This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
STU
3).
(v3.3.0:
R4
Ballot
2).
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
Pharmacy
Work
Group
|
Maturity Level : 2 | Trial Use | Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson |
Detailed Descriptions for the elements in the MedicationAdministration resource.
| MedicationAdministration | |
| Element Id | 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 |
| Comments |
The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html). |
|
|
|
| Element Id | 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.
|
| Note | This is a business identifer, not a resource identifier (see discussion ) |
| Control | 0..* |
| Type | Identifier |
|
|
|
| Element Id | MedicationAdministration.instantiates |
| Definition |
A
protocol,
guideline,
|
| Control | 0..* |
| Type |
|
| Summary | true |
| MedicationAdministration.partOf | |
| Element Id | 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 | |
| Element Id | MedicationAdministration.status |
| Definition |
Will
generally
be
set
to
show
that
the
administration
has
been
completed.
For
some
long
running
administrations
such
as
|
| Control | 1..1 |
| Terminology Binding | MedicationAdministrationStatus ( Required ) |
| Type | code |
| Is Modifier | true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid) |
| Summary | true |
| Comments |
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
| MedicationAdministration.category | |
| Element Id | MedicationAdministration.category |
| Definition |
Indicates the type of medication administration and where the medication is expected to be consumed or administered. |
| Control | 0..1 |
| Terminology Binding | MedicationAdministrationCategory ( Preferred ) |
| Type | CodeableConcept |
| MedicationAdministration.medication[x] | |
| Element Id | MedicationAdministration.medication[x] |
| 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. |
| Control | 1..1 |
| Terminology Binding | SNOMED CT Medication Codes ( Example ) |
| Type | CodeableConcept | Reference ( 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. For example if you require form or lot number, then you must reference the Medication resource. . |
| MedicationAdministration.subject | |
| Element Id | MedicationAdministration.subject |
| Definition |
The person or animal or group receiving the medication. |
| Control | 1..1 |
| Type | Reference ( Patient | Group ) |
| Summary | true |
| MedicationAdministration.context | |
| Element Id | MedicationAdministration.context |
| Definition |
The
visit,
|
| Control | 0..1 |
| Type | Reference ( Encounter | EpisodeOfCare ) |
| MedicationAdministration.supportingInformation | |
| Element Id | 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] | |
| Element Id | 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 |
| MedicationAdministration.performer | |
| Element Id | MedicationAdministration.performer |
| Definition |
|
| Control | 0..* |
| Summary | true |
|
|
|
| Element Id | MedicationAdministration.performer.function |
| Definition |
|
| Control |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Definition |
|
| Control |
|
| Type |
|
|
|
true |
|
|
|
|
|
|
| Definition |
A code indicating why the administration was not performed. |
| Control | 0..* |
| Terminology Binding | SNOMED CT Reason Medication Not Given Codes ( Example ) |
| Type | CodeableConcept |
|
|
|
| Element Id | MedicationAdministration.reasonCode |
| Definition |
A code indicating why the medication was given. |
| Control | 0..* |
| Terminology Binding | Reason Medication Given Codes ( Example ) |
| Type | CodeableConcept |
|
|
|
| Element Id | MedicationAdministration.reasonReference |
| Definition |
Condition or observation that supports why the medication was administered. |
| Control | 0..* |
| Type | Reference ( Condition | Observation | DiagnosticReport ) |
| Comments |
This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. |
|
|
|
| Element Id | MedicationAdministration.request |
| Definition |
The original request, instruction or authority to perform the administration. |
| Control | 0..1 |
| Type | Reference ( MedicationRequest ) |
| Comments | This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value. |
| MedicationAdministration.device | |
| Element Id | 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 | |
| Element Id | MedicationAdministration.note |
| Definition |
Extra information about the medication administration that is not conveyed by the other attributes. |
| Control | 0..* |
| Type | Annotation |
| MedicationAdministration.dosage | |
| Element Id | MedicationAdministration.dosage |
| Definition |
Describes the medication dosage information details e.g. dose, rate, site, route, etc. |
| Control | 0..1 |
| Invariants |
Defined
on
this
element
mad-1 : SHALL have at least one of dosage.dose or dosage.rate[x] ( expression
:
dose.exists()
or
rate.exists(),
xpath:
exists(f:dose)
or
exists(f:*[starts-with(local-name(.),
'rate')]))
|
| MedicationAdministration.dosage.text | |
| Element Id | MedicationAdministration.dosage.text |
| Definition |
Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. |
| Control | 0..1 |
| Type | string |
| MedicationAdministration.dosage.site | |
| Element Id | MedicationAdministration.dosage.site |
| Definition |
A
coded
specification
of
the
anatomic
site
where
the
medication
first
entered
the
body.
For
example,
|
| Control | 0..1 |
| Terminology Binding | SNOMED CT Anatomical Structure for Administration Site Codes ( Example ) |
| Type | CodeableConcept |
| Comments |
If
the
use
case
requires
attributes
from
the
BodySite
resource
(e.g.
to
identify
and
track
separately)
then
use
the
standard
extension
|
| MedicationAdministration.dosage.route | |
| Element Id | 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 Codes ( Example ) |
| Type | CodeableConcept |
| MedicationAdministration.dosage.method | |
| Element Id | 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 | SNOMED CT Administration Method Codes ( Example ) |
| Type | CodeableConcept |
| 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. |
| MedicationAdministration.dosage.dose | |
| Element Id | MedicationAdministration.dosage.dose |
| 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 |
| Comments |
If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration. |
| MedicationAdministration.dosage.rate[x] | |
| Element Id | 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. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. |
| Control | 0..1 |
| Type | Ratio | SimpleQuantity |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| 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. |
| MedicationAdministration.eventHistory | |
| Element Id | 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
|