{ "resourceType": "StructureDefinition", "id": "b8fc5d8c-421a-44c9-957e-2926cca0b1f9", "meta": { "lastUpdated": "2019-07-31T17:26:58.8384319+00:00" }, "url": "http://ots.nccn.org/hl7/fhir/StructureDefinition/RegimenEntryTemplate", "name": "RegimenEntryTemplate", "title": "RegimenEntryTemplate", "status": "active", "experimental": false, "date": "2019-07-31T17:26:58.6309538+00:00", "publisher": "National Comprehensive Cancer Network, Inc.", "contact": [ { "telecom": [ { "system": "url", "value": "https://www.nccn.org/about/contact.aspx", "use": "work" } ] } ], "description": "The child-most action(s) defined by an OrderTemplate are internal references to a RegimenEntryTemplate (a profile of the ActivityDefinition resource at http://hl7.org/fhir/activitydefinition.html). The RegimenEntryTemplate defines a single medication and its dosage instructions. Because a RegimenEntryTemplate is so dependent on the OrderTemplate from which it comes, it is defined as an internal or contained resource within the OrderTemplate. Please see http://hl7.org/fhir/plandefinition.html for more information regarding the relationship between PlanDefinition and ActivityDefinition, and please see https://www.hl7.org/fhir/references.html for more information on contained resources. Note that the RegimenEntryTemplate is of kind (ActivityDefinition.kind) MedicationRequest (see http://hl7.org/fhir/medicationrequest.html).", "copyright": "National Comprehensive Cancer Network, Inc. (c) 2017. All right reserved.", "fhirVersion": "3.0.1", "kind": "resource", "abstract": false, "type": "ActivityDefinition", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition", "derivation": "constraint", "differential": { "element": [ { "id": "ActivityDefinition.meta", "path": "ActivityDefinition.meta", "short": "Metadata about the ActivityDefinition.", "definition": "Metadata about the ActivityDefinition. Only meta.profile is used.", "min": 1 }, { "id": "ActivityDefinition.meta.versionId", "path": "ActivityDefinition.meta.versionId", "max": "0" }, { "id": "ActivityDefinition.meta.lastUpdated", "path": "ActivityDefinition.meta.lastUpdated", "max": "0" }, { "id": "ActivityDefinition.meta.profile", "path": "ActivityDefinition.meta.profile", "short": "Profiles this resource claims to conform to.", "min": 1, "max": "1", "fixedUri": "http://ots.nccn.org/hl7/fhir/StructureDefinition/RegimenEntryTemplate", "mustSupport": false }, { "id": "ActivityDefinition.meta.security", "path": "ActivityDefinition.meta.security", "max": "0" }, { "id": "ActivityDefinition.meta.tag", "path": "ActivityDefinition.meta.tag", "max": "0" }, { "id": "ActivityDefinition.implicitRules", "path": "ActivityDefinition.implicitRules", "max": "0" }, { "id": "ActivityDefinition.language", "path": "ActivityDefinition.language", "short": "Language of the resource content.", "definition": "The language in which the resource is written.", "comment": "Fixed to 'en-US', or English (United States).", "min": 1, "fixedCode": "en-US" }, { "id": "ActivityDefinition.text", "path": "ActivityDefinition.text", "max": "0" }, { "id": "ActivityDefinition.contained", "path": "ActivityDefinition.contained", "max": "0" }, { "id": "ActivityDefinition.url", "path": "ActivityDefinition.url", "max": "0" }, { "id": "ActivityDefinition.identifier", "path": "ActivityDefinition.identifier", "max": "0" }, { "id": "ActivityDefinition.version", "path": "ActivityDefinition.version", "max": "0" }, { "id": "ActivityDefinition.name", "path": "ActivityDefinition.name", "max": "0" }, { "id": "ActivityDefinition.title", "path": "ActivityDefinition.title", "max": "0" }, { "id": "ActivityDefinition.status", "path": "ActivityDefinition.status", "definition": "The publication status of the template from which this medication entry is derived from.", "comment": "Published templates have a status of \"active\". Draft or test templates have a status of \"draft\". Only published/\"active\" templates are appropriate for use in a clinical setting.\r\n\r\nA list of status codes are available at: http://hl7.org/fhir/publication-status." }, { "id": "ActivityDefinition.experimental", "path": "ActivityDefinition.experimental", "max": "0" }, { "id": "ActivityDefinition.date", "path": "ActivityDefinition.date", "max": "0" }, { "id": "ActivityDefinition.publisher", "path": "ActivityDefinition.publisher", "max": "0" }, { "id": "ActivityDefinition.description", "path": "ActivityDefinition.description", "max": "0" }, { "id": "ActivityDefinition.purpose", "path": "ActivityDefinition.purpose", "max": "0" }, { "id": "ActivityDefinition.usage", "path": "ActivityDefinition.usage", "max": "0" }, { "id": "ActivityDefinition.approvalDate", "path": "ActivityDefinition.approvalDate", "max": "0" }, { "id": "ActivityDefinition.lastReviewDate", "path": "ActivityDefinition.lastReviewDate", "max": "0" }, { "id": "ActivityDefinition.effectivePeriod", "path": "ActivityDefinition.effectivePeriod", "max": "0" }, { "id": "ActivityDefinition.useContext", "path": "ActivityDefinition.useContext", "max": "0" }, { "id": "ActivityDefinition.jurisdiction", "path": "ActivityDefinition.jurisdiction", "max": "0" }, { "id": "ActivityDefinition.topic", "path": "ActivityDefinition.topic", "max": "0" }, { "id": "ActivityDefinition.contributor", "path": "ActivityDefinition.contributor", "max": "0" }, { "id": "ActivityDefinition.contact", "path": "ActivityDefinition.contact", "max": "0" }, { "id": "ActivityDefinition.copyright", "path": "ActivityDefinition.copyright", "max": "0" }, { "id": "ActivityDefinition.relatedArtifact", "path": "ActivityDefinition.relatedArtifact", "max": "0" }, { "id": "ActivityDefinition.library", "path": "ActivityDefinition.library", "max": "0" }, { "id": "ActivityDefinition.kind", "path": "ActivityDefinition.kind", "definition": "A description of the kind of resource the activity definition is representing. In this case, a MedicationRequest.", "comment": "An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called \"MedicationRequest\" rather than \"MedicationPrescription\" or \"MedicationOrder\" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.", "min": 1, "fixedCode": "MedicationRequest" }, { "id": "ActivityDefinition.code", "path": "ActivityDefinition.code", "max": "0" }, { "id": "ActivityDefinition.timing[x]", "path": "ActivityDefinition.timing[x]", "max": "0" }, { "id": "ActivityDefinition.location", "path": "ActivityDefinition.location", "max": "0" }, { "id": "ActivityDefinition.participant", "path": "ActivityDefinition.participant", "max": "0" }, { "id": "ActivityDefinition.product[x]:productCodeableConcept", "path": "ActivityDefinition.productCodeableConcept", "sliceName": "productCodeableConcept", "short": "Medication being administered/supplied.", "definition": "Identifies the medication/agent being consumed or supplied in the activity.", "comment": "n/a", "min": 1, "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "required", "description": "Code describing the type of substance or medication.", "valueSetReference": { "reference": "http://ots.nccn.org/hl7/fhir/ValueSet/rxnorm-ingredients" } } }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.coding", "path": "ActivityDefinition.productCodeableConcept.coding", "short": "Medication code defined by Rxnorm.", "definition": "A reference to a code defined by Rxnorm.", "comment": "n/a", "requirements": "n/a", "min": 1, "max": "1" }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.coding.system", "path": "ActivityDefinition.productCodeableConcept.coding.system", "short": "Rxnorm coding system.", "definition": "All RxNorm codes whose TTY (Term Type) is IN (ingredient), PIN (precise ingredient), or MIN (multiple ingredients).", "comment": "n/a", "requirements": "n/a", "min": 1, "binding": { "strength": "required", "description": "Rxnorm coding system.", "valueSetUri": "http://www.nlm.nih.gov/research/umls/rxnorm" } }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.coding.version", "path": "ActivityDefinition.productCodeableConcept.coding.version", "max": "0" }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.coding.code", "path": "ActivityDefinition.productCodeableConcept.coding.code", "short": "Medicaton code.", "definition": "Rxnorm medication code (RXCUI).", "comment": "For instance, the Rxnorm code for Methotrexate Sodium is 287734.", "requirements": "n/a", "min": 1, "example": [ { "label": "Rxnorm code", "valueCode": "287734" } ] }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.productCodeableConcept.coding.display", "short": "String text of the medication.", "definition": "Usually the Precise Ingredient according to Rxnorm. For instance, \"Methotrexate Sodium\".", "comment": "n/a", "requirements": "n/a", "min": 1, "example": [ { "label": "Rxnorm display", "valueString": "Methotrexate Sodium" } ] }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.coding.userSelected", "path": "ActivityDefinition.productCodeableConcept.coding.userSelected", "max": "0" }, { "id": "ActivityDefinition.product[x]:productCodeableConcept.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.productCodeableConcept.text", "short": "Plain text representation of medication.", "definition": "Usually the Ingredient according to Rxnorm. For instance, \"Methotrexate\".", "comment": "n/a", "requirements": "n/a", "min": 1, "example": [ { "label": "Rxnorm medication text", "valueString": "Methotrexate" } ] }, { "id": "ActivityDefinition.quantity", "path": "ActivityDefinition.quantity", "max": "0" }, { "id": "ActivityDefinition.dosage", "path": "ActivityDefinition.dosage", "min": 1, "max": "1" }, { "id": "ActivityDefinition.dosage.extension", "path": "ActivityDefinition.dosage.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "ActivityDefinition.dosage.extension:fullyStructured", "path": "ActivityDefinition.dosage.extension", "sliceName": "fullyStructured", "definition": "Indicates whether or not information contained within the template could be completely structured and parsed into a FHIR-equivalent representation of that information. If there is any \"custom\" text that was entered into the NCCN Chemotherapy Order Template Tool when authoring the template, then this extension's value would be false.", "comment": "n/a", "min": 1, "type": [ { "code": "Extension", "profile": "http://ots.nccn.org/hl7/fhir/StructureDefinition/fullyStructured" } ] }, { "id": "ActivityDefinition.dosage.sequence", "path": "ActivityDefinition.dosage.sequence", "max": "0" }, { "id": "ActivityDefinition.dosage.text", "path": "ActivityDefinition.dosage.text", "short": "Detailed dosage instructions.", "definition": "Provides detailed dosage instructions in the same way that they are described for MedicationRequest resources.", "comment": "For example, \"15 mg intrathecal\", \"60?-?75 mg/m2 IV push on Day 1\", or \"12 mg intrathecal on Days 1, 8, and 15 of Course 2 (Consolidation 1B)\"", "min": 1, "example": [ { "label": "Dosage text example", "valueString": "15 mg intrathecal" } ] }, { "id": "ActivityDefinition.dosage.additionalInstruction", "path": "ActivityDefinition.dosage.additionalInstruction", "max": "0" }, { "id": "ActivityDefinition.dosage.patientInstruction", "path": "ActivityDefinition.dosage.patientInstruction", "max": "0" }, { "id": "ActivityDefinition.dosage.timing", "path": "ActivityDefinition.dosage.timing", "short": "When medication should be administered.", "definition": "When medication should be administered. See https://www.hl7.org/fhir/datatypes.html#Timing for more information and examples." }, { "id": "ActivityDefinition.dosage.timing.extension", "path": "ActivityDefinition.dosage.timing.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "ActivityDefinition.dosage.timing.extension:daysOfCycle", "path": "ActivityDefinition.dosage.timing.extension", "sliceName": "daysOfCycle", "type": [ { "code": "Extension", "profile": "http://ots.nccn.org/hl7/fhir/StructureDefinition/daysOfCycle" } ] }, { "id": "ActivityDefinition.dosage.timing.event", "path": "ActivityDefinition.dosage.timing.event", "max": "0" }, { "id": "ActivityDefinition.dosage.timing.repeat", "path": "ActivityDefinition.dosage.timing.repeat", "short": "When the event is to occur.", "definition": "A set of rules that describe when the event is scheduled. See https://www.hl7.org/fhir/datatypes.html#Timing for more information and example.", "comment": "For example, if the ActivityDefinition.dosage.text was \"600,000 units/kg IV over 15 minutes every 8 hours for a maximum of 14 doses on Days 1 ? 5 and 15 ? 19 (for a maximum of 28 total doses per cycle)\" then the ActivityDefinition.dosage.timing.repeat would be:\r\n\r\nduration value=\"15\"\r\ndurationUnit value=\"min\"\r\nfrequency value=\"1\"\r\nperiod value=\"8\"\r\nperiodUnit value=\"h\"" }, { "id": "ActivityDefinition.dosage.timing.repeat.bounds[x]:boundsRange", "path": "ActivityDefinition.dosage.timing.repeat.boundsRange", "sliceName": "boundsRange", "type": [ { "code": "Range" } ] }, { "id": "ActivityDefinition.dosage.timing.repeat.dayOfWeek", "path": "ActivityDefinition.dosage.timing.repeat.dayOfWeek", "max": "0" }, { "id": "ActivityDefinition.dosage.timing.repeat.timeOfDay", "path": "ActivityDefinition.dosage.timing.repeat.timeOfDay", "max": "0" }, { "id": "ActivityDefinition.dosage.timing.repeat.when", "path": "ActivityDefinition.dosage.timing.repeat.when", "max": "0" }, { "id": "ActivityDefinition.dosage.timing.repeat.offset", "path": "ActivityDefinition.dosage.timing.repeat.offset", "max": "0" }, { "id": "ActivityDefinition.dosage.timing.code", "path": "ActivityDefinition.dosage.timing.code", "max": "0" }, { "id": "ActivityDefinition.dosage.asNeeded[x]", "path": "ActivityDefinition.dosage.asNeeded[x]", "max": "0" }, { "id": "ActivityDefinition.dosage.site", "path": "ActivityDefinition.dosage.site", "max": "0" }, { "id": "ActivityDefinition.dosage.route", "path": "ActivityDefinition.dosage.route", "short": "How drug should enter body.", "definition": "How the medication/agent should enter the body. Picked from SNOMED-CT.", "comment": "Examples include IV, IV push, IV continuous infusion, PO, subcutaneous, percutaneous, etc.", "requirements": "n/a", "min": 1 }, { "id": "ActivityDefinition.dosage.route.coding", "path": "ActivityDefinition.dosage.route.coding", "short": "Code defined by the SNOMED-CT terminology system", "definition": "A reference to a code defined by SNOMED-CT.", "comment": "n/a", "requirements": "n/a", "min": 1, "max": "1" }, { "id": "ActivityDefinition.dosage.route.coding.system", "path": "ActivityDefinition.dosage.route.coding.system", "short": "SNOMED-CT", "comment": "n/a", "requirements": "n/a", "min": 1, "fixedUri": "http://snomed.info/sct" }, { "id": "ActivityDefinition.dosage.route.coding.version", "path": "ActivityDefinition.dosage.route.coding.version", "max": "0" }, { "id": "ActivityDefinition.dosage.route.coding.code", "path": "ActivityDefinition.dosage.route.coding.code", "short": "SNOMED-CT ConceptID", "definition": "SNOMED-CT ConceptID", "comment": "For example, the SNOMED-CT code for \"Intravenous route\" is 47625008.", "requirements": "n/a", "min": 1, "example": [ { "label": "SNOMED-CT code", "valueCode": "47625008" } ] }, { "id": "ActivityDefinition.dosage.route.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.dosage.route.coding.display", "short": "String name of code.", "comment": "For example, the SNOMED-CT display text is \"Intravenous route\" for code 47625008.", "requirements": "n/a", "min": 1, "example": [ { "label": "SNOMED-CT display", "valueString": "Intravenous route" } ] }, { "id": "ActivityDefinition.dosage.route.coding.userSelected", "path": "ActivityDefinition.dosage.route.coding.userSelected", "max": "0" }, { "id": "ActivityDefinition.dosage.route.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.dosage.route.text", "short": "Plain text representation of the concept.", "definition": "An often abbreviated version of route.coding.display.", "comment": "For example, route.coding.display might be \"Intravenous route\" but route.text is \"IV\".", "requirements": "n/a", "min": 1, "example": [ { "label": "Route text", "valueString": "IV" } ] }, { "id": "ActivityDefinition.dosage.method", "path": "ActivityDefinition.dosage.method", "short": "IV administration methods.", "definition": "Administration methods for medications given with a route of IV. Applicable only if route is IV push or IV continuous infusion.", "comment": "n/a", "requirements": "n/a", "binding": { "strength": "required", "description": "IV administration methods", "valueSetReference": { "reference": "http://ots.nccn.org/hl7/fhir/ValueSet/iv-administration-methods-ValueSet" } } }, { "id": "ActivityDefinition.dosage.method.coding", "path": "ActivityDefinition.dosage.method.coding", "short": "Codes for IV administration methods.", "definition": "Administration methods for medications given with a route of IV. Applicable only if route is IV push or IV continuous infusion.", "comment": "n/a", "requirements": "n/a", "min": 1, "max": "1", "binding": { "strength": "required", "description": "SNOMED-CT", "valueSetUri": "http://snomed.info/sct" } }, { "id": "ActivityDefinition.dosage.method.coding.system", "path": "ActivityDefinition.dosage.method.coding.system", "short": "Identity of the terminology system.", "comment": "n/a", "requirements": "n/a", "min": 1, "binding": { "strength": "required", "description": "SNOMED-CT", "valueSetUri": "http://snomed.info/sct" } }, { "id": "ActivityDefinition.dosage.method.coding.version", "path": "ActivityDefinition.dosage.method.coding.version", "max": "0" }, { "id": "ActivityDefinition.dosage.method.coding.code", "path": "ActivityDefinition.dosage.method.coding.code", "short": "SNOMED-CT code.", "definition": "Administration methods for medications given with a route of IV. Applicable only if route is IV push (code 420620005) or IV continuous infusion (code 261754007).", "comment": "n/a", "requirements": "n/a", "min": 1, "example": [ { "label": "SNOMED-CT code for IV push", "valueCode": "420620005" } ] }, { "id": "ActivityDefinition.dosage.method.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.dosage.method.coding.display", "short": "String name of code.", "definition": "Text of the SNOMED-CT code.", "comment": "For example, \"Push - dosing instruction imperative (qualifier value)\".", "min": 1, "example": [ { "label": "SNOMED-CT IV method display", "valueString": "Push - dosing instruction imperative (qualifier value)" } ] }, { "id": "ActivityDefinition.dosage.method.coding.userSelected", "path": "ActivityDefinition.dosage.method.coding.userSelected", "max": "0" }, { "id": "ActivityDefinition.dosage.method.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.dosage.method.text", "short": "Plain text representation of the concept.", "definition": "A more human-friendly, common, and abbreviated name for the SNOMED-CT concept.", "comment": "For example, \"Push - dosing instruction imperative (qualifier value)\" would have a text value of \"IV push\".", "requirements": "n/a", "min": 1, "example": [ { "label": "SNOMED-CT IV method text", "valueString": "IV push" } ] }, { "id": "ActivityDefinition.dosage.dose[x]", "path": "ActivityDefinition.dosage.dose[x]", "definition": "Amount of medication per dose. Usually coded to http://unitsofmeasure.org.", "binding": { "strength": "extensible", "valueSetUri": "http://unitsofmeasure.org" } }, { "id": "ActivityDefinition.dosage.maxDosePerPeriod", "path": "ActivityDefinition.dosage.maxDosePerPeriod", "max": "0" }, { "id": "ActivityDefinition.dosage.maxDosePerAdministration", "path": "ActivityDefinition.dosage.maxDosePerAdministration", "short": "Upper limit on medication per administration.", "definition": "An example is if dosage.text said \"20 mg/m2 (maximum 44 mg) IV over 10 - 30 minutes daily on Days 1 - 2\", then the \"maximum 44 mg\" part would get parsed and coded here. Usually coded to http://unitsofmeasure.org." }, { "id": "ActivityDefinition.dosage.maxDosePerAdministration.value", "path": "ActivityDefinition.dosage.maxDosePerAdministration.value", "example": [ { "label": "Max dose value", "valueDecimal": 44 } ] }, { "id": "ActivityDefinition.dosage.maxDosePerAdministration.system", "path": "ActivityDefinition.dosage.maxDosePerAdministration.system", "binding": { "strength": "extensible", "valueSetReference": { "reference": "http://unitsofmeasure.org" } } }, { "id": "ActivityDefinition.dosage.maxDosePerLifetime", "path": "ActivityDefinition.dosage.maxDosePerLifetime", "max": "0" }, { "id": "ActivityDefinition.dosage.rateQuantity:rateQuantity", "path": "ActivityDefinition.dosage.rateQuantity", "sliceName": "rateQuantity", "short": "Amount of medication per unit of time.", "definition": "An example would be Gemcitabine 800 mg/m? IV at a rate of 10 mg/m?/minute on Days 1 and 8, then the rate portion is \"10 mg/m2/minute\" and that would get parsed out and coded here.", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ] }, { "id": "ActivityDefinition.dosage.rateQuantity:rateQuantity.value", "path": "ActivityDefinition.dosage.rateQuantity.value", "comment": "An example would be Gemcitabine 800 mg/m? IV at a rate of 10 mg/m?/minute on Days 1 and 8, then the rate portion is \"10 mg/m2/minute\" and that would get parsed out and coded here.", "requirements": "n/a", "min": 1, "example": [ { "label": "Rate value", "valueDecimal": 10 } ] }, { "id": "ActivityDefinition.dosage.rateQuantity:rateQuantity.unit", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "ActivityDefinition.dosage.rateQuantity.unit", "short": "Unit representation.", "comment": "An example would be Gemcitabine 800 mg/m? IV at a rate of 10 mg/m?/minute on Days 1 and 8, then the rate portion is \"10 mg/m2/minute\" and that would get parsed out and coded here.", "min": 1, "example": [ { "label": "Rate unit", "valueString": "mg/m2/minute" } ] }, { "id": "ActivityDefinition.dosage.rateQuantity:rateQuantity.system", "path": "ActivityDefinition.dosage.rateQuantity.system", "max": "0" }, { "id": "ActivityDefinition.dosage.rateQuantity:rateQuantity.code", "path": "ActivityDefinition.dosage.rateQuantity.code", "max": "0" }, { "id": "ActivityDefinition.bodySite", "path": "ActivityDefinition.bodySite", "max": "0" }, { "id": "ActivityDefinition.transform", "path": "ActivityDefinition.transform", "max": "0" }, { "id": "ActivityDefinition.dynamicValue", "path": "ActivityDefinition.dynamicValue", "max": "0" } ] } }