Release 4 FHIR CI-Build

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See the Directory of published versions icon . Page versions: R5 R4B R4 R3 R2

11.5 Resource Medication - Content

Responsible Owner: Pharmacy icon Work Group Maturity Level : 3   Trial Use Security Category : Business Compartments : Not linked to any No defined compartments

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

Representing medications in the majority of most healthcare settings is a matter of identifying an item from a list and then conveying a reference for the item selected either into a patient-related resource or to other applications. selected. Additional information about the medication is frequently provided for human verification, verification (e.g., the product name), but a full representation of the details of composition and efficacy of the medicine is conveyed by referring to drug dictionaries by means of the codes they define. There are some occasions where it is necessary to identify slightly more detail, such as when dispensing a package containing a particular medication requires identification both of the medicine and the package at once. There are also some occasions (e.g. custom formulations) where the composition of a medicine must be represented. In these cases, the ingredients of the medicine have to must be specified together with the amount contained, though the Medication resource does not provide full details.

The Medication resource allows for medications to be characterized by the form of the drug and drug, the ingredient (or ingredients), as well as and how it is packaged. The medication will include the ingredient(s) ingredient(s), and their strength(s) and the package can include the amount (for example, number of tablets, volume, etc.) that is contained in a particular container (for example, 100 capsules of Amoxicillin 500mg per bottle).

The Medication resource can be used to describe a compounded (aka extemporaneous or magistral) product that is manufactured by the pharmacy at the time of dispensing. In this case there will be multiple ingredients which are typically base chemicals (for example, hydrocortisone powder) and there may be other ingredients that are manufactured products (for example, Glaxal Base).

When a medication includes a package, further details about the composition The Medication resource can also be provided. A package has a container (vacuum packed box, jar, etc.) and a list of used to describe combination packaged products. In this case, the ingredients will refer to the component products either as codes or other packages that are in the package. as references to Medication resource instances.

This resource is referenced by

Structure

Amount 0..* Active or inactive ingredient 1..1 Ratio
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . Medication TU DomainResource Definition of a Medication

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Business identifier for this medication

. . . code Σ 0..1 CodeableConcept Codes that identify this medication
Binding: SNOMED CT Medication Codes ( Example )
. . . status ?! Σ 0..1 code active | inactive | entered-in-error
Binding: Medication status codes Status Codes ( Required )
. . . form doseForm 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMED CT Form Codes ( Example )
. . amount . packageSize Σ C 0..1 Ratio BackboneElement When the code does not specify the package size, this backbone element can be used to specify the overall amount of drug medication in the package
+ Rule: Either numberOfItems or amountPerItem must exist
. . . ingredient . numberOfItems 0..1 BackboneElement SimpleQuantity The number of items in the package that are represented by the code
. . . item[x] . amountPerItem 0..1 Ratio The actual ingredient or content amount per each item
. . . ingredient itemCodeableConcept 0..* CodeableConcept BackboneElement Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications

. . . . itemReference item 1..1 Reference CodeableReference ( Substance | SubstanceDefinition | Medication ) The specific substance or medication that is the ingredient
Binding: SNOMED CT Medication Codes ( Example )
. . . . isActive 0..1 boolean Active ingredient indicator
. . . . strength role 0..1 CodeableConcept A code that defines the type of ingredient, active, base, etc.
Binding: RoleClassIngredientEntity icon ( Example )
0..1
. . . . strength[x] 0..1 Quantity of ingredient present
Binding: Medication Ingredient Strength Codes ( Preferred )
. . batch . . . strengthRatio Ratio
. . . . . strengthCodeableConcept CodeableConcept
. . . . . strengthQuantity 0..1 BackboneElement Quantity
. . . instance 0..1 BackboneElement Details about packaged medications
. . . lotNumber . identifier 0..* Identifier Identifier for the physical instance, typically a serial number

0..1
. . . . lotNumber 0..1 string Identifier assigned to batch
. . . . expirationDate 0..1 dateTime When batch instance will expire
. . . definition 0..1 Reference ( MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition ) Formal definition of the medication

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Medication ( DomainResource ) Business identifier for this medication identifier : Identifier [0..*] 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 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 code : CodeableConcept [0..1] « A coded concept that defines the type of a medication. null (Strength=Example) SNOMEDCTMedicationCodes ?? » A code to indicate if the medication is in active use (this element modifies the meaning of other elements) status : code [0..1] « A coded concept defining if the medication is in active use. null (Strength=Required) Medication Status MedicationStatusCodes ! » Describes the details of the manufacturer of The company or other legal entity that has authorization, from the medication product. This is not intended appropriate drug regulatory authority, to represent market a medicine in one or more jurisdictions. Typically abbreviated MAH.Note: The MAH may manufacture the distributor product and may also contract the manufacturing of a medication the product to one or more companies (organizations) manufacturer marketingAuthorizationHolder : Reference [0..1] « Organization » Describes the form of the item. Powder; tablets; capsule form doseForm : CodeableConcept [0..1] « A coded concept defining the form of a medication. null (Strength=Example) SNOMEDCTFormCodes ?? » Specific amount of the drug in the packaged product. For example, when specifying A reference to a product definitional resource that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification more information about this medication definition : Reference [0..1] « MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition » PackageSize The number of items in the package amount (For example, 3 mL, 10mL, etc.) that are represented by the code, e.g. 5 vials or 100 tablets numberOfItems : Quantity ( SimpleQuantity ) [0..1] The amount per each item, e.g. 10 ml / vial amountPerItem : Ratio [0..1] Ingredient 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 of a medication resource (Substance or Medication) item[x] item : Type CodeableReference [1..1] « CodeableConcept Substance | Reference ( Substance SubstanceDefinition | Medication ) ; null (Strength=Example) SNOMEDCTMedicationCodes ?? » Indication of whether this ingredient affects the therapeutic action of the drug isActive : boolean [0..1] Indication of whether this ingredient affects the therapeutic action of the drug role : CodeableConcept [0..1] « null (Strength=Example) RoleClassIngredientEntity ?? » Specifies how many (or how much) of the items there are in this 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 strength strength[x] : Ratio DataType [0..1] « Ratio | CodeableConcept | Quantity ; null (Strength=Preferred) MedicationIngredientStrengthC... ? » Batch Instance Identifier for the physical instance, typically a serial number identifier : Identifier [0..*] The assigned lot number of a batch of the specified product lotNumber : string [0..1] When this specific batch instance of product will expire expirationDate : dateTime [0..1] When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package packageSize [0..1] Identifies a particular constituent of interest in the product ingredient [0..*] Information that only applies to packages (not products) batch instance [0..1]

XML Template

<

<Medication xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <</code>

 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>

 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <</manufacturer>
 <</form>
 <</amount>
 <
  <</item[x]>

 <marketingAuthorizationHolder><!-- 0..1 Reference(Organization) Organization that has authorization to market medication --></marketingAuthorizationHolder>
 <doseForm><!-- 0..1 CodeableConcept powder | tablets | capsule + --></doseForm>
 <packageSize>  <!-- 0..1 When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package -->
  <numberOfItems><!-- 0..1 Quantity(SimpleQuantity) The number of items in the package that are represented by the code --></numberOfItems>
  <amountPerItem><!-- 0..1 Ratio The amount per each item --></amountPerItem>
 </packageSize>
 <ingredient>  <!-- 0..* Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications -->
  <item><!-- 1..1 CodeableReference(Medication|Substance|SubstanceDefinition) The specific substance or medication that is the ingredient --></item>

  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <</strength>

  <role><!-- 0..1 CodeableConcept A code that defines the type of ingredient, active, base, etc. icon --></role>
  <strength[x]><!-- 0..1 Ratio|CodeableConcept|Quantity Quantity of ingredient present --></strength[x]>

 </ingredient>
 <
  <
  <
 </batch>

 <instance>  <!-- 0..1 Details about packaged medications -->
  <identifier><!-- 0..* Identifier Identifier for the physical instance, typically a serial number --></identifier>
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When instance will expire -->
 </instance>
 <definition><!-- 0..1 Reference(AdministrableProductDefinition|
   ManufacturedItemDefinition|MedicinalProductDefinition|
   PackagedProductDefinition) Formal definition of the medication --></definition>
</Medication>

JSON Template

{doco
  "resourceType" : "",

  "resourceType" : "Medication",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier for this medication
  "

  "code" : { CodeableConcept }, // Codes that identify this medication

  "status" : "<code>", // active | inactive | entered-in-error
  "
  "
  "
  "
    
    " },
    " },

  "marketingAuthorizationHolder" : { Reference(Organization) }, // Organization that has authorization to market medication
  "doseForm" : { CodeableConcept }, // powder | tablets | capsule +
  "packageSize" : { // When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package
    "numberOfItems" : { Quantity(SimpleQuantity) }, // The number of items in the package that are represented by the code
    "amountPerItem" : { Ratio } // The amount per each item
  },
  "ingredient" : [{ // Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications
    "item" : { CodeableReference(Medication|Substance|SubstanceDefinition) }, // R!  The specific substance or medication that is the ingredient

    "isActive" : <boolean>, // Active ingredient indicator
    "

    "role" : { CodeableConcept }, // A code that defines the type of ingredient, active, base, etc. icon
    // strength[x]: Quantity of ingredient present. One of these 3:

    "strengthRatio" : { Ratio },
    "strengthCodeableConcept" : { CodeableConcept },
    "strengthQuantity" : { Quantity }

  }],
  "
    "
    "
  }

  "instance" : { // Details about packaged medications
    "identifier" : [{ Identifier }], // Identifier for the physical instance, typically a serial number
    "lotNumber" : "<string>", // Identifier assigned to batch
    "expirationDate" : "<dateTime>" // When instance will expire
  },
  "definition" : { Reference(AdministrableProductDefinition|
   ManufacturedItemDefinition|MedicinalProductDefinition|
   PackagedProductDefinition) } // Formal definition of the medication
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:;

[ a fhir:Medication;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
    # . One of these 2
      fhir: ]
      fhir:) ]
    fhir:
    fhir:
  ], ...;
  fhir:
    fhir:
    fhir:
  ];

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifier for this medication
  fhir:code [ CodeableConcept ] ; # 0..1 Codes that identify this medication
  fhir:status [ code ] ; # 0..1 active | inactive | entered-in-error
  fhir:marketingAuthorizationHolder [ Reference(Organization) ] ; # 0..1 Organization that has authorization to market medication
  fhir:doseForm [ CodeableConcept ] ; # 0..1 powder | tablets | capsule +
  fhir:packageSize [ # 0..1 When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package
    fhir:numberOfItems [ Quantity(SimpleQuantity) ] ; # 0..1 The number of items in the package that are represented by the code
    fhir:amountPerItem [ Ratio ] ; # 0..1 The amount per each item
  ] ;
  fhir:ingredient ( [ # 0..* Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications
    fhir:item [ CodeableReference(Medication|Substance|SubstanceDefinition) ] ; # 1..1 The specific substance or medication that is the ingredient
    fhir:isActive [ boolean ] ; # 0..1 Active ingredient indicator
    fhir:role [ CodeableConcept ] ; # 0..1 A code that defines the type of ingredient, active, base, etc.
    # strength[x] : 0..1 Quantity of ingredient present. One of these 3
      fhir:strength [  a fhir:Ratio ; Ratio ]
      fhir:strength [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:strength [  a fhir:Quantity ; Quantity ]
  ] ... ) ;
  fhir:instance [ # 0..1 Details about packaged medications
    fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Identifier for the physical instance, typically a serial number
    fhir:lotNumber [ string ] ; # 0..1 Identifier assigned to batch
    fhir:expirationDate [ dateTime ] ; # 0..1 When instance will expire
  ] ;
  fhir:definition [ Reference(AdministrableProductDefinition|ManufacturedItemDefinition|
  MedicinalProductDefinition|PackagedProductDefinition) ] ; # 0..1 Formal definition of the medication
]

Changes since R3 from both R4 and R4B

Medication
Medication.identifier Medication.marketingAuthorizationHolder
  • Added Element
Medication.status Medication.doseForm
  • Change value set Added Element
Medication.packageSize
  • Added Element
Medication.packageSize.numberOfItems
  • Added Element
Medication.packageSize.amountPerItem
  • Added Element
Medication.ingredient.item
  • Renamed from http://hl7.org/fhir/ValueSet/medication-status item[x] to http://hl7.org/fhir/ValueSet/medication-status|4.0.1 item
  • Now marked as Modifier Add Type CodeableReference
  • Remove Types CodeableConcept, Reference(Substance | Medication)
Medication.amount Medication.ingredient.role
  • Added Element
Medication.ingredient.strength[x]
  • Renamed from strength to strength[x]
  • Add Types CodeableConcept, Quantity
Medication.ingredient.strength Medication.instance
  • Added Element
Medication.batch Medication.instance.identifier
  • Added Element
Medication.batch.lotNumber Medication.instance.lotNumber
  • Added Element
Medication.batch.expirationDate Medication.instance.expirationDate
  • Added Element
Medication.isBrand Medication.definition
  • deleted Added Element
Medication.isOverTheCounter Medication.manufacturer
  • deleted Deleted
Medication.ingredient.amount Medication.form
  • deleted Deleted
Medication.package Medication.amount
  • deleted Deleted
Medication.image Medication.batch
  • deleted Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON . See R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 22 fail round-trip testing and 22 r3 resources are invalid (0 errors). ) for R4B as XML or JSON .

Structure

Amount 0..* Active or inactive ingredient 1..1 Ratio
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . Medication TU DomainResource Definition of a Medication

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Business identifier for this medication

. . . code Σ 0..1 CodeableConcept Codes that identify this medication
Binding: SNOMED CT Medication Codes ( Example )
. . . status ?! Σ 0..1 code active | inactive | entered-in-error
Binding: Medication status codes Status Codes ( Required )
. . . form doseForm 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMED CT Form Codes ( Example )
. . amount . packageSize Σ C 0..1 Ratio BackboneElement When the code does not specify the package size, this backbone element can be used to specify the overall amount of drug medication in the package
+ Rule: Either numberOfItems or amountPerItem must exist
. . . ingredient . numberOfItems 0..1 BackboneElement SimpleQuantity The number of items in the package that are represented by the code
. . . item[x] . amountPerItem 0..1 Ratio The actual ingredient or content amount per each item
. . . ingredient itemCodeableConcept 0..* CodeableConcept BackboneElement Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications

. . . . itemReference item 1..1 Reference CodeableReference ( Substance | SubstanceDefinition | Medication ) The specific substance or medication that is the ingredient
Binding: SNOMED CT Medication Codes ( Example )
. . . . isActive 0..1 boolean Active ingredient indicator
. . . . strength role 0..1 CodeableConcept A code that defines the type of ingredient, active, base, etc.
Binding: RoleClassIngredientEntity icon ( Example )
0..1
. . . . strength[x] 0..1 Quantity of ingredient present
Binding: Medication Ingredient Strength Codes ( Preferred )
. . batch . . . strengthRatio Ratio
. . . . . strengthCodeableConcept CodeableConcept
. . . . . strengthQuantity 0..1 BackboneElement Quantity
. . . instance 0..1 BackboneElement Details about packaged medications
. . . lotNumber . identifier 0..* Identifier Identifier for the physical instance, typically a serial number

0..1
. . . . lotNumber 0..1 string Identifier assigned to batch
. . . . expirationDate 0..1 dateTime When batch instance will expire
. . . definition 0..1 Reference ( MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition ) Formal definition of the medication

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Medication ( DomainResource ) Business identifier for this medication identifier : Identifier [0..*] 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 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 code : CodeableConcept [0..1] « A coded concept that defines the type of a medication. null (Strength=Example) SNOMEDCTMedicationCodes ?? » A code to indicate if the medication is in active use (this element modifies the meaning of other elements) status : code [0..1] « A coded concept defining if the medication is in active use. null (Strength=Required) Medication Status MedicationStatusCodes ! » Describes the details of the manufacturer of The company or other legal entity that has authorization, from the medication product. This is not intended appropriate drug regulatory authority, to represent market a medicine in one or more jurisdictions. Typically abbreviated MAH.Note: The MAH may manufacture the distributor product and may also contract the manufacturing of a medication the product to one or more companies (organizations) manufacturer marketingAuthorizationHolder : Reference [0..1] « Organization » Describes the form of the item. Powder; tablets; capsule form doseForm : CodeableConcept [0..1] « A coded concept defining the form of a medication. null (Strength=Example) SNOMEDCTFormCodes ?? » Specific amount of the drug in the packaged product. For example, when specifying A reference to a product definitional resource that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification more information about this medication definition : Reference [0..1] « MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition » PackageSize The number of items in the package amount (For example, 3 mL, 10mL, etc.) that are represented by the code, e.g. 5 vials or 100 tablets numberOfItems : Quantity ( SimpleQuantity ) [0..1] The amount per each item, e.g. 10 ml / vial amountPerItem : Ratio [0..1] Ingredient 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 of a medication resource (Substance or Medication) item[x] item : Type CodeableReference [1..1] « CodeableConcept Substance | Reference ( Substance SubstanceDefinition | Medication ) ; null (Strength=Example) SNOMEDCTMedicationCodes ?? » Indication of whether this ingredient affects the therapeutic action of the drug isActive : boolean [0..1] Indication of whether this ingredient affects the therapeutic action of the drug role : CodeableConcept [0..1] « null (Strength=Example) RoleClassIngredientEntity ?? » Specifies how many (or how much) of the items there are in this 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 strength strength[x] : Ratio DataType [0..1] « Ratio | CodeableConcept | Quantity ; null (Strength=Preferred) MedicationIngredientStrengthC... ? » Batch Instance Identifier for the physical instance, typically a serial number identifier : Identifier [0..*] The assigned lot number of a batch of the specified product lotNumber : string [0..1] When this specific batch instance of product will expire expirationDate : dateTime [0..1] When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package packageSize [0..1] Identifies a particular constituent of interest in the product ingredient [0..*] Information that only applies to packages (not products) batch instance [0..1]

XML Template

<

<Medication xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <</code>

 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>

 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <</manufacturer>
 <</form>
 <</amount>
 <
  <</item[x]>

 <marketingAuthorizationHolder><!-- 0..1 Reference(Organization) Organization that has authorization to market medication --></marketingAuthorizationHolder>
 <doseForm><!-- 0..1 CodeableConcept powder | tablets | capsule + --></doseForm>
 <packageSize>  <!-- 0..1 When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package -->
  <numberOfItems><!-- 0..1 Quantity(SimpleQuantity) The number of items in the package that are represented by the code --></numberOfItems>
  <amountPerItem><!-- 0..1 Ratio The amount per each item --></amountPerItem>
 </packageSize>
 <ingredient>  <!-- 0..* Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications -->
  <item><!-- 1..1 CodeableReference(Medication|Substance|SubstanceDefinition) The specific substance or medication that is the ingredient --></item>

  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <</strength>

  <role><!-- 0..1 CodeableConcept A code that defines the type of ingredient, active, base, etc. icon --></role>
  <strength[x]><!-- 0..1 Ratio|CodeableConcept|Quantity Quantity of ingredient present --></strength[x]>

 </ingredient>
 <
  <
  <
 </batch>

 <instance>  <!-- 0..1 Details about packaged medications -->
  <identifier><!-- 0..* Identifier Identifier for the physical instance, typically a serial number --></identifier>
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When instance will expire -->
 </instance>
 <definition><!-- 0..1 Reference(AdministrableProductDefinition|
   ManufacturedItemDefinition|MedicinalProductDefinition|
   PackagedProductDefinition) Formal definition of the medication --></definition>
</Medication>

JSON Template

{doco
  "resourceType" : "",

  "resourceType" : "Medication",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier for this medication
  "

  "code" : { CodeableConcept }, // Codes that identify this medication

  "status" : "<code>", // active | inactive | entered-in-error
  "
  "
  "
  "
    
    " },
    " },

  "marketingAuthorizationHolder" : { Reference(Organization) }, // Organization that has authorization to market medication
  "doseForm" : { CodeableConcept }, // powder | tablets | capsule +
  "packageSize" : { // When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package
    "numberOfItems" : { Quantity(SimpleQuantity) }, // The number of items in the package that are represented by the code
    "amountPerItem" : { Ratio } // The amount per each item
  },
  "ingredient" : [{ // Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications
    "item" : { CodeableReference(Medication|Substance|SubstanceDefinition) }, // R!  The specific substance or medication that is the ingredient

    "isActive" : <boolean>, // Active ingredient indicator
    "

    "role" : { CodeableConcept }, // A code that defines the type of ingredient, active, base, etc. icon
    // strength[x]: Quantity of ingredient present. One of these 3:

    "strengthRatio" : { Ratio },
    "strengthCodeableConcept" : { CodeableConcept },
    "strengthQuantity" : { Quantity }

  }],
  "
    "
    "
  }

  "instance" : { // Details about packaged medications
    "identifier" : [{ Identifier }], // Identifier for the physical instance, typically a serial number
    "lotNumber" : "<string>", // Identifier assigned to batch
    "expirationDate" : "<dateTime>" // When instance will expire
  },
  "definition" : { Reference(AdministrableProductDefinition|
   ManufacturedItemDefinition|MedicinalProductDefinition|
   PackagedProductDefinition) } // Formal definition of the medication
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:;

[ a fhir:Medication;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
    # . One of these 2
      fhir: ]
      fhir:) ]
    fhir:
    fhir:
  ], ...;
  fhir:
    fhir:
    fhir:
  ];

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifier for this medication
  fhir:code [ CodeableConcept ] ; # 0..1 Codes that identify this medication
  fhir:status [ code ] ; # 0..1 active | inactive | entered-in-error
  fhir:marketingAuthorizationHolder [ Reference(Organization) ] ; # 0..1 Organization that has authorization to market medication
  fhir:doseForm [ CodeableConcept ] ; # 0..1 powder | tablets | capsule +
  fhir:packageSize [ # 0..1 When the code does not specify the package size, this backbone element can be used to specify the overall amount of medication in the package
    fhir:numberOfItems [ Quantity(SimpleQuantity) ] ; # 0..1 The number of items in the package that are represented by the code
    fhir:amountPerItem [ Ratio ] ; # 0..1 The amount per each item
  ] ;
  fhir:ingredient ( [ # 0..* Components of a medication. These can be ingredient substances or other medications, in the case of combination packaged medications
    fhir:item [ CodeableReference(Medication|Substance|SubstanceDefinition) ] ; # 1..1 The specific substance or medication that is the ingredient
    fhir:isActive [ boolean ] ; # 0..1 Active ingredient indicator
    fhir:role [ CodeableConcept ] ; # 0..1 A code that defines the type of ingredient, active, base, etc.
    # strength[x] : 0..1 Quantity of ingredient present. One of these 3
      fhir:strength [  a fhir:Ratio ; Ratio ]
      fhir:strength [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:strength [  a fhir:Quantity ; Quantity ]
  ] ... ) ;
  fhir:instance [ # 0..1 Details about packaged medications
    fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Identifier for the physical instance, typically a serial number
    fhir:lotNumber [ string ] ; # 0..1 Identifier assigned to batch
    fhir:expirationDate [ dateTime ] ; # 0..1 When instance will expire
  ] ;
  fhir:definition [ Reference(AdministrableProductDefinition|ManufacturedItemDefinition|
  MedicinalProductDefinition|PackagedProductDefinition) ] ; # 0..1 Formal definition of the medication
]

Changes since Release 3 from both R4 and R4B

Medication
Medication.identifier Medication.marketingAuthorizationHolder
  • Added Element
Medication.status Medication.doseForm
  • Change value set Added Element
Medication.packageSize
  • Added Element
Medication.packageSize.numberOfItems
  • Added Element
Medication.packageSize.amountPerItem
  • Added Element
Medication.ingredient.item
  • Renamed from http://hl7.org/fhir/ValueSet/medication-status item[x] to http://hl7.org/fhir/ValueSet/medication-status|4.0.1 item
  • Now marked as Modifier Add Type CodeableReference
  • Remove Types CodeableConcept, Reference(Substance | Medication)
Medication.amount Medication.ingredient.role
  • Added Element
Medication.ingredient.strength[x]
  • Renamed from strength to strength[x]
  • Add Types CodeableConcept, Quantity
Medication.ingredient.strength Medication.instance
  • Added Element
Medication.batch Medication.instance.identifier
  • Added Element
Medication.batch.lotNumber Medication.instance.lotNumber
  • Added Element
Medication.batch.expirationDate Medication.instance.expirationDate
  • Added Element
Medication.isBrand Medication.definition
  • deleted Added Element
Medication.isOverTheCounter Medication.manufacturer
  • deleted Deleted
Medication.ingredient.amount Medication.form
  • deleted Deleted
Medication.package Medication.amount
  • deleted Deleted
Medication.image Medication.batch
  • deleted Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON . See R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 22 fail round-trip testing and 22 r3 resources are invalid (0 errors). ) for R4B as XML or JSON .

 

See the Profiles & Extensions and the alternate Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

Path Definition ValueSet Type Reference Documentation
Medication.code A coded concept that defines the type of a medication. SNOMEDCTMedicationCodes Example SNOMEDCTMedicationCodes

This value set includes all drug or medicament substance codes and all pharmaceutical/biologic products from SNOMED CT - provided as an exemplar value set.

Medication.status A coded concept defining if the medication is in active use. MedicationStatusCodes Required

Medication Status Codes

Medication.form Medication.doseForm SNOMEDCTFormCodes Example A coded concept defining the

This value set includes all dose form of a medication. codes from SNOMED CT - provided as an exemplar.

Medication.ingredient.item SNOMEDCTMedicationCodes Example

This value set includes all drug or medicament substance codes and all pharmaceutical/biologic products from SNOMED CT - provided as an exemplar value set.

Medication.ingredient.role SNOMEDCTFormCodes RoleClassIngredientEntity icon Example

Relates a component (player) to a mixture (scoper). E.g., Glucose and Water are ingredients of D5W, latex may be an ingredient in a tracheal tube.

Medication.ingredient.strength[x] MedicationIngredientStrengthCodes Preferred

Medication Ingredient Strength Codes

UniqueKey Level Location Description Expression
img  med-1 Rule Medication.packageSize Either numberOfItems or inactive (e.g. the medication can be documented, but not ordered). Pharmacy is evaluating formulary use cases. Feedback is encouraged to the Pharmacy working group. amountPerItem must exist numberOfItems.exists() or amountPerItem.exists()

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
code token Returns medications for a specific code Medication.code 13 19 Resources
expiration-date date Returns medications in a batch with this expiration date Medication.batch.expirationDate Medication.instance.expirationDate
form token Returns medications for a specific dose form Medication.form Medication.doseForm
identifier token Returns medications with this external identifier Medication.identifier 59 Resources
ingredient reference Returns medications for this ingredient reference (Medication.ingredient.item as Reference) ( Medication , Substance ) Medication.ingredient.item.reference
ingredient-code token Returns medications for this ingredient code (Medication.ingredient.item as CodeableConcept) Medication.ingredient.item.concept
lot-number token Returns medications in a batch with this lot number Medication.batch.lotNumber Medication.instance.lotNumber
marketingauthorizationholder manufacturer reference Returns medications made or sold for this manufacturer marketing authorization holder Medication.manufacturer Medication.marketingAuthorizationHolder
( Organization )
serial-number token Returns medications in a instance with this lot number Medication.identifier
status token Returns medications for this status Medication.status