This
page
is
part
of
the
FHIR
Specification
(v1.0.2:
DSTU
(v3.0.2:
STU
2).
3).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
R3
R2
R3
R2
Pharmacy
Work
Group
| Maturity Level : 2 | Trial Use | Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson |
Detailed Descriptions for the elements in the MedicationAdministration resource.
| 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. |
| Control | 1..1 |
|
|
The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html). |
| Invariants |
Defined
on
this
element
mad-2 : Reason not given is only permitted if :
reasonNotGiven.empty()
or
notGiven
=
true,
xpath:
not(exists(f:reasonNotGiven)
and
mad-3 : Reason given is only permitted if :
reasonCode.empty()
or
notGiven.empty()
or
notGiven
=
'false',
xpath:
not(exists(f:reasonCode)
and
|
| 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. |
| Note | This is a business identifer, not a resource identifier (see discussion ) |
| Control | 0..* |
| Type | Identifier |
| MedicationAdministration.definition | |
| Definition | A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event. |
| Control | 0..* |
| Type | Reference ( PlanDefinition | ActivityDefinition ) |
| Summary | true |
| MedicationAdministration.partOf | |
| Definition | A larger event of which this particular event is a component or step. |
| Control | 0..* |
| Type | Reference ( MedicationAdministration | Procedure ) |
| 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. |
| Control | 1..1 |
| Terminology Binding |
|
| Type | code |
| Is Modifier | true |
| Summary | true |
| Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
|
|
|
| Definition |
|
| Control | 0..1 |
| Terminology Binding | MedicationAdministrationCategory ( Preferred ) |
| Type | CodeableConcept |
| MedicationAdministration.medication[x] | |
| Definition |
Identifies
the
|
| Control | 1..1 |
| Terminology Binding | SNOMED CT Medication Codes ( Example ) |
| Type |
CodeableConcept
|
Reference
(
|
| [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. For example if you require form or lot number, then you must reference the Medication resource. . |
|
|
|
| Definition |
The
|
| Control |
|
| Type |
Reference
(
|
| Summary | true |
|
|
|
| Definition |
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 | EpisodeOfCare ) |
| MedicationAdministration.supportingInformation | |
| Definition | Additional information (for example, patient height and weight) that supports the administration of the medication. |
| Control | 0..* |
| Type | Reference ( Any ) |
| MedicationAdministration.effective[x] | |
| 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. |
| Control | 1..1 |
| Type | dateTime | Period |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Summary | true |
|
|
|
| Definition |
The
|
| Control |
|
| Summary | true |
| MedicationAdministration.performer.actor | |
| Definition | The device, practitioner, etc. who performed the action. |
| Control | 1..1 |
| Type |
Reference
(
|
| Summary | true |
|
| |
| Definition | The organization the device or practitioner was acting on behalf of. |
| Control | 0..1 |
| Type | Reference ( Organization ) |
| MedicationAdministration.notGiven | |
| Definition |
Set this to true if the record is saying that the medication was NOT administered. |
| Control | 0..1 |
| Type | boolean |
| Is Modifier | true |
| Meaning if Missing | If this is missing, then the medication was administered |
| Summary | true |
| Comments | This element is labeled as a modifier because it indicates that a administration didn't happen. |
| MedicationAdministration.reasonNotGiven | |
| Definition |
A code indicating why the administration was not performed. |
| Control | 0..* |
| Terminology Binding |
SNOMED
CT
Reason
Medication
Not
Given
|
| Type | CodeableConcept |
|
|
Affect
this
element
mad-2 : Reason not given is only permitted if :
reasonNotGiven.empty()
or
notGiven
=
true,
xpath:
not(exists(f:reasonNotGiven)
and
|
|
|
|
| Definition |
A code indicating why the medication was given. |
| Control | 0..* |
| Terminology Binding |
Reason
Medication
Given
|
| Type | CodeableConcept |
|
|
Affect
this
element
mad-3 : Reason given is only permitted if :
reasonCode.empty()
or
notGiven.empty()
or
notGiven
=
'false',
xpath:
not(exists(f:reasonCode)
and
|
|
|
|
| Definition |
|
| Control |
|
| Type |
|
|
|
This
is
a
reference
to
a
condition
that
is
the
reason
for
the
medication
request.
If
only
a
code
exists,
use
|
|
|
|
| Definition |
|
| Control |
|
| Type |
|
| MedicationAdministration.device | |
| Definition |
The device used in administering the medication to the patient. For example, a particular infusion pump. |
| Control | 0..* |
| Type | Reference ( Device ) |
| MedicationAdministration.note | |
| Definition |
Extra information about the medication administration that is not conveyed by the other attributes. |
| Control |
|
| Type |
|
| MedicationAdministration.dosage | |
| Definition |
Describes the medication dosage information details e.g. dose, rate, site, route, etc. |
| Control | 0..1 |
|
|
Defined
on
this
element
mad-1 : SHALL have at least one of :
dose.exists()
or
|
| MedicationAdministration.dosage.text | |
| Definition |
Free
text
dosage
The
dosage
instructions
should
reflect
the
|
| Control | 0..1 |
| Type | string |
|
|
|
| Definition |
A coded specification of the anatomic site where the medication first entered the body. For example, "left arm". |
| Control | 0..1 |
| Terminology Binding |
SNOMED
CT
Anatomical
Structure
for
Administration
Site
|
| Type |
CodeableConcept
|
|
|
If
the
use
case
requires
attributes
from
the
BodySite
resource
(e.g.
to
identify
and
track
separately)
then
use
|
| 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. |
| Control | 0..1 |
| Terminology Binding |
SNOMED
CT
Route
|
| Type | CodeableConcept |
| 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. |
| Control | 0..1 |
| Terminology Binding |
|
| Type | CodeableConcept |
|
|
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. |
|
|
|
| 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. |
| Control | 0..1 |
| Type | SimpleQuantity |
|
|
If
the
administration
is
not
instantaneous
(rate
is
|
| 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.
|
| Control | 0..1 |
| Type |
Ratio
|
|
| [x] Note | See Choice of Data Types for further information about how to use [x] |
|
|
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. |
| MedicationAdministration.eventHistory | |
| Definition | A summary of the events of interest that have occurred, such as when the administration was verified. |
| Control | 0..* |
| Type | Reference ( Provenance ) |
| Comments | This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject. |