ELGA e-Medikation (R4) ENTWURF
0.1.1 - ci-build

ELGA e-Medikation (R4) ENTWURF, published by ELGA GmbH. This guide is not an authorized publication; it is the continuous build for version 0.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7Austria/ELGA-e-Medikation-R4/ and changes regularly. See the Directory of published versions

Resource Profile: AtEmedMedication - Detailed Descriptions

Draft as of 2026-02-17

Definitions for the at-emed-medication resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Medication
Definition

This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

ShortDefinition of a Medication
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Medication.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Medication.text
Definition

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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortTODO: Freitext für magistrale Anwendungen oder Abbildung in Substance.description?Text summary of the resource, for human interpretation
Comments

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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Medication.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Medication.identifier
Definition

Business identifier for this medication.

ShortEindeutiger Identifikator für das Arzneimittel. Wird nicht benötigt, da PZN, sofern vorhanden, im Code angegeben wird.Business identifier for this medication
Comments

The serial number could be included as an identifier.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Medication.code
Definition

A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.

ShortCode des Arzneimittels. Hier muss die Pharmazentralnummer (PZN) aus der ASP-Liste angegeben werden, sofern vorhanden. TODO: Slicing für meherere Codings Gem. CDA V3: Das Codesystem Pharmazentralnummer {1.2.40.0.34.4.16} wird am Terminologieserver in der ASP-Liste (Liste der humanen Arzneispezialitäten gelistet nach PZN) publiziert, die ASP-Liste enthält neben der Pharmazentralnummer {1.2.40.0.34.4.17} auch die korrespondierende Zulassungsnummer und Package Reference Number der AGES {1.2.40.0.34.4.26}. Für die Kompatibilität zum EU Kontext wird zukünftig auch die PCID der EMA {1.2.40.0.34.4.27} ermöglicht.Codes that identify this medication
Comments

Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

Control0..1
BindingThe codes SHALL be taken from For example codes, see https://termgit.elga.gv.at/CodeSystem/asp-listehttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
(required to https://termgit.elga.gv.at/CodeSystem/asp-liste)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Medication.status
Definition

A code to indicate if the medication is in active use.

ShortVerfügbarkeitsstatus des Arzneimittels:(req) active | inactive | entered-in-error. https://hl7.org/fhir/R4/valueset-medication-status.html. Keine Verwendung im Kontext Planeintrag.active | inactive | entered-in-error
Comments

This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

Control0..01
BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medication-status|4.0.1)

A coded concept defining if the medication is in active use.

Typecode
Is Modifiertrue because This element changes the interpretation of all descriptive attributes.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Medication.manufacturer
Definition

Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.

ShortDer Hersteller des Arzneimittels. Keine Verwendung im Kontext Planeintrag. TODO: Prüfen, ob im Kontext durchgeführte Abgabe und magistraler Zubereitung erforderlich; HL7ATCoreOrganization schränkt auf Organisationen gemäß GDA-Index ein.Manufacturer of the item
Control0..01
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Medication.form
Definition

Describes the form of the item. Powder; tablets; capsule.

ShortDie Darreichungsform des Arzneimittels. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung. Gem. CDA V3: Für die e-Medikation ist das CodeSystem ​Medikation_Darreichungsform 1.2.40.0.10.1.4.3.4.3.5 zu verwenden. Für den eHDSI Kontext ist das CodeSystem 0.4.0.127.0.16.1.1.2.1 zu verwenden.powder | tablets | capsule +
Comments

When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

Control0..1
BindingThe codes SHALL be taken from For example codes, see https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart.htmlhttp://hl7.org/fhir/ValueSet/medication-form-codes|4.0.1
(required to https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart.html)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Medication.amount
Definition

Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).

ShortDie Gesamtmenge des Arzneimittels in der Verpackung. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung.Amount of drug in package
Control0..1
TypeRatio
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Medication.ingredient
Definition

Identifies a particular constituent of interest in the product.

ShortWirkstoffe. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung. Gemäß AG: Einschränkung auf CodeableConcept, TODO: prüfen, wie Freitext bei magistraler Zubereitung abgebildet wird: Evtl. in einer Substance-Ressource in der description (string).Active or inactive ingredient
Comments

The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Medication.ingredient.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Medication.ingredient.item[x]
Definition

The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

ShortThe actual ingredient or content
Control1..1
TypeChoice of: CodeableConcept, Reference(ELGA e-Med Substanz, Substance, Medication)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summaryfalse
Requirements

The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Medication.ingredient.item[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 26. Medication.ingredient.item[x]:itemCodeableConcept
    Slice NameitemCodeableConcept
    Definition

    The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

    ShortInhaltsstoff codiert. TODO: prüfen, Einschränkung auf SPOR (EMA). Gemüß CDA v3: Wirkstoff-Codes stammen aus der ATC-Klassifikation (Anatomical Therapeutic Chemical Classification), die von der WHO herausgegeben wird. Weitere Codes, wie auch die deutsche Bezeichnung der Codes, entsprechen dem GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WidO), AOK Bundesverband GbR, Deutschland, welcher auf den WHO ATC basiert. Zusätzlich kommen ergänzende Codes aus dem Arzneimittelverzeichnis der AGES zum Einsatz.The actual ingredient or content
    Control01..1
    TypeCodeableConcept, Reference(Substance, Medication)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Medication.ingredient.item[x]:itemReference
    Slice NameitemReference
    Definition

    The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

    ShortReferenz auf Ressourcen Substance im Fall von magistraler AnwendungThe actual ingredient or content
    Control01..1
    TypeReference(ELGA e-Med Substanz, Substance, Medication), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Medication.ingredient.item[x]:itemReference.reference
    Definition

    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

    ShortLiteral reference, Relative, internal or absolute URL
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control0..1
    This element is affected by the following invariants: ref-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    contained-sub: Substance must be contained (reference.startsWith('#'))
    32. Medication.ingredient.isActive
    Definition

    Indication of whether this ingredient affects the therapeutic action of the drug.

    ShortAktive Wirkstoff TRUE/FALSEActive ingredient indicator
    Control0..1
    Typeboolean
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Requirements

    True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Medication.ingredient.strength
    Definition

    Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.

    ShortMenge der vorhandenen ZutatQuantity of ingredient present
    Control0..1
    TypeRatio
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Medication.batch
    Definition

    Information that only applies to packages (not products).

    ShortInformationen zur Charge des Arzneimittels. Keine Verwenund im Kontext Planeintrag.Details about packaged medications
    Control0..01
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. Medication
    2. Medication.text
    ShortTODO: Freitext für magistrale Anwendungen oder Abbildung in Substance.description?
    Must Supporttrue
    4. Medication.identifier
    ShortEindeutiger Identifikator für das Arzneimittel. Wird nicht benötigt, da PZN, sofern vorhanden, im Code angegeben wird.
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0
    6. Medication.code
    ShortCode des Arzneimittels. Hier muss die Pharmazentralnummer (PZN) aus der ASP-Liste angegeben werden, sofern vorhanden. TODO: Slicing für meherere Codings Gem. CDA V3: Das Codesystem Pharmazentralnummer {1.2.40.0.34.4.16} wird am Terminologieserver in der ASP-Liste (Liste der humanen Arzneispezialitäten gelistet nach PZN) publiziert, die ASP-Liste enthält neben der Pharmazentralnummer {1.2.40.0.34.4.17} auch die korrespondierende Zulassungsnummer und Package Reference Number der AGES {1.2.40.0.34.4.26}. Für die Kompatibilität zum EU Kontext wird zukünftig auch die PCID der EMA {1.2.40.0.34.4.27} ermöglicht.
    BindingThe codes SHALL be taken from https://termgit.elga.gv.at/CodeSystem/asp-liste
    (required to https://termgit.elga.gv.at/CodeSystem/asp-liste)
    Must Supporttrue
    8. Medication.code.coding
    10. Medication.code.coding.display
    ShortJuristisch zu prüfen, ob mindestens ein Displayname (Handelsname) zur PZN angegeben werden muss (Zwecks Prüfung auf Übereinstimmung und historischer Verfügbarkeit, im Falle von sich ändernden PZNs; evtl. könnte die Fachanwendung.
    12. Medication.status
    ShortVerfügbarkeitsstatus des Arzneimittels:(req) active | inactive | entered-in-error. https://hl7.org/fhir/R4/valueset-medication-status.html. Keine Verwendung im Kontext Planeintrag.
    Control0..0
    14. Medication.manufacturer
    ShortDer Hersteller des Arzneimittels. Keine Verwendung im Kontext Planeintrag. TODO: Prüfen, ob im Kontext durchgeführte Abgabe und magistraler Zubereitung erforderlich; HL7ATCoreOrganization schränkt auf Organisationen gemäß GDA-Index ein.
    Control0..0
    16. Medication.form
    ShortDie Darreichungsform des Arzneimittels. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung. Gem. CDA V3: Für die e-Medikation ist das CodeSystem ​Medikation_Darreichungsform 1.2.40.0.10.1.4.3.4.3.5 zu verwenden. Für den eHDSI Kontext ist das CodeSystem 0.4.0.127.0.16.1.1.2.1 zu verwenden.
    BindingThe codes SHALL be taken from https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart.html
    (required to https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart.html)
    Must Supporttrue
    18. Medication.amount
    ShortDie Gesamtmenge des Arzneimittels in der Verpackung. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung.
    Must Supporttrue
    20. Medication.ingredient
    ShortWirkstoffe. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung. Gemäß AG: Einschränkung auf CodeableConcept, TODO: prüfen, wie Freitext bei magistraler Zubereitung abgebildet wird: Evtl. in einer Substance-Ressource in der description (string).
    Must Supporttrue
    22. Medication.ingredient.item[x]
    TypeChoice of: CodeableConcept, Reference(ELGA e-Med Substanz)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on Medication.ingredient.item[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 24. Medication.ingredient.item[x]:itemCodeableConcept
      Slice NameitemCodeableConcept
      ShortInhaltsstoff codiert. TODO: prüfen, Einschränkung auf SPOR (EMA). Gemüß CDA v3: Wirkstoff-Codes stammen aus der ATC-Klassifikation (Anatomical Therapeutic Chemical Classification), die von der WHO herausgegeben wird. Weitere Codes, wie auch die deutsche Bezeichnung der Codes, entsprechen dem GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WidO), AOK Bundesverband GbR, Deutschland, welcher auf den WHO ATC basiert. Zusätzlich kommen ergänzende Codes aus dem Arzneimittelverzeichnis der AGES zum Einsatz.
      Control0..1
      TypeCodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      26. Medication.ingredient.item[x]:itemReference
      Slice NameitemReference
      ShortReferenz auf Ressourcen Substance im Fall von magistraler Anwendung
      Control0..1
      TypeReference(ELGA e-Med Substanz)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      28. Medication.ingredient.item[x]:itemReference.reference
      Invariantscontained-sub: Substance must be contained (reference.startsWith('#'))
      30. Medication.ingredient.isActive
      ShortAktive Wirkstoff TRUE/FALSE
      Must Supporttrue
      32. Medication.ingredient.strength
      ShortMenge der vorhandenen Zutat
      Must Supporttrue
      34. Medication.batch
      ShortInformationen zur Charge des Arzneimittels. Keine Verwenund im Kontext Planeintrag.
      Control0..0

      Guidance on how to interpret the contents of this table can be foundhere

      0. Medication
      Definition

      This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

      ShortDefinition of a Medication
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Medication.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Medication.meta
      Definition

      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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Medication.implicitRules
      Definition

      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.

      ShortA set of rules under which this content was created
      Comments

      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.

      Control0..1
      Typeuri
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Medication.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Medication.text
      Definition

      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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortTODO: Freitext für magistrale Anwendungen oder Abbildung in Substance.description?
      Comments

      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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Medication.contained
      Definition

      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.

      ShortContained, inline Resources
      Comments

      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.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Medication.extension
      Definition

      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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. Medication.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      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.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Medication.identifier
      Definition

      Business identifier for this medication.

      ShortEindeutiger Identifikator für das Arzneimittel. Wird nicht benötigt, da PZN, sofern vorhanden, im Code angegeben wird.
      Comments

      The serial number could be included as an identifier.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Medication.code
      Definition

      A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.

      ShortCode des Arzneimittels. Hier muss die Pharmazentralnummer (PZN) aus der ASP-Liste angegeben werden, sofern vorhanden. TODO: Slicing für meherere Codings Gem. CDA V3: Das Codesystem Pharmazentralnummer {1.2.40.0.34.4.16} wird am Terminologieserver in der ASP-Liste (Liste der humanen Arzneispezialitäten gelistet nach PZN) publiziert, die ASP-Liste enthält neben der Pharmazentralnummer {1.2.40.0.34.4.17} auch die korrespondierende Zulassungsnummer und Package Reference Number der AGES {1.2.40.0.34.4.26}. Für die Kompatibilität zum EU Kontext wird zukünftig auch die PCID der EMA {1.2.40.0.34.4.27} ermöglicht.
      Comments

      Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

      Control0..1
      BindingThe codes SHALL be taken from https://termgit.elga.gv.at/CodeSystem/asp-liste
      (required to https://termgit.elga.gv.at/CodeSystem/asp-liste)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Medication.code.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      24. Medication.code.extension
      Definition

      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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Medication.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 26. Medication.code.coding
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Medication.code.coding.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        30. Medication.code.coding.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Medication.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 32. Medication.code.coding.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

          Control0..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be unambiguous about the source of the definition of the symbol.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Medication.code.coding.version
          Definition

          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

          ShortVersion of the system - if relevant
          Comments

          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

          NoteThis is a business version Id, not a resource version Id (see discussion)
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Medication.code.coding.code
          Definition

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          ShortSymbol in syntax defined by the system
          Control0..1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to refer to a particular code in the system.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Medication.code.coding.display
          Definition

          A representation of the meaning of the code in the system, following the rules of the system.

          ShortJuristisch zu prüfen, ob mindestens ein Displayname (Handelsname) zur PZN angegeben werden muss (Zwecks Prüfung auf Übereinstimmung und historischer Verfügbarkeit, im Falle von sich ändernden PZNs; evtl. könnte die Fachanwendung.
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Medication.code.coding.userSelected
          Definition

          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

          ShortIf this coding was chosen directly by the user
          Comments

          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

          Control0..1
          Typeboolean
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Medication.code.text
          Definition

          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

          ShortPlain text representation of the concept
          Comments

          Very often the text is the same as a displayName of one of the codings.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Medication.status
          Definition

          A code to indicate if the medication is in active use.

          ShortVerfügbarkeitsstatus des Arzneimittels:(req) active | inactive | entered-in-error. https://hl7.org/fhir/R4/valueset-medication-status.html. Keine Verwendung im Kontext Planeintrag.
          Comments

          This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

          Control0..0
          BindingThe codes SHALL be taken from Medication Status Codes
          (required to http://hl7.org/fhir/ValueSet/medication-status|4.0.1)

          A coded concept defining if the medication is in active use.

          Typecode
          Is Modifiertrue because This element changes the interpretation of all descriptive attributes.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Medication.manufacturer
          Definition

          Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.

          ShortDer Hersteller des Arzneimittels. Keine Verwendung im Kontext Planeintrag. TODO: Prüfen, ob im Kontext durchgeführte Abgabe und magistraler Zubereitung erforderlich; HL7ATCoreOrganization schränkt auf Organisationen gemäß GDA-Index ein.
          Control0..0
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Medication.form
          Definition

          Describes the form of the item. Powder; tablets; capsule.

          ShortDie Darreichungsform des Arzneimittels. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung. Gem. CDA V3: Für die e-Medikation ist das CodeSystem ​Medikation_Darreichungsform 1.2.40.0.10.1.4.3.4.3.5 zu verwenden. Für den eHDSI Kontext ist das CodeSystem 0.4.0.127.0.16.1.1.2.1 zu verwenden.
          Comments

          When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

          Control0..1
          BindingThe codes SHALL be taken from https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart.html
          (required to https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart.html)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Medication.amount
          Definition

          Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).

          ShortDie Gesamtmenge des Arzneimittels in der Verpackung. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung.
          Control0..1
          TypeRatio
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Medication.ingredient
          Definition

          Identifies a particular constituent of interest in the product.

          ShortWirkstoffe. Wenn PZN vorhanden 0..0, da Anreicherung aus ASP-Liste durch Fachanwendung. Gemäß AG: Einschränkung auf CodeableConcept, TODO: prüfen, wie Freitext bei magistraler Zubereitung abgebildet wird: Evtl. in einer Substance-Ressource in der description (string).
          Comments

          The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Medication.ingredient.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          56. Medication.ingredient.extension
          Definition

          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.

          ShortAdditional content defined by implementations
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          58. Medication.ingredient.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          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.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          60. Medication.ingredient.item[x]
          Definition

          The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

          ShortThe actual ingredient or content
          Control1..1
          TypeChoice of: CodeableConcept, Reference(ELGA e-Med Substanz)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Requirements

          The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Medication.ingredient.item[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 62. Medication.ingredient.item[x]:itemCodeableConcept
            Slice NameitemCodeableConcept
            Definition

            The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

            ShortInhaltsstoff codiert. TODO: prüfen, Einschränkung auf SPOR (EMA). Gemüß CDA v3: Wirkstoff-Codes stammen aus der ATC-Klassifikation (Anatomical Therapeutic Chemical Classification), die von der WHO herausgegeben wird. Weitere Codes, wie auch die deutsche Bezeichnung der Codes, entsprechen dem GKV-Arzneimittelindex im Wissenschaftlichen Institut der AOK (WidO), AOK Bundesverband GbR, Deutschland, welcher auf den WHO ATC basiert. Zusätzlich kommen ergänzende Codes aus dem Arzneimittelverzeichnis der AGES zum Einsatz.
            Control0..1
            TypeCodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. Medication.ingredient.item[x]:itemReference
            Slice NameitemReference
            Definition

            The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

            ShortReferenz auf Ressourcen Substance im Fall von magistraler Anwendung
            Control0..1
            TypeReference(ELGA e-Med Substanz)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. Medication.ingredient.item[x]:itemReference.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            68. Medication.ingredient.item[x]:itemReference.extension
            Definition

            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.

            ShortAdditional content defined by implementations
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Medication.ingredient.item[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 70. Medication.ingredient.item[x]:itemReference.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control0..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              contained-sub: Substance must be contained (reference.startsWith('#'))
              72. Medication.ingredient.item[x]:itemReference.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

              Aa resource (or, for logical models, the URI of the logical model).

              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. Medication.ingredient.item[x]:itemReference.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Medication.ingredient.item[x]:itemReference.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Medication.ingredient.isActive
              Definition

              Indication of whether this ingredient affects the therapeutic action of the drug.

              ShortAktive Wirkstoff TRUE/FALSE
              Control0..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summaryfalse
              Requirements

              True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Medication.ingredient.strength
              Definition

              Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.

              ShortMenge der vorhandenen Zutat
              Control0..1
              TypeRatio
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. Medication.batch
              Definition

              Information that only applies to packages (not products).

              ShortInformationen zur Charge des Arzneimittels. Keine Verwenund im Kontext Planeintrag.
              Control0..0
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))