|
MedicationAdministration
|
|
Definition
|
Describes
the
event
of
a
patient
consuming
or
otherwise
being
administered
a
medication.
This
may
be
as
simple
as
swallowing
a
tablet
or
it
may
be
a
long
running
infusion.
Related
resources
tie
this
event
to
the
authorizing
prescription,
and
the
specific
encounter
between
patient
and
health
care
practitioner.
Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.
|
|
Control
|
1..1
|
|
Summary
|
true
|
|
Invariants
|
Defined
on
this
element
Defined on this element
mad-2
:
Reason
not
given
is
only
permitted
if
wasNotGiven
is
true
(xpath:
not(exists(f:reasonNotGiven)
and
f:wasNotGiven/@value=false()))
: Reason not given is only permitted if wasNotGiven is true (
expression
: reasonNotGiven.empty() or wasNotGiven = true, xpath: not(exists(f:reasonNotGiven) and f:wasNotGiven/@value=false()))
mad-3
:
Reason
given
is
only
permitted
if
wasNotGiven
is
false
(xpath:
not(exists(f:reasonGiven)
and
f:wasNotGiven/@value=true()))
: Reason given is only permitted if wasNotGiven is false (
expression
: reasonGiven.empty() or wasNotGiven = 'false', xpath: not(exists(f:reasonGiven) and f:wasNotGiven/@value=true()))
|
|
MedicationAdministration.identifier
|
|
Definition
|
External
identifier
-
FHIR
will
generate
its
own
internal
identifiers
(probably
URLs)
which
do
not
need
to
be
explicitly
managed
by
the
resource.
The
identifier
here
is
one
that
would
be
used
by
another
non-FHIR
system
-
for
example
an
automated
medication
pump
would
provide
a
record
each
time
it
operated;
an
administration
while
the
patient
was
off
the
ward
might
be
made
with
a
different
system
and
entered
after
the
event.
Particularly
important
if
these
records
have
to
be
updated.
External identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.
|
|
Note
|
This
is
a
business
identifer,
not
a
resource
identifier
(see
This is a business identifer, not a resource identifier (see
discussion
)
|
|
Control
|
0..*
|
|
Type
|
Identifier
|
|
Summary
|
true
|
|
MedicationAdministration.status
|
|
Definition
|
Will
generally
be
set
to
show
that
the
administration
has
been
completed.
For
some
long
running
administrations
such
as
infusions
it
is
possible
for
an
administration
to
be
started
but
not
completed
or
it
may
be
paused
while
some
other
process
is
under
way.
Will generally be set to show that the administration has been completed. For some long running administrations such as infusions it is possible for an administration to be started but not completed or it may be paused while some other process is under way.
|
|
Control
|
1..1
|
|
Binding
|
MedicationAdministrationStatus:
A
set
of
codes
indicating
the
current
status
of
a
MedicationAdministration.
(
MedicationAdministrationStatus:
A set of codes indicating the current status of a MedicationAdministration.
(
Required
)
|
|
Type
|
code
|
Is
Modifier
Is Modifier
|
true
|
|
Summary
|
true
|
MedicationAdministration.patient
MedicationAdministration.medication[x]
|
|
Definition
|
The
person
or
animal
receiving
the
medication.
Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.
|
|
Control
|
1..1
|
|
Type
|
CodeableConcept
|
Reference
(
Patient
Medication
)
|
|
[x] Note
|
See
Choice of Data Types
for further information about how to use [x] |
|
Summary
|
true
|
|
Comments
|
If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. Note: do not use Medication.name to describe the administered medication. When the only available information is a text description of the medication, Medication.code.text should be used.
|
MedicationAdministration.practitioner
MedicationAdministration.patient
|
|
Definition
|
The
individual
who
was
responsible
for
giving
the
medication
to
the
patient.
The person or animal receiving the medication.
|
|
Control
|
0..1
1..1
|
|
Type
|
Reference
(
Practitioner
|
Patient
|
RelatedPerson
)
|
|
Summary
|
true
|
|
MedicationAdministration.encounter
|
|
Definition
|
The
visit,
admission
or
other
contact
between
patient
and
health
care
provider
the
medication
administration
was
performed
as
part
of.
The visit, admission or other contact between patient and health care provider the medication administration was performed as part of.
|
|
Control
|
0..1
|
|
Type
|
Reference
(
Encounter
)
|
|
Summary
|
true
|
MedicationAdministration.prescription
MedicationAdministration.effectiveTime[x]
|
|
Definition
|
The
original
request,
instruction
or
authority
to
perform
the
administration.
A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.
|
|
Control
|
0..1
1..1
|
|
Type
|
Reference
dateTime
(
MedicationOrder
|
Period
)
|
|
[x] Note
|
See
Choice of Data Types
for further information about how to use [x] |
|
Summary
|
true
|
MedicationAdministration.wasNotGiven
MedicationAdministration.practitioner
|
|
Definition
|
Set
this
to
true
if
the
record
is
saying
that
the
medication
was
NOT
administered.
The individual who was responsible for giving the medication to the patient.
|
|
Control
|
0..1
|
|
Type
|
boolean
Reference
Is
Modifier
(
Practitioner
|
Patient
|
RelatedPerson
true
Meaning
if
Missing
If
this
is
missing,
then
the
medication
was
administered
)
|
|
Summary
|
true
|
MedicationAdministration.reasonNotGiven
MedicationAdministration.prescription
|
|
Definition
|
A
code
indicating
why
the
administration
was
not
performed.
The original request, instruction or authority to perform the administration.
|
|
Control
|
0..*
Binding
Reason
Medication
Not
Given
Codes:
A
set
of
codes
indicating
the
reason
why
the
MedicationAdministration
is
negated.
(
Example
)
0..1
|
|
Type
|
CodeableConcept
Reference
(
MedicationOrder
)
|
|
Summary
|
true
|
Invariants
Affect
this
element
mad-2
:
Reason
not
given
is
only
permitted
if
wasNotGiven
is
true
(xpath:
not(exists(f:reasonNotGiven)
and
f:wasNotGiven/@value=false()))
MedicationAdministration.reasonGiven
MedicationAdministration.wasNotGiven
|
|
Definition
|
A
code
indicating
why
the
medication
was
given.
Set this to true if the record is saying that the medication was NOT administered.
|
|
Control
|
0..*
0..1
|
Binding
Type
|
Reason
Medication
Given
Codes:
A
set
of
codes
indicating
the
reason
why
the
MedicationAdministration
was
made.
(
Example
boolean
)
|
Type
Is Modifier
|
true
|
CodeableConcept
|
Meaning if Missing
|
If this is missing, then the medication was administered
|
|
Summary
|
true
|
Invariants
Affect
this
element
mad-3
:
Reason
given
is
only
permitted
if
wasNotGiven
is
false
(xpath:
not(exists(f:reasonGiven)
and
f:wasNotGiven/@value=true()))
MedicationAdministration.effectiveTime[x]
MedicationAdministration.reasonNotGiven
|
|
Definition
|
A
specific
date/time
or
interval
of
time
during
which
the
administration
took
place
(or
did
not
take
place,
when
the
'notGiven'
attribute
is
true).
For
many
administrations,
such
as
swallowing
a
tablet
the
use
of
dateTime
is
more
appropriate.
A code indicating why the administration was not performed.
|
|
Control
|
1..1
0..*
|
Type
Binding
|
dateTime
|
Period
Reason Medication Not Given Codes:
A set of codes indicating the reason why the MedicationAdministration is negated.
(
Example
)
|
[x]
Note
Type
|
See
Choice
of
Data
Types
CodeableConcept
for
further
information
about
how
to
use
[x]
|
|
Summary
|
true
|
|
Invariants
|
Affect this element
mad-2
: Reason not given is only permitted if wasNotGiven is true (
expression
: reasonNotGiven.empty() or wasNotGiven = true, xpath: not(exists(f:reasonNotGiven) and f:wasNotGiven/@value=false())) |
MedicationAdministration.medication[x]
MedicationAdministration.reasonGiven
|
|
Definition
|
Identifies
the
medication
that
was
administered.
This
is
either
a
link
to
a
resource
representing
the
details
of
the
medication
or
a
simple
attribute
carrying
a
code
that
identifies
the
medication
from
a
known
list
of
medications.
A code indicating why the medication was given.
|
|
Control
|
1..1
0..*
|
Type
Binding
|
CodeableConcept
|
Reference
(
Medication
Reason Medication Given Codes:
A set of codes indicating the reason why the MedicationAdministration was made.
(
Example
)
|
[x]
Note
Type
|
See
Choice
of
Data
Types
CodeableConcept
for
further
information
about
how
to
use
[x]
|
|
Summary
|
true
|
Comments
Invariants
|
If
only
a
code
is
specified,
then
it
needs
to
be
a
code
for
a
specific
product.
If
more
information
is
required,
then
the
use
of
the
medication
resource
is
recommended.
Note:
do
not
use
Medication.name
to
describe
the
administered
medication.
When
the
only
available
information
is
a
text
description
of
the
medication,
Medication.code.text
should
be
used.
Affect this element
mad-3
: Reason given is only permitted if wasNotGiven is false (
expression
: reasonGiven.empty() or wasNotGiven = 'false', xpath: not(exists(f:reasonGiven) and f:wasNotGiven/@value=true()))
|
|
MedicationAdministration.device
|
|
Definition
|
The
device
used
in
administering
the
medication
to
the
patient.
For
example,
a
particular
infusion
pump.
The device used in administering the medication to the patient. For example, a particular infusion pump.
|
|
Control
|
0..*
|
|
Type
|
Reference
(
Device
)
|
|
Summary
|
true
|
|
MedicationAdministration.note
|
|
Definition
|
Extra
information
about
the
medication
administration
that
is
not
conveyed
by
the
other
attributes.
Extra information about the medication administration that is not conveyed by the other attributes.
|
|
Control
|
0..1
0..*
|
|
Type
|
string
Annotation
|
|
Summary
|
true
|
|
MedicationAdministration.dosage
|
|
Definition
|
Describes
the
medication
dosage
information
details
e.g.
dose,
rate,
site,
route,
etc.
Describes the medication dosage information details e.g. dose, rate, site, route, etc.
|
|
Control
|
0..1
|
|
Summary
|
true
|
|
Invariants
|
Defined
on
this
element
Defined on this element
mad-1
:
SHALL
have
at
least
one
of
dosage.quantity
and
dosage.rate[x]
(xpath:
exists(f:quantity)
or
exists(f:rateRatio)
or
exists(f:rateRange))
To
Do
The
RMIM
has
priority
code
on
the
act
relationship.
How
do
we
handle
this?
: SHALL have at least one of dosage.quantity and dosage.rate[x] (
expression
: quantity or rate, xpath: exists(f:quantity) or exists(f:rateRatio) or exists(f:rateRange))
|
|
MedicationAdministration.dosage.text
|
|
Definition
|
Free
text
dosage
instructions
can
be
used
for
cases
where
the
instructions
are
too
complex
to
code.
When
coded
instructions
are
present,
the
free
text
instructions
may
still
be
present
for
display
to
humans
taking
or
administering
the
medication.
Free text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication.
|
|
Control
|
0..1
|
|
Type
|
string
|
|
Summary
|
true
|
|
MedicationAdministration.dosage.site[x]
|
|
Definition
|
A
coded
specification
of
the
anatomic
site
where
the
medication
first
entered
the
body.
For
example,
"left
arm".
A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".
|
|
Control
|
0..1
|
|
Binding
|
SNOMED
CT
Anatomical
Structure
for
Administration
Site
Codes:
A
coded
concept
describing
the
site
location
the
medicine
enters
into
or
onto
the
body.
(
SNOMED CT Anatomical Structure for Administration Site Codes:
A coded concept describing the site location the medicine enters into or onto the body.
(
Example
)
|
|
Type
|
CodeableConcept
|
Reference
(
BodySite
)
|
[x]
Note
[x] Note
|
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
See
Choice of Data Types
for further information about how to use [x]
|
|
Summary
|
true
|
|
MedicationAdministration.dosage.route
|
|
Definition
|
A
code
specifying
the
route
or
physiological
path
of
administration
of
a
therapeutic
agent
into
or
onto
the
patient.
For
example,
topical,
intravenous,
etc.
A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.
|
|
Control
|
0..1
|
|
Binding
|
SNOMED
CT
Route
Codes:
A
coded
concept
describing
the
route
or
physiological
path
of
administration
of
a
therapeutic
agent
into
or
onto
the
body
of
a
subject.
(
SNOMED CT Route Codes:
A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
(
Example
)
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
MedicationAdministration.dosage.method
|
|
Definition
|
A
coded
value
indicating
the
method
by
which
the
medication
is
intended
to
be
or
was
introduced
into
or
on
the
body.
This
attribute
will
most
often
NOT
be
populated.
It
is
most
commonly
used
for
injections.
For
example,
Slow
Push,
Deep
IV.
A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.
|
|
Control
|
0..1
|
|
Binding
|
MedicationAdministrationMethod
:
A
coded
concept
describing
the
technique
by
which
the
medicine
is
administered.
: A coded concept describing the technique by which the medicine is administered.
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
Comments
|
One
of
the
reasons
this
attribute
is
not
used
often,
is
that
the
method
is
often
pre-coordinated
with
the
route
and/or
form
of
administration.
This
means
the
codes
used
in
route
or
form
may
pre-coordinate
the
method
in
the
route
code
or
the
form
code.
The
implementation
decision
about
what
coding
system
to
use
for
route
or
form
code
will
determine
how
frequently
the
method
code
will
be
populated
e.g.
if
route
or
form
code
pre-coordinate
method
code,
then
this
attribute
will
not
be
populated
often;
if
there
is
no
pre-coordination
then
method
code
may
be
used
frequently.
One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.
|
|
MedicationAdministration.dosage.quantity
|
|
Definition
|
The
amount
of
the
medication
given
at
one
administration
event.
Use
this
value
when
the
administration
is
essentially
an
instantaneous
event
such
as
a
swallowing
a
tablet
or
giving
an
injection.
The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.
|
|
Control
|
0..1
|
|
Type
|
SimpleQuantity
|
|
Summary
|
true
|
|
Comments
|
If
the
administration
is
not
instantaneous
(rate
is
present
or
timing
has
a
duration),
this
can
be
specified
to
convey
the
total
amount
administered
over
period
of
time
of
a
single
administration
(as
indicated
by
schedule).
If the administration is not instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount administered over period of time of a single administration (as indicated by schedule).
|
|
MedicationAdministration.dosage.rate[x]
|
|
Definition
|
Identifies
the
speed
with
which
the
medication
was
or
will
be
introduced
into
the
patient.
Typically
the
rate
for
an
infusion
e.g.
100
ml
per
1
hour
or
100
ml/hr.
May
also
be
expressed
as
a
rate
per
unit
of
time
e.g.
500
ml
per
2
hours.
Currently
we
do
not
specify
a
default
of
'1'
in
the
denominator,
but
this
is
being
discussed.
Other
examples:
200
mcg/min
or
200
mcg/1
minute;
1
liter/8
hours.
Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.
|
|
Control
|
0..1
|
|
Type
|
Ratio
|
Range
|
[x]
Note
[x] Note
|
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
See
Choice of Data Types
for further information about how to use [x]
|
|
Summary
|
true
|
|
Comments
|
If
the
rate
changes
over
time,
and
you
want
to
capture
this
in
MedicationAdministration,
then
each
change
should
be
captured
as
a
distinct
MedicationAdministration,
with
a
specific
MedicationAdministration.dosage.rate,
and
the
date
time
when
the
rate
change
occurred.
Typically,
the
MedicationAdministration.dosage.rate
element
is
not
used
to
convey
an
average
rate.
If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.
|
©
HL7.org
2011+.
FHIR
DSTU2
(v1.0.2-7202)
generated
on
Sat,
Oct
24,
2015
07:43+1100.
Links:
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