias value="Toedieningssnelheid" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19942" /> <comment value="AdministeringSpeed" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]:rateRange"> <path value="Dosage.doseAndRate.rate[x]" /> <sliceName value="rateRange" /> <type> <code value="Range" /> </type> </element> <element id="Dosage.doseAndRate.rate[x]:rateRange.low"> <path value="Dosage.doseAndRate.rate[x].low" /> <short value="minimumValue" /> <definition value="The minimal value of the range. The boundary is inclusive." /> <alias value="minimumWaarde" /> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.2" /> <comment value="minimumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]:rateRange.high"> <path value="Dosage.doseAndRate.rate[x].high" /> <short value="maximumValue" /> <definition value="The maximum value of the range. The boundary is inclusive." /> <alias value="maximumWaarde" /> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.3" /> <comment value="maximumValue" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]:rateQuantity"> <path value="Dosage.doseAndRate.rate[x]" /> <sliceName value="rateQuantity" /> <short value="nominalValue" /> <definition value="The nominal value of the quantity." /> <alias value="nominaleWaarde" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> </element> <element id="Dosage.maxDosePerPeriod"> <path value="Dosage.maxDosePerPeriod" /> <short value="MaximumDose" /> <definition value="A maximum dose maximizes (in time) the usage of a drug in an 'as needed' prescription." /> <alias value="MaximaleDosering" /> <mapping> <identity value="zib-instructionsforuse-v1.2.1-2020EN" /> <map value="NL-CM:9.12.19946" /> <comment value="MaximumDose" /> </mapping> </element> <element id="Dosage.maxDosePerPeriod.numerator"> <path value="Dosage.maxDosePerPeriod.numerator" /> <type> <code value="Quantity" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdSimpleQuantity" /> </type> </element> <element id="Dosage.maxDosePerPeriod.denominator"> <path value="Dosage.maxDosePerPeriod.denominator" /> <type> <code value="Quantity" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdSimpleQuantity" /> </type> </element> </differential> </StructureDefinition>