Data Exchange For Quality Measures Implementation Guide
4.0.0 - STU4 United States of America flag

Data Exchange For Quality Measures Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-deqm/ and changes regularly. See the Directory of published versions

Resource Profile: DEQM MedicationAdministration Profile ( Experimental )

Official URL: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/medicationadministration-deqm Version: 4.0.0
Active as of 2018-06-19 Computable Name: DEQMMedicationAdministrationProfile

The DEQM MedicationAdministration Profile describes the event of a patient consuming or otherwise being administered a medication

We seek comment on which of the two methods below is appropriate, and when, based on your experience. For the evaluateMeasure operation, you can manage what data to evaluate the measure in one of two ways: 1) Define the CQL rules to only look at a resource that has certain elements or elements of a certain value. This scenario puts the burden on the measure developer to add the specific needs into the CQL statements 2) Specify that a specific profile of a Resource should be used to calculate the measure. This would require the generator of the FHIR data to insure that a Resource meets the conditions of the profile Most of the examples and profiles in the DEQM assume the first (1) approach above. However DEQM MedicationAdministration profile is created here to represent how measure requirements could be handled by profiling a resource, (2) above.

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each MedicationAdministration must have:

  1. A medication code that identifies the medication that was administered
  2. The period of time during which the administration took place

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from QICoreMedicationAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: Non-Negative MedicationAdministration Status (required)
... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (preferred)
... medication[x] SΣ1..1CodeableConceptWhat was administered
Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications

... subject SΣ1..1Reference(QICore Patient)Who received medication
... context S0..1Reference(QICore Encounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... effective[x] SΣ1..1PeriodStart and end time of administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (preferred)
... dosage C0..1BackboneElementDetails of how medication was taken
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... dose S0..1SimpleQuantityAmount of medication per dose

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationAdministration.statusrequiredNonNegativeMedicationAdministrationStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medication-admin-status
MedicationAdministration.statusReasonpreferredSNOMEDCTReasonMedicationNotGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes
from the FHIR Standard
MedicationAdministration.medication[x]preferredMedication Clinical Drug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.reasonCodepreferredReasonMedicationGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-given-codes
from the FHIR Standard
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... instantiates Σ0..*uriInstantiates protocol or definition
... partOf Σ0..*Reference(MedicationAdministration | Procedure)Part of referenced event
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: Non-Negative MedicationAdministration Status (required)
... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (preferred)
... category 0..1CodeableConceptType of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.

... medication[x] SΣ1..1CodeableConceptWhat was administered
Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications

... subject SΣ1..1Reference(QICore Patient)Who received medication
... context S0..1Reference(QICore Encounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... supportingInformation 0..*Reference(Resource)Additional information to support administration
... effective[x] SΣ1..1PeriodStart and end time of administration
... performer Σ0..*BackboneElementWho performed the medication administration and what they did
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptType of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.

.... actor Σ1..1Reference(QICore Practitioner | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (preferred)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication was administered
... request 0..1Reference(QICore MedicationRequest)Request administration performed against
... device 0..*Reference(QICore Device | US Core Implantable Device Profile)Device used to administer
... note 0..*AnnotationInformation about the administration
... dosage C0..1BackboneElementDetails of how medication was taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity(SimpleQuantity)
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationAdministration.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationAdministration.statusrequiredNonNegativeMedicationAdministrationStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medication-admin-status
MedicationAdministration.statusReasonpreferredSNOMEDCTReasonMedicationNotGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes
from the FHIR Standard
MedicationAdministration.categorypreferredMedicationAdministration Category Codes
http://hl7.org/fhir/ValueSet/medication-admin-category
from the FHIR Standard
MedicationAdministration.medication[x]preferredMedication Clinical Drug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.performer.functionexampleMedicationAdministration Performer Function Codes
http://hl7.org/fhir/ValueSet/med-admin-perform-function
from the FHIR Standard
MedicationAdministration.reasonCodepreferredReasonMedicationGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-given-codes
from the FHIR Standard
MedicationAdministration.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationAdministration.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard

This structure is derived from QICoreMedicationAdministration

Summary

Must-Support: 2 elements

Differential View

This structure is derived from QICoreMedicationAdministration

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: Non-Negative MedicationAdministration Status (required)
... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (preferred)
... medication[x] SΣ1..1CodeableConceptWhat was administered
Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications

... subject SΣ1..1Reference(QICore Patient)Who received medication
... context S0..1Reference(QICore Encounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... effective[x] SΣ1..1PeriodStart and end time of administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (preferred)
... dosage C0..1BackboneElementDetails of how medication was taken
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... dose S0..1SimpleQuantityAmount of medication per dose

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationAdministration.statusrequiredNonNegativeMedicationAdministrationStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medication-admin-status
MedicationAdministration.statusReasonpreferredSNOMEDCTReasonMedicationNotGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes
from the FHIR Standard
MedicationAdministration.medication[x]preferredMedication Clinical Drug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.reasonCodepreferredReasonMedicationGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-given-codes
from the FHIR Standard
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*QICoreMedicationAdministrationAdministration of medication to a patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... instantiates Σ0..*uriInstantiates protocol or definition
... partOf Σ0..*Reference(MedicationAdministration | Procedure)Part of referenced event
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: Non-Negative MedicationAdministration Status (required)
... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (preferred)
... category 0..1CodeableConceptType of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.

... medication[x] SΣ1..1CodeableConceptWhat was administered
Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications

... subject SΣ1..1Reference(QICore Patient)Who received medication
... context S0..1Reference(QICore Encounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... supportingInformation 0..*Reference(Resource)Additional information to support administration
... effective[x] SΣ1..1PeriodStart and end time of administration
... performer Σ0..*BackboneElementWho performed the medication administration and what they did
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptType of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.

.... actor Σ1..1Reference(QICore Practitioner | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (preferred)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication was administered
... request 0..1Reference(QICore MedicationRequest)Request administration performed against
... device 0..*Reference(QICore Device | US Core Implantable Device Profile)Device used to administer
... note 0..*AnnotationInformation about the administration
... dosage C0..1BackboneElementDetails of how medication was taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity(SimpleQuantity)
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationAdministration.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationAdministration.statusrequiredNonNegativeMedicationAdministrationStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-medication-admin-status
MedicationAdministration.statusReasonpreferredSNOMEDCTReasonMedicationNotGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes
from the FHIR Standard
MedicationAdministration.categorypreferredMedicationAdministration Category Codes
http://hl7.org/fhir/ValueSet/medication-admin-category
from the FHIR Standard
MedicationAdministration.medication[x]preferredMedication Clinical Drug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.performer.functionexampleMedicationAdministration Performer Function Codes
http://hl7.org/fhir/ValueSet/med-admin-perform-function
from the FHIR Standard
MedicationAdministration.reasonCodepreferredReasonMedicationGivenCodes
http://hl7.org/fhir/ValueSet/reason-medication-given-codes
from the FHIR Standard
MedicationAdministration.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationAdministration.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard

This structure is derived from QICoreMedicationAdministration

Summary

Must-Support: 2 elements

 

Other representations of profile: CSV, Excel, Schematron

Notes:

This profile is used in the following transactions: