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).
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. It covers medication, including ingredients, for the ingredients purposes of prescribing, dispensing, and the packaging for administering a medication. 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 medicine 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 cases, the ingredients of the medicine have to must be specified together with the amount contained, though the medication 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 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).

If 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

0..1 Codes that identify active | inactive | entered-in-error True if a brand isOverTheCounter True if medication does not require a prescription Active Quantity of E.g. box, vial, blister-pack BackboneElement Identifies Picture
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
. . code . identifier Σ 0..* CodeableConcept Identifier Business identifier for this medication
SNOMED CT Medication Codes ( Example )
. . status . code Σ 0..1 code CodeableConcept Codes that identify this medication
MedicationStatus Binding: SNOMED CT Medication Codes ( Required Example )
. . isBrand . status ?! Σ 0..1 boolean code active | inactive | entered-in-error
Binding: Medication Status Codes Σ 0..1 boolean ( Required )
. . form . doseForm 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMED CT Form Codes ( Example )
. . . ingredient packageSize Σ 0..* C 0..1 BackboneElement 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
Active + Rule: Either numberOfItems or inactive ingredient amountPerItem must exist
. . . item[x] . numberOfItems 1..1 0..1 SimpleQuantity The product contained number of items in the package that are represented by the code
. . . . itemCodeableConcept amountPerItem CodeableConcept itemReference 0..1 Reference ( Substance | Medication Ratio ) The amount per each item
. . isActive . ingredient 0..1 0..* boolean BackboneElement Components of a medication. These can be ingredient indicator substances or other medications, in the case of combination packaged medications

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

. . . . lotNumber 0..1 string Identifier assigned to batch
. . . . expirationDate 0..1 dateTime When batch instance will expire
. . image . definition 0..* 0..1 Attachment 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) SNOMED CT Medication 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) MedicationStatus MedicationStatusCodes ! » 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) isBrand marketingAuthorizationHolder : boolean Reference [0..1] « Organization » Set to true if Describes the medication can be obtained without an order from a prescriber form of the item. Powder; tablets; capsule isOverTheCounter doseForm : boolean CodeableConcept [0..1] « null (Strength=Example) SNOMEDCTFormCodes ?? » Describes the details of the manufacturer of the medication product. This is not intended A reference to represent the distributor of a definitional resource that provides more information about this medication product manufacturer definition : Reference [0..1] Organization « MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition » PackageSize 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 form numberOfItems : CodeableConcept Quantity [0..1] A coded concept defining the form of a medication (Strength=Example) SNOMED CT Form ( SimpleQuantity ?? ) [0..1] Photo(s) or graphic representation(s) of the medication The amount per each item, e.g. 10 ml / vial image amountPerItem : Attachment Ratio [0..*] [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 resource (Substance or Medication) item[x] item : Type CodeableReference [1..1] CodeableConcept « Substance | Reference ( Substance SubstanceDefinition | Medication ) ; null (Strength=Example) SNOMEDCTMedicationCodes ?? » Indication of whether thisingredient affectsthe 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 amount strength[x] : Ratio DataType [0..1] Package The kind of container that this package comes as container « Ratio : | CodeableConcept [0..1] | Quantity ; A coded concept defining the kind of container a medication package is packaged in (Strength=Example) null (Strength=Preferred) MedicationContainer ?? MedicationIngredientStrengthC... ? » Content Identifies one of the items in the package item[x] : Type [1..1] CodeableConcept | Reference ( Medication ) Instance The amount of the product that is in Identifier for the package physical instance, typically a serial number amount identifier : Quantity ( SimpleQuantity Identifier ) [0..1] Batch [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] Identifies a particular constituent When the code does not specify the package size, this backbone element can be used to specify the overall amount of interest medication in the product package ingredient packageSize [0..*] [0..1] A set of components that go to make up the described item content [0..*] Information about Identifies a group particular constituent of medication produced or packaged from one production run interest in the product batch ingredient [0..*] Information that only applies to packages (not products) package 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 -->
 <</code>
 <
 <
 <
 <</manufacturer>
 <</form>
 <
  <</item[x]>
  <
  <</amount>

 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <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 -->
  <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>
 <
  <</container>
  <
   <</item[x]>
   <</amount>
  </content>
  <
   <
   <
  </batch>
 </package>
 <</image>

 <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:
      # . 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 DSTU2 from both R4 and R4B

Medication
Medication.status Medication.marketingAuthorizationHolder
  • Added Element
Medication.isOverTheCounter Medication.doseForm
  • Added Element
Medication.form Medication.packageSize
  • Added Element
Medication.ingredient Medication.packageSize.numberOfItems
  • Added Element
Medication.ingredient.item[x] Medication.packageSize.amountPerItem
  • Added Element
Medication.ingredient.isActive Medication.ingredient.item
  • Added Element Renamed from item[x] to item
  • Add Type CodeableReference
  • Remove Types CodeableConcept, Reference(Substance | Medication)
Medication.ingredient.amount Medication.ingredient.role
  • Added Element
Medication.package.content.item[x] Medication.ingredient.strength[x]
  • Renamed from item strength to item[x] strength[x]
  • Add CodeableConcept Types CodeableConcept, Quantity
Medication.package.batch Medication.instance
  • Added Element
Medication.package.batch.lotNumber Medication.instance.identifier
  • Added Element
Medication.package.batch.expirationDate Medication.instance.lotNumber
  • Added Element
Medication.image Medication.instance.expirationDate
  • Added Element
Medication.definition
  • Added Element
Medication.product Medication.manufacturer
  • deleted Deleted
Medication.form
  • Deleted
Medication.amount
  • Deleted
Medication.batch
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON . See R2 <--> R3 Conversion Maps (status = 23 tests that all execute ok. 16 fail round-trip testing and 1 r3 resources are invalid (1 errors). ). for R4B as XML or JSON .

Structure

0..1 Codes that identify active | inactive | entered-in-error True if a brand isOverTheCounter True if medication does not require a prescription Active Quantity of E.g. box, vial, blister-pack BackboneElement Identifies Picture
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
. . code . identifier Σ 0..* CodeableConcept Identifier Business identifier for this medication
SNOMED CT Medication Codes ( Example )
. . status . code Σ 0..1 code CodeableConcept Codes that identify this medication
MedicationStatus Binding: SNOMED CT Medication Codes ( Required Example )
. . isBrand . status ?! Σ 0..1 boolean code active | inactive | entered-in-error
Binding: Medication Status Codes Σ 0..1 boolean ( Required )
. . form . doseForm 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMED CT Form Codes ( Example )
. . . ingredient packageSize Σ 0..* C 0..1 BackboneElement 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
Active + Rule: Either numberOfItems or inactive ingredient amountPerItem must exist
. . . item[x] . numberOfItems 1..1 0..1 SimpleQuantity The product contained number of items in the package that are represented by the code
. . . . itemCodeableConcept amountPerItem CodeableConcept itemReference 0..1 Reference ( Substance | Medication Ratio ) The amount per each item
. . isActive . ingredient 0..1 0..* boolean BackboneElement Components of a medication. These can be ingredient indicator substances or other medications, in the case of combination packaged medications

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

. . . . lotNumber 0..1 string Identifier assigned to batch
. . . . expirationDate 0..1 dateTime When batch instance will expire
. . image . definition 0..* 0..1 Attachment 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) SNOMED CT Medication 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) MedicationStatus MedicationStatusCodes ! » 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) isBrand marketingAuthorizationHolder : boolean Reference [0..1] « Organization » Set to true if Describes the medication can be obtained without an order from a prescriber form of the item. Powder; tablets; capsule isOverTheCounter doseForm : boolean CodeableConcept [0..1] « null (Strength=Example) SNOMEDCTFormCodes ?? » Describes the details of the manufacturer of the medication product. This is not intended A reference to represent the distributor of a definitional resource that provides more information about this medication product manufacturer definition : Reference [0..1] Organization « MedicinalProductDefinition | AdministrableProductDefinition | PackagedProductDefinition | ManufacturedItemDefinition » PackageSize 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 form numberOfItems : CodeableConcept Quantity [0..1] A coded concept defining the form of a medication (Strength=Example) SNOMED CT Form ( SimpleQuantity ?? ) [0..1] Photo(s) or graphic representation(s) of the medication The amount per each item, e.g. 10 ml / vial image amountPerItem : Attachment Ratio [0..*] [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 resource (Substance or Medication) item[x] item : Type CodeableReference [1..1] CodeableConcept « Substance | Reference ( Substance SubstanceDefinition | Medication ) ; null (Strength=Example) SNOMEDCTMedicationCodes ?? » Indication of whether thisingredient affectsthe 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 amount strength[x] : Ratio DataType [0..1] Package The kind of container that this package comes as container « Ratio : | CodeableConcept [0..1] | Quantity ; A coded concept defining the kind of container a medication package is packaged in (Strength=Example) null (Strength=Preferred) MedicationContainer ?? MedicationIngredientStrengthC... ? » Content Identifies one of the items in the package item[x] : Type [1..1] CodeableConcept | Reference ( Medication ) Instance The amount of the product that is in Identifier for the package physical instance, typically a serial number amount identifier : Quantity ( SimpleQuantity Identifier ) [0..1] Batch [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] Identifies a particular constituent When the code does not specify the package size, this backbone element can be used to specify the overall amount of interest medication in the product package ingredient packageSize [0..*] [0..1] A set of components that go to make up the described item content [0..*] Information about Identifies a group particular constituent of medication produced or packaged from one production run interest in the product batch ingredient [0..*] Information that only applies to packages (not products) package 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 -->
 <</code>
 <
 <
 <
 <</manufacturer>
 <</form>
 <
  <</item[x]>
  <
  <</amount>

 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <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 -->
  <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>
 <
  <</container>
  <
   <</item[x]>
   <</amount>
  </content>
  <
   <
   <
  </batch>
 </package>
 <</image>

 <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:
      # . 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 DSTU2 from both R4 and R4B

Medication
Medication.status Medication.marketingAuthorizationHolder
  • Added Element
Medication.isOverTheCounter Medication.doseForm
  • Added Element
Medication.form Medication.packageSize
  • Added Element
Medication.ingredient Medication.packageSize.numberOfItems
  • Added Element
Medication.ingredient.item[x] Medication.packageSize.amountPerItem
  • Added Element
Medication.ingredient.isActive Medication.ingredient.item
  • Added Element Renamed from item[x] to item
  • Add Type CodeableReference
  • Remove Types CodeableConcept, Reference(Substance | Medication)
Medication.ingredient.amount Medication.ingredient.role
  • Added Element
Medication.package.content.item[x] Medication.ingredient.strength[x]
  • Renamed from item strength to item[x] strength[x]
  • Add CodeableConcept Types CodeableConcept, Quantity
Medication.package.batch Medication.instance
  • Added Element
Medication.package.batch.lotNumber Medication.instance.identifier
  • Added Element
Medication.package.batch.expirationDate Medication.instance.lotNumber
  • Added Element
Medication.image Medication.instance.expirationDate
  • Added Element
Medication.definition
  • Added Element
Medication.product Medication.manufacturer
  • deleted Deleted
Medication.form
  • Deleted
Medication.amount
  • Deleted
Medication.batch
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON . See R2 <--> R3 Conversion Maps (status = 23 tests that all execute ok. 16 fail round-trip testing and 1 r3 resources are invalid (1 errors). ). for R4B as XML or JSON .

 

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

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

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

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

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 Form Codes - provided as an exemplar value set.

Medication.ingredient.role A coded concept defining the kind of container a medication package is packaged in 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] MedicationContainer MedicationIngredientStrengthCodes Preferred

Medication Ingredient Strength Codes

UniqueKey Level Location Description Expression
img  med-1 Rule Medication.packageSize Either numberOfItems or 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 Codes that identify this medication Returns medications for a specific code Medication.code 4 19 Resources
expiration-date container token date E.g. box, vial, blister-pack Returns medications in a batch with this expiration date Medication.package.container Medication.instance.expirationDate
form token powder | tablets | capsule + Returns medications for a specific dose form Medication.form Medication.doseForm
identifier ingredient reference token The product contained Returns medications with this external identifier Medication.ingredient.item.as(Reference) ( Medication , Substance ) Medication.identifier 59 Resources
ingredient-code ingredient token reference The product contained Returns medications for this ingredient reference Medication.ingredient.item.as(CodeableConcept) Medication.ingredient.item.reference
ingredient-code manufacturer reference token Manufacturer of the item Returns medications for this ingredient code Medication.manufacturer ( Organization ) Medication.ingredient.item.concept
over-the-counter lot-number token True if medication does not require Returns medications in a prescription batch with this lot number Medication.isOverTheCounter Medication.instance.lotNumber
package-item marketingauthorizationholder reference The item in the package Returns medications made or sold for this marketing authorization holder Medication.package.content.item.as(Reference) Medication.marketingAuthorizationHolder
( Medication Organization )
package-item-code serial-number token The item Returns medications in the package a instance with this lot number Medication.package.content.item.as(CodeableConcept) Medication.identifier
status token active | inactive | entered-in-error Returns medications for this status Medication.status