<status value="draft" /> <description value="This profile describes Dosage constraints for MERT medication exchange." /> <fhirVersion value="4.0.1" /> <kind value="complex-type" /> <abstract value="false" /> <type value="Dosage" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Dosage" /> <derivation value="constraint" /> <snapshot> <element id="Dosage"> <path value="Dosage" /> <short value="How the medication is/was taken or should be taken" /> <definition value="Indicates how the medication is/was taken or should be taken by the patient." /> <min value="0" /> <max value="*" /> <base> <path value="Dosage" /> <min value="0" /> <max value="*" /> </base> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" /> </mapping> </element> <element id="Dosage.id"> <path value="Dosage.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Dosage.extension"> <path value="Dosage.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Dosage.modifierExtension"> <path value="Dosage.modifierExtension" /> <short value="Extensions that cannot be ignored even if unrecognized" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." /> <comment value="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." /> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." /> <alias value="extensions" /> <alias value="user content" /> <alias value="modifiers" /> <min value="0" /> <max value="*" /> <base> <path value="BackboneElement.modifierExtension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <isModifier value="true" /> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Dosage.sequence"> <path value="Dosage.sequence" /> <short value="The order of the dosage instructions" /> <definition value="Indicates the order in which the dosage instructions should be applied or interpreted." /> <comment value="32 bit number; for values larger than this, use decimal" /> <requirements value="If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.sequence" /> <min value="0" /> <max value="1" /> </base> <type> <code value="integer" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="TQ1-1" /> </mapping> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> </element> <element id="Dosage.text"> <path value="Dosage.text" /> <short value="Free text dosage instructions (SIG)." /> <definition value="Free text dosage instructions e.g. SIG." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <requirements value="Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-6; RXE-21" /> </mapping> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> </element> <element id="Dosage.additionalInstruction"> <path value="Dosage.additionalInstruction" /> <short value="Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"" /> <definition value="Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps")." /> <comment value="Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text." /> <requirements value="Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded." /> <min value="0" /> <max value="*" /> <base> <path value="Dosage.additionalInstruction" /> <min value="0" /> <max value="*" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdditionalInstruction" /> </extension> <strength value="example" /> <description value="A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery"." /> <valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-7" /> </mapping> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> </element> <element id="Dosage.patientInstruction"> <path value="Dosage.patientInstruction" /> <short value="Patient or consumer oriented instructions" /> <definition value="Instructions in terms that are understood by the patient or consumer." /> <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.patientInstruction" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-7" /> </mapping> <mapping> <identity value="rim" /> <map value=".text" /> </mapping> </element> <element id="Dosage.timing"> <path value="Dosage.timing" /> <short value="When medication should be administered" /> <definition value="When medication should be administered." /> <comment value="This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing." /> <requirements value="The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." /> <min value="1" /> <max value="1" /> <base> <path value="Dosage.timing" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Timing" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="QSET<TS> (GTS)" /> </mapping> <mapping> <identity value="rim" /> <map value=".effectiveTime" /> </mapping> </element> <element id="Dosage.asNeeded[x]"> <path value="Dosage.asNeeded[x]" /> <short value="Take "as needed" (for x)" /> <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept)." /> <comment value="MERT does not support asNeededCodeableConcept; use asNeededBoolean." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.asNeeded[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="boolean" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="TQ1-9" /> </mapping> <mapping> <identity value="rim" /> <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept" /> </mapping> </element> <element id="Dosage.site"> <path value="Dosage.site" /> <short value="Body site to administer to" /> <definition value="Body site to administer to." /> <comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both." /> <requirements value="A coded specification of the anatomic site where the medication first enters the body." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.site" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAdministrationSite" /> </extension> <strength value="example" /> <description value="A coded concept describing the site location the medicine enters into or onto the body." /> <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-codes" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="RXR-2" /> </mapping> <mapping> <identity value="rim" /> <map value=".approachSiteCode" /> </mapping> </element> <element id="Dosage.route"> <path value="Dosage.route" /> <short value="Route of administration (free text preferred in route.text)." /> <definition value="How drug should enter body." /> <comment value="MERT captures route as free text using route.text (CodeableConcept.text) rather than coded route values." /> <requirements value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.route" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RouteOfAdministration" /> </extension> <strength value="example" /> <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject." /> <valueSet value="http://hl7.org/fhir/ValueSet/route-codes" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="RXR-1" /> </mapping> <mapping> <identity value="rim" /> <map value=".routeCode" /> </mapping> </element> <element id="Dosage.route.id"> <path value="Dosage.route.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Dosage.route.extension"> <path value="Dosage.route.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Dosage.route.coding"> <path value="Dosage.route.coding" /> <short value="Code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." /> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." /> <min value="0" /> <max value="*" /> <base> <path value="CodeableConcept.coding" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Coding" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.1-8, C*E.10-22" /> </mapping> <mapping> <identity value="rim" /> <map value="union(., ./translation)" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" /> </mapping> </element> <element id="Dosage.route.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="Dosage.route.text" /> <short value="Plain text representation of the concept" /> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." /> <comment value="Very often the text is the same as a displayName of one of the codings." /> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." /> <min value="1" /> <max value="1" /> <base> <path value="CodeableConcept.text" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="C*E.9. But note many systems use C*E.2 for this" /> </mapping> <mapping> <identity value="rim" /> <map value="./originalText[mediaType/code="text/plain"]/data" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" /> </mapping> </element> <element id="Dosage.method"> <path value="Dosage.method" /> <short value="Technique for administering medication" /> <definition value="Technique for administering medication." /> <comment value="Terminologies used often pre-coordinate this term with the route and or form of administration." /> <requirements value="A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.method" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAdministrationMethod" /> </extension> <strength value="example" /> <description value="A coded concept describing the technique by which the medicine is administered." /> <valueSet value="http://hl7.org/fhir/ValueSet/administration-method-codes" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="RXR-4" /> </mapping> <mapping> <identity value="rim" /> <map value=".doseQuantity" /> </mapping> </element> <element id="Dosage.doseAndRate"> <path value="Dosage.doseAndRate" /> <short value="Amount of medication administered" /> <definition value="The amount of medication administered." /> <min value="0" /> <max value="*" /> <base> <path value="Dosage.doseAndRate" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Element" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="TQ1-2" /> </mapping> </element> <element id="Dosage.doseAndRate.id"> <path value="Dosage.doseAndRate.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Dosage.doseAndRate.extension"> <path value="Dosage.doseAndRate.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="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." /> <comment value="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." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Dosage.doseAndRate.type"> <path value="Dosage.doseAndRate.type" /> <short value="The kind of dose or rate specified" /> <definition value="The kind of dose or rate specified, for example, ordered or calculated." /> <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." /> <requirements value="If the type is not populated, assume to be "ordered"." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.doseAndRate.type" /> <min value="0" /> <max value="1" /> </base> <type> <code value="CodeableConcept" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DoseAndRateType" /> </extension> <strength value="example" /> <description value="The kind of dose or rate specified." /> <valueSet value="http://hl7.org/fhir/ValueSet/dose-rate-type" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE" /> </mapping> <mapping> <identity value="rim" /> <map value="CD" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-21; RXE-23" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]"> <path value="Dosage.doseAndRate.dose[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <short value="Amount of medication per dose" /> <definition value="Amount of medication per dose." /> <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours." /> <requirements value="The amount of therapeutic or other substance given at one administration event." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.doseAndRate.dose[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-2, RXE-3" /> </mapping> <mapping> <identity value="rim" /> <map value=".doseQuantity" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseRange" /> <short value="Amount of medication per dose" /> <definition value="Amount of medication per dose." /> <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours." /> <requirements value="The amount of therapeutic or other substance given at one administration event." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.doseAndRate.dose[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Range" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mustSupport value="true" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-2, RXE-3" /> </mapping> <mapping> <identity value="rim" /> <map value=".doseQuantity" /> </mapping> </element> <element id="Dosage.doseAndRate.dose[x]:doseQuantity"> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="normative" /> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version"> <valueCode value="4.0.0" /> </extension> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseQuantity" /> <short value="A fixed quantity (no comparator)" /> <definition value="The comparator is not used on a SimpleQuantity" /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <requirements value="The amount of therapeutic or other substance given at one administration event." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.doseAndRate.dose[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <mustSupport value="true" /> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-2, RXE-3" /> </mapping> <mapping> <identity value="rim" /> <map value=".doseQuantity" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> </element> <element id="Dosage.doseAndRate.rate[x]"> <path value="Dosage.doseAndRate.rate[x]" /> <short value="Amount of medication per unit of time" /> <definition value="Amount of medication per unit of time." /> <comment value="It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour." /> <requirements value="Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.doseAndRate.rate[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Ratio" /> </type> <type> <code value="Range" /> </type> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="RXE22, RXE23, RXE-24" /> </mapping> <mapping> <identity value="rim" /> <map value=".rateQuantity" /> </mapping> </element> <element id="Dosage.maxDosePerPeriod"> <path value="Dosage.maxDosePerPeriod" /> <short value="Upper limit on medication per unit of time" /> <definition value="Upper limit on medication per unit of time." /> <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day"." /> <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.maxDosePerPeriod" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Ratio" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="rat-1" /> <severity value="error" /> <human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" /> <expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" /> <xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))" /> <source value="http://hl7.org/fhir/StructureDefinition/Ratio" /> </constraint> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="N/A" /> </mapping> <mapping> <identity value="rim" /> <map value="RTO" /> </mapping> <mapping> <identity value="v2" /> <map value="RXO-23, RXE-19" /> </mapping> <mapping> <identity value="rim" /> <map value=".maxDoseQuantity" /> </mapping> </element> <element id="Dosage.maxDosePerAdministration"> <path value="Dosage.maxDosePerAdministration" /> <short value="Upper limit on medication per administration" /> <definition value="Upper limit on medication per administration." /> <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg." /> <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.maxDosePerAdministration" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="rim" /> <map value="not supported" /> </mapping> </element> <element id="Dosage.maxDosePerLifetime"> <path value="Dosage.maxDosePerLifetime" /> <short value="Upper limit on medication per lifetime of the patient" /> <definition value="Upper limit on medication per lifetime of the patient." /> <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." /> <requirements value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject." /> <min value="0" /> <max value="1" /> <base> <path value="Dosage.maxDosePerLifetime" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="qty-3" /> <severity value="error" /> <human value="If a code for the unit is present, the system SHALL also be present" /> <expression value="code.empty() or system.exists()" /> <xpath value="not(exists(f:code)) or exists(f:system)" /> <source value="http://hl7.org/fhir/StructureDefinition/Quantity" /> </constraint> <constraint> <key value="sqty-1" /> <severity value="error" /> <human value="The comparator is not used on a SimpleQuantity" /> <expression value="comparator.empty()" /> <xpath value="not(exists(f:comparator))" /> <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </constraint> <isModifier value="false" /> <isSummary value="true" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="v2" /> <map value="SN (see also Range) or CQ" /> </mapping> <mapping> <identity value="rim" /> <map value="PQ, IVL<PQ>, MO, CO, depending on the values" /> </mapping> <mapping> <identity value="rim" /> <map value="not supported" /> </mapping> </element> </snapshot> <differential> <element id="Dosage.text"> <path value="Dosage.text" /> <short value="Free text dosage instructions (SIG)." /> <mustSupport value="true" /> </element> <element id="Dosage.timing"> <path value="Dosage.timing" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Dosage.asNeeded[x]"> <path value="Dosage.asNeeded[x]" /> <comment value="MERT does not support asNeededCodeableConcept; use asNeededBoolean." /> <type> <code value="boolean" /> </type> <mustSupport value="true" /> </element> <element id="Dosage.route"> <path value="Dosage.route" /> <short value="Route of administration (free text preferred in route.text)." /> <comment value="MERT captures route as free text using route.text (CodeableConcept.text) rather than coded route values." /> <mustSupport value="true" /> </element> <element id="Dosage.route.text"> <path value="Dosage.route.text" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Dosage.doseAndRate"> <path value="Dosage.doseAndRate" /> <mustSupport value="true" /> </element> <element id="Dosage.doseAndRate.dose[x]"> <path value="Dosage.doseAndRate.dose[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Dosage.doseAndRate.dose[x]:doseRange"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseRange" /> <min value="0" /> <max value="1" /> <type> <code value="Range" /> </type> <mustSupport value="true" /> </element> <element id="Dosage.doseAndRate.dose[x]:doseQuantity"> <path value="Dosage.doseAndRate.dose[x]" /> <sliceName value="doseQuantity" /> <min value="0" /> <max value="1" /> <type> <code value="Quantity" /> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" /> </type> <mustSupport value="true" /> </element> </differential> </StructureDefinition>