QI-Core Implementation Guide
7.0.0-ballot - 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-ballot 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 Not Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationnotdone Version: 7.0.0-ballot
Active as of 2018-08-22 Computable Name: QICoreMedicationAdministrationNotDone

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

QI Elements:
  • implicitRules: (QI) A set of rules under which this content was created
  • recorded: (QI) Extension
  • status: (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
  • statusReason: (QI) Reason administration not performed
  • medication[x]: (QI) What was administered
  • notDoneValueSet: (QI) Url of a value set of activities not requested or performed
  • 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
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

See the patterns page for implementation and usage patterns.

Examples

Negation example using a valuesetMedication not administered using a value set to indicate what was not administered; indicates that none of the medications in the given value set were administered
Negation example using a codeMedication not administered using a code to indicate that a particular medication was not administered; indicates that a specific medication, by code, was not administered

Both of these example instances meet measure intent for exclusion as defined in the following example CQL: 

define "Low Dose Unfractionated Heparin for VTE Prophylaxis Not Administered":
  ["MedicationAdministrationNotDone": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
    where VTEMedication.category ~ QICoreCommon."Inpatient"
      and (VTEMedication.reasonCode in "Medical Reason" or VTEMedication.reasonCode in "Patient Refusal")

For a more complete discussion of representation of negation within QI-Core and quality improvement artifacts, see the Negation in QI-Core topic.

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
mna-1: To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
... implicitRules 0..1 uri (QI) A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... recorded 1..1 dateTime (QI) Extension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status 1..1 code (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Fixed Value: not-done
... medication[x] C 1..1 CodeableConcept (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject 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] 1..1 dateTime, Period (QI) Start and end time of administration
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationAdministration.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4

Constraints

IdGradePath(s)DetailsRequirements
mna-1errorMedicationAdministrationTo indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
: medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
mna-1: To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ 0..1 uri (QI) A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... recorded 1..1 dateTime (QI) Extension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason 1..* CodeableConcept (QI) Reason administration not performed
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed


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

.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
MedicationAdministration.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4

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()
mna-1errorMedicationAdministrationTo indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
: medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
mna-1: To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet 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 (QI) 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 1..* Extension Extension
Slice: Unordered, Open by value:url
.... recorded 1..1 dateTime (QI) Extension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-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.


Fixed Value: not-done
... statusReason 1..* CodeableConcept (QI) Reason administration not performed
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed


... 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 CodeableConcept (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... 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
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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 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 Path of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... 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 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

PathConformanceValueSet / CodeURI
MedicationAdministration.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationAdministration.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
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.routeexampleSNOMEDCTRouteCodes
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()
mna-1errorMedicationAdministrationTo indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
: medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').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
mna-1: To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
... implicitRules 0..1 uri (QI) A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... recorded 1..1 dateTime (QI) Extension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status 1..1 code (QI) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Fixed Value: not-done
... medication[x] C 1..1 CodeableConcept (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject 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] 1..1 dateTime, Period (QI) Start and end time of administration
... request 0..1 Reference(QICore MedicationRequest) (QI) Request administration performed against

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
MedicationAdministration.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4

Constraints

IdGradePath(s)DetailsRequirements
mna-1errorMedicationAdministrationTo indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
: medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
mna-1: To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ 0..1 uri (QI) A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... recorded 1..1 dateTime (QI) Extension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason 1..* CodeableConcept (QI) Reason administration not performed
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed


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

.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
MedicationAdministration.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
MedicationAdministration.medication[x]preferredMedicationClinicalDrug .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4

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()
mna-1errorMedicationAdministrationTo indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
: medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
mna-1: To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet 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 (QI) 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 1..* Extension Extension
Slice: Unordered, Open by value:url
.... recorded 1..1 dateTime (QI) Extension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-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.


Fixed Value: not-done
... statusReason 1..* CodeableConcept (QI) Reason administration not performed
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed


... 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 CodeableConcept (QI) What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications

.... 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
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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 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 Path of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... 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 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

PathConformanceValueSet / CodeURI
MedicationAdministration.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationAdministration.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
from the FHIR Standard
MedicationAdministration.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
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.routeexampleSNOMEDCTRouteCodes
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()
mna-1errorMedicationAdministrationTo indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided
: medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists()

 

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