QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot

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 8.0.0-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: 8.0.0-ballot
Standards status: Trial-use Active as of 2018-08-22 | Maturity Level: 4 | Computable Name: QICoreMedicationAdministrationNotDone

Negation profile of MedicationAdministration for decision support/quality metrics. Indicates that a medication was not administered for a reason.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
QI Elements:

- medication[x]: (QI) What was administered
- dosage: (QI) Details of how medication was taken
- statusReason: (QI) Reason administration not performed
- medication[x].extension(codeOptions): (QI) Url of a value set of candidate medications
- subject: (QI) Who received medication
- request: (QI) Request administration performed against
- effective[x]: (QI) Start and end time of administration
- status: (QI) not-done
- context: (QI) Encounter or Episode of Care administered as part of

Primary code path: medication
(PCPath) This element is the primary code path for this resource CQL Retrieve
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 an expression to retrieve instances that meet measure intent for exclusion:

    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.

See the patterns page for implementation and usage patterns.

### Examples

Negation example using a valueset | Medication 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 code | Medication not administered using a code to indicate that a particular medication was not administered; indicates that a specific medication, by code, was not administered

Usages:

- Examples for this Profile: MedicationAdministration/negation-example and MedicationAdministration/negation-with-code-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | QICoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (QI) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..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] | Σ 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
extension: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
effective[x] | Σ | 1..1 |  | (QI) Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | QICore Negation Reason Codes | 📦8.0.0-ballot | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20240606 | VSAC v0.23

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If 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-4 | error | MedicationAdministration | If 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-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qma-1 | error | MedicationAdministration | 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 | `(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | QICoreMedicationAdministration | Administration of medication to a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
status |  | 1..1 | code | (QI) not-done Fixed Value: not-done
statusReason |  | 1..1 | CodeableConcept | (QI) Reason administration not performed Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​statusReason | Base | extensible | QICore Negation Reason Codes | 📦8.0.0-ballot | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | QICoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1
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 Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
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) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..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] | Σ 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
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
extension: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 Constraints: mad-1
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(4.0.1) | (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
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | QICore Negation Reason Codes | 📦8.0.0-ballot | This IG
MedicationAdministration.​category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20240606 | VSAC v0.23
MedicationAdministration.​performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationAdministration.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If 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-4 | error | MedicationAdministration | If 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-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`
qma-1 | error | MedicationAdministration | 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 | `(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()`

Summary

Mandatory: 1 element
Fixed: 1 element

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | QICoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (QI) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..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] | Σ 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
extension: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
effective[x] | Σ | 1..1 |  | (QI) Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | QICore Negation Reason Codes | 📦8.0.0-ballot | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20240606 | VSAC v0.23

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If 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-4 | error | MedicationAdministration | If 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-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qma-1 | error | MedicationAdministration | 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 | `(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | QICoreMedicationAdministration | Administration of medication to a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
status |  | 1..1 | code | (QI) not-done Fixed Value: not-done
statusReason |  | 1..1 | CodeableConcept | (QI) Reason administration not performed Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​statusReason | Base | extensible | QICore Negation Reason Codes | 📦8.0.0-ballot | This IG

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | QICoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1
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 Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
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) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..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] | Σ 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
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
extension: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 Constraints: mad-1
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(4.0.1) | (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
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | QICore Negation Reason Codes | 📦8.0.0-ballot | This IG
MedicationAdministration.​category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20240606 | VSAC v0.23
MedicationAdministration.​performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationAdministration.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If 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-4 | error | MedicationAdministration | If 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-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`
qma-1 | error | MedicationAdministration | 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 | `(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()`

Summary

Mandatory: 1 element
Fixed: 1 element

Maturity: 4

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