FHIR Release 3 (STU) CI-Build

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0 . For a full list Continuous Integration Build of available versions, see FHIR (will be incorrect/inconsistent at times).
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Responsible Owner: Pharmacy icon Work Group Maturity Level : 3   Trial Use Security Category : Business Compartments : Not linked to any No defined compartments

Detailed Descriptions for the elements in the Medication resource.

Control Control Control Control Control Control Control Control Control Medication.package.content Control Control
Definition Element Id Medication
Definition

This resource is primarily used for the identification and definition of a medication. It covers medication, including ingredients, for the ingredients purposes of prescribing, dispensing, and the packaging administering a medication as well as for making statements about medication use.

Short Display Definition of a Medication
Cardinality 0..*
Type DomainResource
Summary false
Element Id Medication.identifier
Definition

Business identifier for this medication.

Short Display Business identifier for this medication
Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
1..1 Type Identifier
Summary true
Comments

The serial number could be included as an identifier.

Definition Element Id Medication.code
Definition

A code (or set of codes) that specify this medication, or a textual description if no code is available. description. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems. The name of the medication can be conveyed in the code.text even if it is different from any of the coding displayName values.

Short Display Codes that identify this medication
Cardinality 0..1
Terminology Binding SNOMED CT Medication Codes ( Example )
Type CodeableConcept
Summary true
Comments

Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A "A coding may be marked as a "userSelected" "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

Definition Element Id Medication.status
Definition

A code to indicate if the medication is in active use.

Short Display active | inactive | entered-in-error
Cardinality 0..1
Terminology Binding MedicationStatus Medication Status Codes ( Required )
Type code
Is Modifier true (Reason: This element changes the interpretation of all descriptive attributes.)
Summary true
Comments

This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

Definition Element Id Medication.marketingAuthorizationHolder
Definition

Set to true if The company or other legal entity that has authorization, from the item is attributable appropriate drug regulatory authority, to market a specific manufacturer. medicine in one or more jurisdictions. Typically abbreviated MAH.Note: The MAH may manufacture the product and may also contract the manufacturing of the product to one or more companies (organizations).

Short Display Organization that has authorization to market medication
Cardinality 0..1
Type boolean Reference ( Organization )
Summary true
Definition Element Id Medication.doseForm
Definition

Set to true if Describes the medication can be obtained without an order from a prescriber. form of the item. Powder; tablets; capsule.

Short Display powder | tablets | capsule +
Cardinality 0..1
Terminology Binding SNOMED CT Form Codes ( Example )
Type boolean CodeableConcept
Summary false
true Comments

When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

Definition Element Id Medication.packageSize
Definition

Describes When the details of code does not specify the manufacturer of package size, this backbone element can be used to specify the overall amount of medication product. This is in the package.

Short Display When the code does not intended specify the package size, this backbone element can be used to represent specify the distributor overall amount of a medication product. in the package
Control Cardinality 0..1
Type Summary true
Comments Reference ( Organization )

To represent a medication that has 5 vials with 10ml in each vial and the medication code just represents a vial, then the number of Items would be '5 vial' and the amountPerItem would be '10ml/vial'. To represent a medication where there are 300 tablets and the code is for 100mg tablets, the number of items would be '300 tablets'

Constraints Summary
Defined on this element
med-1 Rule Either numberOfItems or amountPerItem must exist true numberOfItems.exists() or amountPerItem.exists()
Definition Element Id Medication.packageSize.numberOfItems
Definition

Describes the form The number of items in the item. Powder; tablets; capsule. package that are represented by the code, e.g. 5 vials or 100 tablets.

Short Display The number of items in the package that are represented by the code
Cardinality 0..1
Terminology Binding Type SNOMED CT Form Codes ( Example SimpleQuantity )
Type Summary false
Comments Element Id Medication.packageSize.amountPerItem
Definition

When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form. The amount per each item, e.g. 10 ml / vial.

Short Display The amount per each item
Cardinality 0..1
Type Ratio
Summary false
Definition Element Id Medication.ingredient
Definition

Identifies a particular constituent of interest in the product.

Short Display Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications
Cardinality 0..*
Comments Summary false
Comments

The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients. If Medication.code represents a fully specified product (the product + the strength + the dosage form) then including ingredients is duplicative. However, there may be implementation considerations which dictate including ingredients when Medication.code is a fully specified product. For compounded products, active and inactive ingredients should be included. However, even with all ingredients specified, a Medication resource should not be considered a "recipe" as the sequence and techniques for preparing the final product cannot be included.

Definition Element Id Medication.ingredient.item
Definition

The actual ingredient - either (substance or medication) that the ingredient.strength relates to. This is represented as a substance (simple ingredient) concept from a code system or described in another medication. resource (Substance or Medication).

Short Display The specific substance or medication that is the ingredient
Cardinality 1..1
Type Terminology Binding SNOMED CT Medication Codes ( Example )
CodeableConcept Type | Reference CodeableReference ( Substance | SubstanceDefinition | Medication )
[x] Note Summary false
See Choice Comments

The ingredient may reference a medication substance (for example, amoxicillin) or another medication (for example in the case of Data Types for further information about how a compounded product, Glaxal Base). A referenced medication may be fully specified (amoxicillin 250 mg capsule), partially specified (amoxicillin 250mg), or may refer to use [x] an abstract ingredient (e.g., amoxicillin).

Definition Element Id Medication.ingredient.isActive
Definition

Indication of whether this ingredient affects the this ingredient affects the therapeutic action of the drug.

Short Display Active ingredient indicator
Cardinality 0..1
Type boolean
Requirements

True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

Summary false
Definition Element Id Medication.ingredient.role
Definition

Specifies how many (or how much) Indication of the items there are in whether this Medication. For example, 250 mg per tablet. This is expressed as a ratio where ingredient affects the numerator is 250mg and therapeutic action of the denominator is 1 tablet. drug.

Short Display A code that defines the type of ingredient, active, base, etc.
Control Cardinality 0..1
Type Terminology Binding Ratio RoleClassIngredientEntity icon ( Example )
Type Medication.package CodeableConcept
Definition Requirements

Information that only applies This can be used in combination with the isActive element to packages (not products). provide further information about the type of ingredient.

Control Summary 0..1 false
Definition Element Id Medication.ingredient.strength[x]
Definition

The kind Specifies how many (or how much) of container that the items there are in this package comes as. Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet but can also be expressed a quantity when the denominator is assumed to be 1 tablet.

Short Display Quantity of ingredient present
Control Cardinality 0..1
Terminology Binding MedicationContainer Medication Ingredient Strength Codes ( Example Preferred )
Type Ratio | CodeableConcept | Quantity
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary false
Definition Comments

A set Medication.ingredient.strength.denominator can cause some confusion. For example, the concentration of components that go a pediatric acetaminophen suspension can be '32 mg / 1 ml' or '160 mg / 5 ml'. Both strengths are the same (32 mg * 5 = 160 mg). In clinical systems (drug databases) strengths are usually to make up unit volumes (32 mg / 1 ml). While on a consumer product it's preferred to say how much per 'typical' dose (160 mg / 5 ml, with 5 ml (1 tsp) being the described item. typical dose). Both representations are valid. Best practice is to select the denominator most relevant to the situation and use that same denominator for all ingredients. Ingredient.strength is problematic for multi-ingredient ingredients. For example, antacid products often contain multiple ingredients, such as 'aluminum & magnesium hydroxide with simethicone 400-400-40 mg/5ml'. Expressing a 'final concentration' in these cases is intractable and the best option is to not include ingredient.strength.

Element Id Medication.instance
Definition

Identifies one of the items in the package. Information that only applies to packages (not products).

Control Short Display 1..1 Details about packaged medications
Type Cardinality CodeableConcept | Reference ( Medication ) 0..1
[x] Note See Choice of Data Types Summary for further information about how to use [x] false
Definition Element Id Medication.instance.identifier
Definition

The amount of the product that is in Identifier for the package. physical instance, typically a serial number.

Control Short Display 0..1 Identifier for the physical instance, typically a serial number
Type Note SimpleQuantity This is a business identifier, not a resource identifier (see discussion )
Cardinality Medication.package.batch 0..*
Definition Type Information about a group of medication produced or packaged from one production run. Identifier
Control Summary 0..* false
Definition Element Id Medication.instance.lotNumber
Definition

The assigned lot number of a batch of the specified product.

Short Display Identifier assigned to batch
Cardinality 0..1
Type string
Summary false
Definition Element Id Medication.instance.expirationDate
Definition

When this specific batch instance of product will expire.

Short Display When instance will expire
Cardinality 0..1
Type dateTime
Summary false
Definition Element Id Medication.definition
Definition

Photo(s) or graphic representation(s) of the A reference to a definitional resource that provides more information about this medication.

Short Display Formal definition of the medication
Control Cardinality 0..* 0..1
Type Attachment Reference ( MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition )
Requirements Summary Note that "image" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg). false