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 Done - XML Profile

Page standards status: Trial-use | Maturity Level: 4

XML representation of the qicore-medicationadministrationdone resource profile.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="qicore-medicationadministrationdone"/>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition qicore-medicationadministrationdone</b></p><a name="qicore-medicationadministrationdone"> </a><a name="hcqicore-medicationadministrationdone"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-medicationadministrationdone-definitions.html#MedicationAdministration">MedicationAdministration</a><a name="MedicationAdministration"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="StructureDefinition-qicore-medicationadministration.html">QICoreMedicationAdministration</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Administration of medication to a patient</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-qicore-medicationadministrationdone-definitions.html#MedicationAdministration.status">status</a><a name="MedicationAdministration.status"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">(QI) in-progress | on-hold | completed | stopped<br class="binding"/><span style="font-weight:bold" title="null" class="binding">Binding: </span><a href="ValueSet-qicore-positive-medication-admin-status.html" title="http://hl7.org/fhir/us/qicore/ValueSet/qicore-positive-medication-admin-status" class="binding">Positive MedicationAdministration Status</a><span title="null" class="binding"> (</span><a href="http://hl7.org/fhir/R4/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set." class="binding">required</a><span title="null" class="binding">)</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-primaryCodePath">
        <valueString value="medication"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-isIncluded">
        <valueBoolean value="true"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-isRetrievable">
        <valueBoolean value="true"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-label">
        <valueString value="MedicationAdministrationDone"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="cqi"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="4">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/qicore/ImplementationGuide/us-qicore"/>
          </extension>
        </valueInteger>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/qicore/ImplementationGuide/us-qicore"/>
          </extension>
        </valueCode>
      </extension>
      <url
           value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministrationdone"/>
      <version value="8.0.0-ballot"/>
      <name value="QICoreMedicationAdministrationDone"/>
      <title value="QICore MedicationAdministration Done"/>
      <status value="draft"/>
      <experimental value="false"/>
      <date value="2018-08-22"/>
      <publisher value="HL7 International / Clinical Quality Information"/>
      <contact>
        <name value="Clinical Quality Information WG"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/cqi"/>
        </telecom>
      </contact>
      <description
                   value="Positive profile of MedicationAdministration for decision support/quality metrics. Indicates that a medication administration is being or was performed (as opposed to the negative profile)"/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <fhirVersion value="4.0.1"/>
      <mapping>
        <identity value="workflow"/>
        <uri value="http://hl7.org/fhir/workflow"/>
        <name value="Workflow Pattern"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <uri value="http://hl7.org/v3"/>
        <name value="RIM Mapping"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <uri value="http://hl7.org/fhir/fivews"/>
        <name value="FiveWs Pattern Mapping"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <uri value="http://hl7.org/v2"/>
        <name value="HL7 v2 Mapping"/>
      </mapping>
      <mapping>
        <identity value="w3c.prov"/>
        <uri value="http://www.w3.org/ns/prov"/>
        <name value="W3C PROV"/>
      </mapping>
      <kind value="resource"/>
      <abstract value="false"/>
      <type value="MedicationAdministration"/>
      <baseDefinition
                      value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="8.0.0-ballot"/>
        </extension>
        <element id="MedicationAdministration">
          <path value="MedicationAdministration"/>
          <short value="Administration of medication to a patient"/>
          <definition
                      value="Describes the event of a patient consuming or otherwise being administered a medication.  This may be as simple as swallowing a tablet or it may be a long running infusion.  Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="dom-2"/>
            <severity value="error"/>
            <human
                   value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
            <expression value="contained.contained.empty()"/>
            <xpath value="not(parent::f:contained and f:contained)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-3"/>
            <severity value="error"/>
            <human
                   value="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"/>
            <expression
                        value="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()"/>
            <xpath
                   value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-4"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
            <expression
                        value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
            <xpath
                   value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-5"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
            <expression value="contained.meta.security.empty()"/>
            <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
              <valueBoolean value="true"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
              <valueMarkdown
                             value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
            </extension>
            <key value="dom-6"/>
            <severity value="warning"/>
            <human
                   value="A resource should have narrative for robust management"/>
            <expression value="text.`div`.exists()"/>
            <xpath value="exists(f:text/h:div)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="qma-1"/>
            <severity value="error"/>
            <human
                   value="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"/>
            <expression
                        value="(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()"/>
            <xpath value="exists(f:extension)"/>
            <source
                    value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Entity. Role, or Act"/>
          </mapping>
          <mapping>
            <identity value="workflow"/>
            <map value="Event"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="SubstanceAdministration"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.id">
          <path value="MedicationAdministration.id"/>
          <short value="Logical id of this artifact"/>
          <definition
                      value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <comment
                   value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="MedicationAdministration.meta">
          <path value="MedicationAdministration.meta"/>
          <short value="Metadata about the resource"/>
          <definition
                      value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.meta"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Meta"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="MedicationAdministration.implicitRules">
          <path value="MedicationAdministration.implicitRules"/>
          <short value="A set of rules under which this content was created"/>
          <definition
                      value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
          <comment
                   value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.implicitRules"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
          <isSummary value="true"/>
        </element>
        <element id="MedicationAdministration.language">
          <path value="MedicationAdministration.language"/>
          <short value="Language of the resource content"/>
          <definition
                      value="The base language in which the resource is written."/>
          <comment
                   value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.language"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
              <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Language"/>
            </extension>
            <strength value="preferred"/>
            <description value="A human language."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1"/>
          </binding>
        </element>
        <element id="MedicationAdministration.text">
          <path value="MedicationAdministration.text"/>
          <short value="Text summary of the resource, for human interpretation"/>
          <definition
                      value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
          <comment
                   value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
          <alias value="narrative"/>
          <alias value="html"/>
          <alias value="xhtml"/>
          <alias value="display"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Narrative"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Act.text?"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.contained">
          <path value="MedicationAdministration.contained"/>
          <short value="Contained, inline Resources"/>
          <definition
                      value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
          <comment
                   value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
          <alias value="inline resources"/>
          <alias value="anonymous resources"/>
          <alias value="contained resources"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.contained"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Resource"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.extension">
          <path value="MedicationAdministration.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.modifierExtension">
          <path value="MedicationAdministration.modifierExtension"/>
          <short value="Extensions that cannot be ignored"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.identifier">
          <path value="MedicationAdministration.identifier"/>
          <short value="External identifier"/>
          <definition
                      value="Identifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server."/>
          <comment
                   value="This is a business identifier, not a resource identifier."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.identifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Identifier"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.identifier"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.identifier"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".id"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.instantiates">
          <path value="MedicationAdministration.instantiates"/>
          <short value="Instantiates protocol or definition"/>
          <definition
                      value="A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.instantiates"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.instantiates"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=DEFN].target[classCode=unspecified]"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.partOf">
          <path value="MedicationAdministration.partOf"/>
          <short value="Part of referenced event"/>
          <definition
                      value="A larger event of which this particular event is a component or step."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.partOf"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Procedure|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.partOf"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=COMP]/target[classCode=SBADM or PROC,moodCode=EVN]"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.status">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.status"/>
          <short value="(QI) in-progress | on-hold | completed | stopped"/>
          <definition
                      value="Will generally be set to show that the administration has been completed.  For some long running administrations such as infusions, it is possible for an administration to be started but not completed or it may be paused while some other process is under way."/>
          <comment
                   value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.status"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/>
          <isSummary value="true"/>
          <binding>
            <strength value="required"/>
            <valueSet
                      value="http://hl7.org/fhir/us/qicore/ValueSet/qicore-positive-medication-admin-status"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.status"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.status"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="RXA-20-Completion Status"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".statusCode"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.statusReason">
          <path value="MedicationAdministration.statusReason"/>
          <short value="Reason administration not performed"/>
          <definition
                      value="A code indicating why the administration was not performed."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.statusReason"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MedicationAdministrationNegationReason"/>
            </extension>
            <strength value="example"/>
            <description
                         value="A set of codes indicating the reason why the MedicationAdministration is negated."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes|4.0.1"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.statusReason"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map
                 value="RXA-9-Administration Notes / RXA-18 Substance/Treatment Refusal Reason"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;reason not given&quot;].value"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.category">
          <path value="MedicationAdministration.category"/>
          <short value="Type of medication usage"/>
          <definition
                      value="Indicates where the medication is expected to be consumed or administered."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.category"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MedicationAdministrationCategory"/>
            </extension>
            <strength value="preferred"/>
            <description
                         value="A coded concept describing where the medication administered is expected to occur."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/medication-admin-category|4.0.1"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type of medication usage&quot;].value"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.medication[x]">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.medication[x]"/>
          <short value="(QI) What was administered"/>
          <definition
                      value="Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications."/>
          <comment
                   value="If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number, then you must reference the Medication resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.medication[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"/>
          </type>
          <condition value="qma-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <strength value="preferred"/>
            <description
                         value="The set of RxNorm codes to represent medications"/>
            <valueSet
                      value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.code"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.what[x]"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="RXA-5-Administered Code"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=CSM].role[classCode=ADMM]"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.medication[x].id">
          <path value="MedicationAdministration.medication[x].id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.medication[x].extension">
          <path value="MedicationAdministration.medication[x].extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <description value="Extensions are always sliced by (at least) url"/>
            <rules value="open"/>
          </slicing>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="MedicationAdministration.medication[x].extension:codeOptions">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.medication[x].extension"/>
          <sliceName value="codeOptions"/>
          <short value="(QI) Url of a value set of candidate medications"/>
          <definition
                      value="A logical reference (e.g. a reference to ValueSet.url) to a value set/version that identifies a set of possible coded values representing the medication."/>
          <comment
                   value="This extension SHALL NOT be used when an appropriate higher level concept code exists. When this extension is used on an element with a required binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set. When used with an extensible binding, the set of possible coded values in the referenced value set SHALL be present in the bound value set unless none of the codes in the bound value set apply to the concept being communicated (based on human review). When this extension appears on a CodeableConcept, the CodeableConcept SHALL have no codings, and the text of the CodeableConcept SHALL include the title of the referenced value set."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/codeOptions|8.0.0-ballot"/>
          </type>
          <condition value="qma-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="CWE."/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="CD.valueSet/CD.valueSetVersion"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.subject">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.subject"/>
          <short value="(QI) Who received medication"/>
          <definition
                      value="The person or animal or group receiving the medication."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.subject"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.subject"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.subject[x]"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="PID-3-Patient ID List"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.subject"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.context">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.context"/>
          <short
                 value="(QI) Encounter or Episode of Care administered as part of"/>
          <definition
                      value="The visit, admission, or other contact between patient and health care provider during which the medication administration was performed."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.context"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.context"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.context"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="PV1-19-Visit Number"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type of encounter or episode&quot;]"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.supportingInformation">
          <path value="MedicationAdministration.supportingInformation"/>
          <short value="Additional information to support administration"/>
          <definition
                      value="Additional information (for example, patient height and weight) that supports the administration of the medication."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.supportingInformation"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.context"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.effective[x]">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.effective[x]"/>
          <short value="(QI) Start and end time of administration"/>
          <definition
                      value="A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.effective[x]"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="dateTime"/>
          </type>
          <type>
            <code value="Period"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.occurrence[x]"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.done[x]"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map
                 value="RXA-3-Date/Time Start of Administration / RXA-4-Date/Time End of Administration"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".effectiveTime"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.performer">
          <path value="MedicationAdministration.performer"/>
          <short
                 value="Who performed the medication administration and what they did"/>
          <definition
                      value="Indicates who or what performed the medication administration and how they were involved."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.performer"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.performer"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.actor"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map
                 value="RXA-10-Administering Provider / PRT-5-Participation Person: PRT-4-Participation='AP' (RXA-10 is deprecated)"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".participation[typeCode=PRF]"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.performer.id">
          <path value="MedicationAdministration.performer.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.performer.extension">
          <path value="MedicationAdministration.performer.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.performer.modifierExtension">
          <path value="MedicationAdministration.performer.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.performer.function">
          <path value="MedicationAdministration.performer.function"/>
          <short value="Type of performance"/>
          <definition
                      value="Distinguishes the type of involvement of the performer in the medication administration."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.performer.function"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MedicationAdministrationPerformerFunction"/>
            </extension>
            <strength value="example"/>
            <description
                         value="A code describing the role an individual played in administering the medication."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/med-admin-perform-function|4.0.1"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.performer.function"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="participation[typeCode=PRF].functionCode"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.performer.actor">
          <path value="MedicationAdministration.performer.actor"/>
          <short value="Who performed the medication administration"/>
          <definition
                      value="Indicates who or what performed the medication administration."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.performer.actor"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.performer.actor"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".role"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.reasonCode">
          <path value="MedicationAdministration.reasonCode"/>
          <short value="Reason administration performed"/>
          <definition value="A code indicating why the medication was given."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.reasonCode"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MedicationAdministrationReason"/>
            </extension>
            <strength value="example"/>
            <description
                         value="A set of codes indicating the reason why the MedicationAdministration was made."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/reason-medication-given-codes|4.0.1"/>
          </binding>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.reasonCode"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="RXE-27 Give Indication"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".reasonCode"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.reasonReference">
          <path value="MedicationAdministration.reasonReference"/>
          <short
                 value="Condition or observation that supports why the medication was administered"/>
          <definition
                      value="Condition or observation that supports why the medication was administered."/>
          <comment
                   value="This is a reference to a condition that is the reason for the medication request.  If only a code exists, use reasonCode."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.reasonReference"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Condition|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Observation|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.reasonReference"/>
          </mapping>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.why[x]"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;reason for use ASSERTION&quot;].value"/>
          </mapping>
          <mapping>
            <identity value="w3c.prov"/>
            <map value="no mapping"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.request">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.request"/>
          <short value="(QI) Request administration performed against"/>
          <definition
                      value="The original request, instruction or authority to perform the administration."/>
          <comment
                   value="This is a reference to the MedicationRequest  where the intent is either order or instance-order.  It should not reference MedicationRequests where the intent is any other value."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.request"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.basedOn"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="ORC-2-Placer Order Number / ORC-3-Filler Order Number"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="InFullfillmentOf-&gt;SubstanceAdministration"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.device">
          <path value="MedicationAdministration.device"/>
          <short value="Device used to administer"/>
          <definition
                      value="The device used in administering the medication to the patient.  For example, a particular infusion pump."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.device"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map
                 value="PRT-10 Participation Device / RXR-3 Administrative Device"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="device-&gt;Access  OR device-&gt;AssignedDevice"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.note">
          <path value="MedicationAdministration.note"/>
          <short value="Information about the administration"/>
          <definition
                      value="Extra information about the medication administration that is not conveyed by the other attributes."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.note"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Annotation"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="workflow"/>
            <map value="Event.note"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=&quot;annotation&quot;].value"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.dosage"/>
          <short value="(QI) Details of how medication was taken"/>
          <definition
                      value="Describes the medication dosage information details e.g. dose, rate, site, route, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="mad-1"/>
            <severity value="error"/>
            <human
                   value="SHALL have at least one of dosage.dose or dosage.rate[x]"/>
            <expression value="dose.exists() or rate.exists()"/>
            <xpath
                   value="exists(f:dose) or exists(f:*[starts-with(local-name(.), 'rate')])"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/>
          </constraint>
          <mustSupport value="false"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="component-&gt;SubstanceAdministrationEvent"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.id">
          <path value="MedicationAdministration.dosage.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.extension">
          <path value="MedicationAdministration.dosage.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.modifierExtension">
          <path value="MedicationAdministration.dosage.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.text">
          <path value="MedicationAdministration.dosage.text"/>
          <short value="Free text dosage instructions e.g. SIG"/>
          <definition
                      value="Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

    The dosage instructions should reflect the dosage of the medication that was administered."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value=".text"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.site">
          <path value="MedicationAdministration.dosage.site"/>
          <short value="Body site administered to"/>
          <definition
                      value="A coded specification of the anatomic site where the medication first entered the body.  For example, &quot;left arm&quot;."/>
          <comment
                   value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage.site"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MedicationAdministrationSite"/>
            </extension>
            <strength value="example"/>
            <description
                         value="A coded concept describing the site location the medicine enters into or onto the body."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map
                 value="RXR-2 Administration Site / RXR-6 Administration Site Modifier"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".approachSiteCode"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.route">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.dosage.route"/>
          <short value="(QI) Path of substance into body"/>
          <definition
                      value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient.  For example, topical, intravenous, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage.route"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <strength value="preferred"/>
            <valueSet value="http://hl7.org/fhir/ValueSet/route-codes"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="RXR-1-Route"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".routeCode"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.method">
          <path value="MedicationAdministration.dosage.method"/>
          <short value="How drug was administered"/>
          <definition
                      value="A coded value indicating the method by which the medication is intended to be or was introduced into or on the body.  This attribute will most often NOT be populated.  It is most commonly used for injections.  For example, Slow Push, Deep IV."/>
          <comment
                   value="One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration.  This means the codes used in route or form may pre-coordinate the method in the route code or the form code.  The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may  be used frequently."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage.method"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MedicationAdministrationMethod"/>
            </extension>
            <strength value="example"/>
            <description
                         value="A coded concept describing the technique by which the medicine is administered."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="RXR-4-Administration Method"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".methodCode"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.dose">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.dosage.dose"/>
          <short value="(QI) Amount of medication per dose"/>
          <definition
                      value="The amount of the medication given at one administration event.   Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection."/>
          <comment
                   value="If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage.dose"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Quantity"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="RXA-6 Administered Amount / RXA-7 Administered Units"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".doseQuantity"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.dosage.rate[x]">
          <path value="MedicationAdministration.dosage.rate[x]"/>
          <short value="Dose quantity per unit of time"/>
          <definition
                      value="Identifies the speed with which the medication was or will be introduced into the patient.  Typically, the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time, e.g. 500 ml per 2 hours.  Other examples:  200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours."/>
          <comment
                   value="If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationAdministration.dosage.rate[x]"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Ratio"/>
          </type>
          <type>
            <code value="Quantity"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="RXA-12-Administered Per (Time Unit)"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value=".rateQuantity"/>
          </mapping>
        </element>
        <element id="MedicationAdministration.eventHistory">
          <path value="MedicationAdministration.eventHistory"/>
          <short value="A list of events of interest in the lifecycle"/>
          <definition
                      value="A summary of the events of interest that have occurred, such as when the administration was verified."/>
          <comment
                   value="This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="MedicationAdministration.eventHistory"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Provenance|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map
                 value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/>
          </mapping>
        </element>
      </snapshot>
      <differential>
        <element id="MedicationAdministration">
          <path value="MedicationAdministration"/>
        </element>
        <element id="MedicationAdministration.status">
          <extension
                     url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement">
            <valueBoolean value="true"/>
          </extension>
          <path value="MedicationAdministration.status"/>
          <short value="(QI) in-progress | on-hold | completed | stopped"/>
          <binding>
            <strength value="required"/>
            <valueSet
                      value="http://hl7.org/fhir/us/qicore/ValueSet/qicore-positive-medication-admin-status"/>
          </binding>
        </element>
      </differential>
    </StructureDefinition>