QI-Core Implementation Guide
7.0.0 - STU7 United States of America flag

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICore MedicationAdministration

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration Version: 7.0.0
Draft as of 2018-08-22 Computable Name: QICoreMedicationAdministration

Profile of MedicationAdministration for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

QI Elements:
  • recorded: (QI) Recorded
  • status: (QI) in-progress | on-hold | completed | entered-in-error | stopped | unknown
  • medication[x]: (QI) What was administered
  • subject: (QI) Who received medication
  • context: (QI) Encounter or Episode of Care administered as part of
  • effective[x]: (QI) Start and end time of administration
  • request: (QI) Request administration performed against
  • dosage: (QI) Details of how medication was taken
  • dosage.route: (QI) Path of substance into body
  • dosage.dose: (QI) Amount of medication per dose
Primary code path: medication
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Usage

The MedicationAdministration profile defines the conformance expectations for a MedicationAdministration event, regardless of whether it is a positive or negative statement. The MedicationAdministrationDone and MedicationAdministrationNotDone profiles represent the positive and negative statements for a MedicationAdministration event.

To create an expression indicating existence of a MedicationAdministration, use the profile QICoreMedicationAdministrationDone; to specifically request information that a MedicationAdministration intentionally did not occur for a medical, patient or system reason, use the profile QICoreMedicationAdministrationNotDone.

The following example illustrates accessing MedicationAdministration data:

define "Low Dose Unfractionated Heparin Administration":
  ["MedicationAdministration": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
    where VTEMedication.status = 'completed'
      and VTEMedication.category ~ QICoreCommon."Inpatient"

See the patterns page for implementation and usage patterns.

Examples

Inhalant Example
Cumulative Duration Example

Usage:

Formal Views of Profile Content

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

This structure is derived from MedicationAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
qma-1: To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
... Slices for extension Content/Rules for all slices
.... recorded 0..1 dateTime (QI) Recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationAdministration.recorded
... status 1..1 code (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
... medication[x] C 1..1 (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medication[x]All Types Content/Rules for all Types
..... Slices for extension Content/Rules for all slices
...... codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... context 0..1 Reference(QICore Encounter | EpisodeOfCare) (QI) Encounter or Episode of Care administered as part of
... effective[x] 1..1 dateTime, Period (QI) Start and end time of administration
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against
... dosage 0..1 BackboneElement (QI) Details of how medication was taken
.... route 0..1 CodeableConcept (QI) Path of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... dose 0..1 SimpleQuantity (QI) Amount of medication per dose

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
qma-1errorMedicationAdministrationTo indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
: (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
qma-1: To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... recorded 0..1 dateTime (QI) Recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationAdministration.recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... medication[x] ΣC 1..1 (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medication[x]All Types Content/Rules for all Types
..... Slices for extension Content/Rules for all slices
...... codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who received medication
... context 0..1 Reference(QICore Encounter | EpisodeOfCare) (QI) Encounter or Episode of Care administered as part of
... effective[x] Σ 1..1 (QI) Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against
... dosage C 0..1 BackboneElement (QI) Details of how medication was taken
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... route 0..1 CodeableConcept (QI) Path of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... dose 0..1 SimpleQuantity (QI) Amount of medication per dose

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationAdministration.statusrequiredMedicationAdministration Status Codes
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationAdministrationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mad-1errorMedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()
qma-1errorMedicationAdministrationTo indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
: (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
qma-1: To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... recorded 0..1 dateTime (QI) Recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationAdministration.recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External identifier
... instantiates Σ 0..* uri Instantiates protocol or definition
... partOf Σ 0..* Reference(MedicationAdministration | Procedure) Part of referenced event
... status ?!Σ 1..1 code (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.

... statusReason 0..* CodeableConcept Reason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.


... category 0..1 CodeableConcept Type of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.

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

.... medication[x]All Types Content/Rules for all Types
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who received medication
... context 0..1 Reference(QICore Encounter | EpisodeOfCare) (QI) Encounter or Episode of Care administered as part of
... supportingInformation 0..* Reference(Resource) Additional information to support administration
... effective[x] Σ 1..1 (QI) Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer Σ 0..* BackboneElement Who performed the medication administration and what they did
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function 0..1 CodeableConcept Type of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.

.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) Who performed the medication administration
... reasonCode 0..* CodeableConcept Reason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.


... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication was administered
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against
... device 0..* Reference(Device) Device used to administer
... note 0..* Annotation Information about the administration
... dosage C 0..1 BackboneElement (QI) Details of how medication was taken
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text 0..1 string Free text dosage instructions e.g. SIG
.... site 0..1 CodeableConcept Body site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

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

.... dose 0..1 SimpleQuantity (QI) Amount of medication per dose
.... rate[x] 0..1 Dose quantity per unit of time
..... rateRatio Ratio
..... rateQuantity Quantity(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.statusrequiredMedicationAdministration Status Codes
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.statusReasonexampleSNOMEDCTReasonMedicationNotGivenCodes
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]preferredMedicationClinicalDrug .
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.reasonCodeexampleReasonMedicationGivenCodes
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

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationAdministrationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mad-1errorMedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()
qma-1errorMedicationAdministrationTo indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
: (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()

Differential View

This structure is derived from MedicationAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
qma-1: To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
... Slices for extension Content/Rules for all slices
.... recorded 0..1 dateTime (QI) Recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationAdministration.recorded
... status 1..1 code (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
... medication[x] C 1..1 (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medication[x]All Types Content/Rules for all Types
..... Slices for extension Content/Rules for all slices
...... codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... context 0..1 Reference(QICore Encounter | EpisodeOfCare) (QI) Encounter or Episode of Care administered as part of
... effective[x] 1..1 dateTime, Period (QI) Start and end time of administration
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against
... dosage 0..1 BackboneElement (QI) Details of how medication was taken
.... route 0..1 CodeableConcept (QI) Path of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... dose 0..1 SimpleQuantity (QI) Amount of medication per dose

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
qma-1errorMedicationAdministrationTo indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
: (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
qma-1: To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... recorded 0..1 dateTime (QI) Recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationAdministration.recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... medication[x] ΣC 1..1 (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... medication[x]All Types Content/Rules for all Types
..... Slices for extension Content/Rules for all slices
...... codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who received medication
... context 0..1 Reference(QICore Encounter | EpisodeOfCare) (QI) Encounter or Episode of Care administered as part of
... effective[x] Σ 1..1 (QI) Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against
... dosage C 0..1 BackboneElement (QI) Details of how medication was taken
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... route 0..1 CodeableConcept (QI) Path of substance into body
Binding: SNOMEDCTRouteCodes (preferred)
.... dose 0..1 SimpleQuantity (QI) Amount of medication per dose

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationAdministration.statusrequiredMedicationAdministration Status Codes
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationAdministration.dosage.routepreferredSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationAdministrationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mad-1errorMedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()
qma-1errorMedicationAdministrationTo indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
: (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
qma-1: To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... recorded 0..1 dateTime (QI) Recorded
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationAdministration.recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External identifier
... instantiates Σ 0..* uri Instantiates protocol or definition
... partOf Σ 0..* Reference(MedicationAdministration | Procedure) Part of referenced event
... status ?!Σ 1..1 code (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.

... statusReason 0..* CodeableConcept Reason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.


... category 0..1 CodeableConcept Type of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.

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

.... medication[x]All Types Content/Rules for all Types
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate medications
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(QICore Medication)
... subject Σ 1..1 Reference(QICore Patient) (QI) Who received medication
... context 0..1 Reference(QICore Encounter | EpisodeOfCare) (QI) Encounter or Episode of Care administered as part of
... supportingInformation 0..* Reference(Resource) Additional information to support administration
... effective[x] Σ 1..1 (QI) Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer Σ 0..* BackboneElement Who performed the medication administration and what they did
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function 0..1 CodeableConcept Type of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.

.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) Who performed the medication administration
... reasonCode 0..* CodeableConcept Reason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.


... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication was administered
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against
... device 0..* Reference(Device) Device used to administer
... note 0..* Annotation Information about the administration
... dosage C 0..1 BackboneElement (QI) Details of how medication was taken
mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text 0..1 string Free text dosage instructions e.g. SIG
.... site 0..1 CodeableConcept Body site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

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

.... dose 0..1 SimpleQuantity (QI) Amount of medication per dose
.... rate[x] 0..1 Dose quantity per unit of time
..... rateRatio Ratio
..... rateQuantity Quantity(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.statusrequiredMedicationAdministration Status Codes
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.statusReasonexampleSNOMEDCTReasonMedicationNotGivenCodes
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]preferredMedicationClinicalDrug .
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.reasonCodeexampleReasonMedicationGivenCodes
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

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationAdministrationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mad-1errorMedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()
qma-1errorMedicationAdministrationTo indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided
: (medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()

 

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