<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="A medication administration is the separate administration of a medicine to the patient by the administrator." /> <purpose value="This MedicationAdministration resource represents the MedicationAdministration2 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) MedicationAdministration2, 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-medicationadministration2-v1.1.1-2020EN" /> <uri value="https://zibs.nl/wiki/MedicationAdministration2-v1.1.1(2020EN)" /> <name value="zib MedicationAdministration2-v1.1.1(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="resource" /> <abstract value="false" /> <type value="MedicationAdministration" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" /> <derivation value="constraint" /> <differential> <element id="MedicationAdministration"> <path value="MedicationAdministration" /> <short value="MedicationAdministration" /> <alias value="Medicatietoediening" /> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.20928" /> <comment value="MedicationAdministration" /> </mapping> </element> <element id="MedicationAdministration.extension:agreedDateTime"> <path value="MedicationAdministration.extension" /> <sliceName value="agreedDateTime" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime" /> </type> </element> <element id="MedicationAdministration.extension:agreedDateTime.value[x]"> <path value="MedicationAdministration.extension.value[x]" /> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23171" /> <comment value="AgreedDateTime" /> </mapping> </element> <element id="MedicationAdministration.extension:medicationAdministrationReasonForDeviation"> <path value="MedicationAdministration.extension" /> <sliceName value="medicationAdministrationReasonForDeviation" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation" /> </type> </element> <element id="MedicationAdministration.extension:medicationAdministrationReasonForDeviation.value[x]"> <path value="MedicationAdministration.extension.value[x]" /> <comment value="This MedicationAdministrationReasonForDeviation extension has overlap with `.statusReason`. Both concepts allow the documentation of reasons why an administration did not take place, potentially resulting in duplicated information in both places. This extension, however, has a broader scope because it also covers the reasons why administrations are performed differently than the agreement." /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-444" /> <comment value="MedicationAdministrationReasonForDeviation" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-444" /> <comment value="MedicationAdministrationReasonForDeviation" /> </mapping> </element> <element id="MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier"> <path value="MedicationAdministration.extension" /> <sliceName value="pharmaceuticalTreatmentIdentifier" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier" /> </type> </element> <element id="MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.value[x]"> <path value="MedicationAdministration.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="MedicationAdministration.extension:injectionPatchSite"> <path value="MedicationAdministration.extension" /> <sliceName value="injectionPatchSite" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.InjectionPatchSite" /> </type> </element> <element id="MedicationAdministration.extension:injectionPatchSite.value[x]"> <path value="MedicationAdministration.extension.value[x]" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-702" /> <comment value="InjectionPatchSite" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-702" /> <comment value="InjectionPatchSite" /> </mapping> </element> <element id="MedicationAdministration.extension:registrationDateTime"> <path value="MedicationAdministration.extension" /> <sliceName value="registrationDateTime" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-RegistrationDateTime" /> </type> </element> <element id="MedicationAdministration.extension:registrationDateTime.value[x]"> <path value="MedicationAdministration.extension.value[x]" /> <definition value="The date and time when the MedicationAdministration 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 MedicationAdministration, 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-1482" /> <comment value="RegistrationDateTime" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1482" /> <comment value="RegistrationDateTime" /> </mapping> </element> <element id="MedicationAdministration.identifier"> <path value="MedicationAdministration.identifier" /> <short value="Identification" /> <alias value="Identificatie" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-447" /> <comment value="Identification" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-447" /> <comment value="Identification" /> </mapping> </element> <element id="MedicationAdministration.status"> <path value="MedicationAdministration.status" /> <short value="MedicationAdministrationStatus" /> <definition value="The status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used: - Active: The product is administered. - Interrupted: Use has (temporarily) been interrupted, because of a side effect, for example. Later, the patient and/or doctor can decide whether or not to resume or discontinue use. - Discontinued: Administration has stopped. - Completed: Administration has been completed. - Not started: The product was never administered." /> <comment value="If no value for MedicationAdministrationStatus is present, and the system is thus unable to infer the status, `.status` will be set to _unknown_." /> <alias value="MedicatietoedieningStatus" /> <binding> <strength value="required" /> <description value="Use ConceptMap 'MedicatieToedieningStatusCodelijst-to-MedicationAdministrationStatusCodes' to translate zib terminology to profile terminology in ValueSet 'MedicationAdministration Status Codes'" /> <valueSet value="http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1"> <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap"> <valueCanonical value="http://nictiz.nl/fhir/ConceptMap/MedicatieToedieningStatusCodelijst-to-MedicationAdministrationStatusCodes" /> </extension> </valueSet> </binding> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.21191" /> <comment value="MedicationAdministrationStatus" /> </mapping> </element> <element id="MedicationAdministration.category"> <path value="MedicationAdministration.category" /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="18629005" /> </coding> </patternCodeableConcept> </element> <element id="MedicationAdministration.category.extension:additionalCategory"> <path value="MedicationAdministration.category.extension" /> <sliceName value="additionalCategory" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-AdditionalCategory" /> </type> </element> <element id="MedicationAdministration.category.extension:additionalCategory.value[x]"> <path value="MedicationAdministration.category.extension.value[x]" /> <short value="Type of medication usage" /> <definition value="Indicates where the medication is expected to be consumed or administered." /> <binding> <strength value="preferred" /> <valueSet value="http://hl7.org/fhir/ValueSet/medication-admin-category" /> </binding> </element> <element id="MedicationAdministration.medication[x]"> <path value="MedicationAdministration.medication[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="MedicationAdministration.medication[x]:medicationReference"> <path value="MedicationAdministration.medication[x]" /> <sliceName value="medicationReference" /> <short value="AdministrationProduct" /> <definition value="The product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet." /> <alias value="ToedieningsProduct" /> <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-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.20929" /> <comment value="AdministrationProduct" /> </mapping> </element> <element id="MedicationAdministration.subject"> <path value="MedicationAdministration.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="MedicationAdministration.context"> <path value="MedicationAdministration.context" /> <short value="RelationEncounter / RelationEpisodeOfCare" /> <comment value="The ext-Context-EpisodeOfCare extension is used to capture a reference to a related EpisodeOfCare if both a reference to an Encounter and an EpisodeOfCare need to be exchanged, or to capture additional EpisodeOfCare resources if multiple related EpisodeOfCare resources need to be exchanged. This `.context` element will then contain the reference to the Encounter resource or the 'first' EpisodeOfCare, respectively." /> <alias value="RelatieContact" /> <alias value="RelatieZorgepisode" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Encounter" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-EpisodeOfCare" /> </type> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1353" /> <comment value="RelationEncounter" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1353" /> <comment value="RelationEncounter" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1355" /> <comment value="RelationEpisodeOfCare" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1355" /> <comment value="RelationEpisodeOfCare" /> </mapping> </element> <element id="MedicationAdministration.context.extension:relationEpisodeOfCare"> <path value="MedicationAdministration.context.extension" /> <sliceName value="relationEpisodeOfCare" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-Context-EpisodeOfCare" /> </type> </element> <element id="MedicationAdministration.context.extension:relationEpisodeOfCare.value[x]"> <path value="MedicationAdministration.context.extension.value[x]" /> <short value="RelatedEpisodeOfCare" /> <alias value="RelatieZorgepisode" /> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1355" /> <comment value="RelationEpisodeOfCare" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1355" /> <comment value="RelationEpisodeOfCare" /> </mapping> </element> <element id="MedicationAdministration.supportingInformation"> <path value="MedicationAdministration.supportingInformation" /> <slicing> <discriminator> <type value="profile" /> <path value="resolve()" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="MedicationAdministration.supportingInformation:administrationAgreement"> <path value="MedicationAdministration.supportingInformation" /> <sliceName value="administrationAgreement" /> <short value="AdministrationAgreement" /> <definition value="Administration agreement on which this administration is based." /> <alias value="Toedieningsafspraak" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/mp-AdministrationAgreement" /> </type> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23237" /> <comment value="AdministrationAgreement" /> </mapping> </element> <element id="MedicationAdministration.supportingInformation:variableDosingRegimen"> <path value="MedicationAdministration.supportingInformation" /> <sliceName value="variableDosingRegimen" /> <short value="VariableDosingRegimen" /> <definition value="Variable dosing regimen on which this administration is based." /> <alias value="WisselendDoseerSchema" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/mp-VariableDosingRegimen" /> </type> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-1325" /> <comment value="RelationVariableDosingRegimen" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-1325" /> <comment value="RelationVariableDosingRegimen" /> </mapping> </element> <element id="MedicationAdministration.effective[x]"> <path value="MedicationAdministration.effective[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="MedicationAdministration.effective[x]:effectiveDateTime"> <path value="MedicationAdministration.effective[x]" /> <sliceName value="effectiveDateTime" /> <short value="AdministrationDateTime" /> <definition value="The date and time at which the medication was administered." /> <alias value="ToedieningsDatumTijd" /> <type> <code value="dateTime" /> </type> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.21193" /> <comment value="AdministrationDateTime" /> </mapping> </element> <element id="MedicationAdministration.performer"> <path value="MedicationAdministration.performer" /> <short value="Administrator" /> <definition value="The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the informal carer, for example." /> <alias value="Toediener" /> <max value="1" /> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.21196" /> <comment value="Administrator [DEPRECATED]" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc1-20250522" /> <map value="mp-dataelement9x-437" /> <comment value="Administrator" /> </mapping> <mapping> <identity value="mp-dataset-mp9-300-rc2-20260213" /> <map value="mp-dataelement9x-437" /> <comment value="Administrator" /> </mapping> </element> <element id="MedicationAdministration.performer.actor"> <path value="MedicationAdministration.performer.actor" /> <short value="Patient / HealthProfessional / Caregiver" /> <alias value="Patiënt" /> <alias value="Zorgverlener" /> <alias value="Mantelzorger" /> <type> <code value="Reference" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson" /> </type> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23380" /> <comment value="Patient" /> </mapping> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23172" /> <comment value="HealthProfessional" /> </mapping> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23355" /> <comment value="Caregiver" /> </mapping> </element> <element id="MedicationAdministration.request"> <path value="MedicationAdministration.request" /> <short value="MedicationAgreement" /> <definition value="Medication agreement on which this administration is based." /> <alias value="Medicatieafspraak" /> <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-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23170" /> <comment value="MedicationAgreement" /> </mapping> </element> <element id="MedicationAdministration.note"> <path value="MedicationAdministration.note" /> <max value="1" /> </element> <element id="MedicationAdministration.note.text"> <path value="MedicationAdministration.note.text" /> <short value="Comment" /> <definition value="Comments on administering the medication." /> <alias value="Toelichting" /> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.21337" /> <comment value="Comment" /> </mapping> </element> <element id="MedicationAdministration.dosage.route"> <path value="MedicationAdministration.dosage.route" /> <short value="RouteOfAdministration" /> <definition value="The route through which the medication is administered (oral, nasal, intravenous,...)." /> <alias value="Toedieningsweg" /> <binding> <strength value="required" /> <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.13.2--20200901000000" /> </binding> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.21195" /> <comment value="RouteOfAdministration" /> </mapping> </element> <element id="MedicationAdministration.dosage.dose"> <path value="MedicationAdministration.dosage.dose" /> <short value="AdministeredAmount" /> <definition value="Amount of the administered product." /> <alias value="ToegediendeHoeveelheid" /> <type> <code value="Quantity" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/pattern-GstdSimpleQuantity" /> </type> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.21194" /> <comment value="AdministeredAmount" /> </mapping> </element> <element id="MedicationAdministration.dosage.rate[x]"> <path value="MedicationAdministration.dosage.rate[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="MedicationAdministration.dosage.rate[x]:rateQuantity"> <path value="MedicationAdministration.dosage.rate[x]" /> <sliceName value="rateQuantity" /> <short value="AdministeringSpeed / nominalValue" /> <definition value="The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. For example, with an administering speed of 10ml/hour: * value = 10 * unit = ml/hour" /> <alias value="Toedieningssnelheid" /> <alias value="nominaleWaarde" /> <type> <code value="Quantity" /> </type> <mapping> <identity value="zib-medicationadministration2-v1.1.1-2020EN" /> <map value="NL-CM:9.13.23159" /> <comment value="AdministeringSpeed" /> </mapping> <mapping> <identity value="zib-range-v1.0.1-2020EN" /> <map value="NL-CM:20.1.4" /> <comment value="nominalValue" /> </mapping> </element> </differential> </StructureDefinition>