CH EMED EPR
2.0.0-ci-build - ci-build
CH EMED EPR, published by CARA. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CARA-ch/ch-emed-epr/ and changes regularly. See the Directory of published versions
Draft as of 2024-12-20 |
Definitions for the ch-emed-epr-dosage-split data type profile.
Guidance on how to interpret the contents of this table can be found here
0. Dosage | |
2. Dosage.extension | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Standard Status | Draft (from Draft) |
4. Dosage.modifierExtension | |
Comments | ...All modifiers SHALL be documented in the profile, in order to be usable. |
Control | 0..0 |
6. Dosage.text | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Standard Status | Draft (from Draft) |
8. Dosage.timing | |
10. Dosage.timing.modifierExtension | |
Comments | ...All modifiers SHALL be documented in the profile, in order to be usable. |
Control | 0..0 |
12. Dosage.timing.event | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Standard Status | Draft (from Draft) |
14. Dosage.timing.repeat | |
16. Dosage.timing.repeat.bounds[x] | |
Control | 0..0 |
18. Dosage.timing.repeat.when | |
Short | ... It shall only contain values from Event Timings |
Invariants | only-standard-event-timings: The timing event shall only be 'MORN', 'NOON', 'EVE' or 'NIGHT'. ($this = 'MORN' or $this = 'NOON' or $this = 'EVE' or $this = 'NIGHT' ) |
20. Dosage.timing.code | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Standard Status | Draft (from Draft) |
22. Dosage.doseAndRate | |
24. Dosage.doseAndRate.type | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Standard Status | Draft (from Draft) |
26. Dosage.doseAndRate.dose[x] | |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Slicing | This element introduces a set of slices on Dosage.doseAndRate.dose[x] . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
28. Dosage.doseAndRate.dose[x]:doseQuantity | |
Slice Name | doseQuantity |
Control | 0..1 |
Type | Quantity(Amount Quantity) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
30. Dosage.doseAndRate.dose[x]:doseRange | |
Slice Name | doseRange |
Control | 0..1 |
Type | Range(Amount Range) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
32. Dosage.doseAndRate.rate[x] | |
Type | Ratio(Ratio (Amount / Time)), Quantity(SimpleQuantity), Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Guidance on how to interpret the contents of this table can be found here
0. Dosage | |
Definition | Indicates how the medication is/was taken or should be taken by the patient. |
Short | CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)How the medication is/was taken or should be taken |
Control | 0..* |
Is Modifier | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
2. Dosage.extension | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. 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. |
Short | ✕ This element is not supportedAdditional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Standard Status | Draft (from Trial Use) |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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()) |
Slicing | This element introduces a set of slices on Dosage.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
4. Dosage.modifierExtension | |
Definition | An Extension 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). |
Short | ExtensionExtensions that cannot be ignored even if unrecognized |
Comments | All modifiers SHALL be documented in the profile, in order to be usable. 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. |
Control | 0..0* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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()) |
6. Dosage.sequence | |
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
Short | The order of the dosage instructions |
Control | 10..1 |
Type | integer |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ch-dosage-2: The sequence number must be greater than 1 ( $this > 1 ) |
8. Dosage.text | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. Free text dosage instructions e.g. SIG. |
Short | ✕ This element is not supportedFree text dosage instructions e.g. SIG |
Control | 0..01 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Standard Status | Draft (from Trial Use) |
Summary | true |
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
10. Dosage.additionalInstruction | |
Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). |
Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" |
Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. |
Control | 0..0* |
Binding | For example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes )A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
12. Dosage.patientInstruction | |
Definition | Instructions in terms that are understood by the patient or consumer. |
Short | Patient or consumer oriented instructions |
Control | 0..01 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. Dosage.timing | |
Definition | When medication should be administered. |
Short | When medication should be administered |
Comments | This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. |
Control | 10..1 |
Type | Timing |
Is Modifier | false |
Summary | true |
Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
16. Dosage.timing.modifierExtension | |
Definition | An Extension 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). |
Short | ExtensionExtensions that cannot be ignored even if unrecognized |
Comments | All modifiers SHALL be documented in the profile, in order to be usable. 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. |
Control | 0..0* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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. Dosage.timing.event | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. Identifies specific times when the event occurs. |
Short | ✕ This element is not supportedWhen the event occurs |
Control | 0..* |
Type | dateTime |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Standard Status | Draft (from Trial Use) |
Summary | true |
Requirements | In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
20. Dosage.timing.repeat | |
Definition | A set of rules that describe when the event is scheduled. |
Short | When the event is to occur |
Control | 10..1 |
Type | Element |
Is Modifier | false |
Summary | true |
Requirements | Many timing schedules are determined by regular repetitions. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) tim-1: if there's a duration, there needs to be duration units ( duration.empty() or durationUnit.exists() )tim-2: if there's a period, there needs to be period units ( period.empty() or periodUnit.exists() )tim-4: duration SHALL be a non-negative value ( duration.exists() implies duration >= 0 )tim-5: period SHALL be a non-negative value ( period.exists() implies period >= 0 )tim-6: If there's a periodMax, there must be a period ( periodMax.empty() or period.exists() )tim-7: If there's a durationMax, there must be a duration ( durationMax.empty() or duration.exists() )tim-8: If there's a countMax, there must be a count ( countMax.empty() or count.exists() )tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) ( offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) )tim-10: If there's a timeOfDay, there cannot be a when, or vice versa ( timeOfDay.empty() or when.empty() )tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists()) tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists()) tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0) tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0) tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists()) tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists()) tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists()) tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty()) |
22. Dosage.timing.repeat.bounds[x] | |
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. |
Short | Length/Range of lengths, or (Start and/or end) limits |
Control | 0..01 |
Type | Choice of: Duration, Range, Period |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Dosage.timing.repeat.bounds[x] . The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
24. Dosage.timing.repeat.bounds[x]:boundsPeriod | |
Slice Name | boundsPeriod |
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. |
Short | Length/Range of lengths, or (Start and/or end) limits |
Control | 0..01 |
Type | Period, Duration, Range |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
26. Dosage.timing.repeat.when | |
Definition | An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. |
Short | ... It shall only contain values from Event TimingsCode for time period of occurrence |
Comments | When more than one event is listed, the event is tied to the union of the specified events. |
Control | 10..* |
Binding | The codes SHALL be taken from EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1 (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1 )Real world event relating to the schedule. |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Requirements | Timings are frequently determined by occurrences such as waking, eating and sleep. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ch-emed-event-timing: For the representation of the time of administration according to the 1-1-1-1 scheme, the values MORN-NOON-EVE-NIGHT are highly recommended. ( $this='MORN' or $this='NOON' or $this='EVE' or $this='NIGHT' )only-standard-event-timings: The timing event shall only be 'MORN', 'NOON', 'EVE' or 'NIGHT'. ( $this = 'MORN' or $this = 'NOON' or $this = 'EVE' or $this = 'NIGHT' ) |
28. Dosage.timing.code | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). |
Short | ✕ This element is not supportedBID | TID | QID | AM | PM | QD | QOD | + |
Comments | BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). |
Control | 0..1 |
Binding | The codes SHOULD be taken from TimingAbbreviationhttp://hl7.org/fhir/ValueSet/timing-abbreviation (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation )Code for a known / defined timing pattern. |
Type | CodeableConcept |
Is Modifier | false |
Standard Status | Draft (from Trial Use) |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
30. Dosage.asNeeded[x] | |
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). |
Short | Take "as needed" (for x) |
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". |
Control | 0..01 |
Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason )A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
Type | Choice of: boolean, CodeableConcept |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
32. Dosage.site | |
Definition | Body site to administer to. |
Short | Body site to administer to |
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. |
Control | 0..01 |
Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes (example to http://hl7.org/fhir/ValueSet/approach-site-codes )A coded concept describing the site location the medicine enters into or onto the body. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | A coded specification of the anatomic site where the medication first enters the body. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
34. Dosage.route | |
Definition | How drug should enter body. |
Short | How drug should enter body |
Control | 0..01 |
Binding | The codes SHOULD be taken from For example codes, see EDQM - RouteOfAdministrationhttp://hl7.org/fhir/ValueSet/route-codes (preferred to http://fhir.ch/ig/ch-term/ValueSet/edqm-routeofadministration ) |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
36. Dosage.method | |
Definition | Technique for administering medication. |
Short | Technique for administering medication |
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. |
Control | 0..01 |
Binding | The codes SHOULD be taken from For example codes, see EDQM - Administration Methodhttp://hl7.org/fhir/ValueSet/administration-method-codes (preferred to http://fhir.ch/ig/ch-term/ValueSet/edqm-administrationmethod ) |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
38. Dosage.doseAndRate | |
Definition | The amount of medication administered. |
Short | Amount of medication administered |
Control | 10..1* |
Type | Element |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
40. Dosage.doseAndRate.type | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. The kind of dose or rate specified, for example, ordered or calculated. |
Short | ✕ This element is not supportedThe kind of dose or rate specified |
Control | 0..1 |
Binding | For example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type (example to http://hl7.org/fhir/ValueSet/dose-rate-type )The kind of dose or rate specified. |
Type | CodeableConcept |
Is Modifier | false |
Standard Status | Draft (from Trial Use) |
Summary | true |
Requirements | If the type is not populated, assume to be "ordered". |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
42. Dosage.doseAndRate.dose[x] | |
Definition | Amount of medication per dose. |
Short | Amount of medication per dose |
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
Control | 10..1 |
Type | Choice of: Range(CH Core Range with EMED Units), Quantity(CH Core Quantity with EMED Units, SimpleQuantity) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Summary | true |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Dosage.doseAndRate.dose[x] . The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
44. Dosage.doseAndRate.dose[x]:doseQuantity | |
Slice Name | doseQuantity |
Definition | The comparator is not used on a SimpleQuantity Amount of medication per dose. |
Short | A fixed quantity (no comparator)Amount of medication per dose |
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Quantity(Amount Quantity, SimpleQuantity), Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present ( code.empty() or system.exists() )sqty-1: The comparator is not used on a SimpleQuantity ( comparator.empty() ) |
46. Dosage.doseAndRate.dose[x]:doseRange | |
Slice Name | doseRange |
Definition | A set of ordered Quantities defined by a low and high limit. Amount of medication per dose. |
Short | Set of values bounded by low and highAmount of medication per dose |
Comments | The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Range(Amount Range), Quantity(SimpleQuantity) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) rng-2: If present, low SHALL have a lower value than high ( low.empty() or high.empty() or (low <= high) ) |
48. Dosage.doseAndRate.rate[x] | |
Definition | A relationship of two Quantity values - expressed as a numerator and a denominator. Amount of medication per unit of time. |
Short | A ratio of two Quantity values - a numerator and a denominatorAmount of medication per unit of time |
Comments | The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Ratio(Ratio (Amount / Time)), Quantity(SimpleQuantity), Range |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Requirements | 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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ( (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()) ) |
50. Dosage.maxDosePerPeriod | |
Definition | Upper limit on medication per unit of time. |
Short | Upper limit on medication per unit of time |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". |
Control | 0..01 |
Type | Ratio |
Is Modifier | false |
Summary | true |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
52. Dosage.maxDosePerAdministration | |
Definition | Upper limit on medication per administration. |
Short | Upper limit on medication per administration |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. |
Control | 0..01 |
Type | Quantity(SimpleQuantity) |
Is Modifier | false |
Summary | true |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
54. Dosage.maxDosePerLifetime | |
Definition | Upper limit on medication per lifetime of the patient. |
Short | Upper limit on medication per lifetime of the patient |
Control | 0..01 |
Type | Quantity(SimpleQuantity) |
Is Modifier | false |
Summary | true |
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
Invariants | ele-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 found here
0. Dosage | |
Definition | Indicates how the medication is/was taken or should be taken by the patient. |
Short | CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest) |
Control | 0..* |
Is Modifier | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
2. Dosage.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
4. Dosage.extension | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Standard Status | Draft (from Trial Use) |
Summary | false |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on Dosage.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
6. Dosage.modifierExtension | |
Definition | An Extension |
Short | Extension |
Comments | All modifiers SHALL be documented in the profile, in order to be usable. |
Control | 0..0 |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Invariants | ele-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. Dosage.sequence | |
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
Short | The order of the dosage instructions |
Control | 1..1 |
Type | integer |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ch-dosage-2: The sequence number must be greater than 1 ( $this > 1 ) |
10. Dosage.text | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Control | 0..0 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Standard Status | Draft (from Trial Use) |
Summary | true |
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
12. Dosage.additionalInstruction | |
Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). |
Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" |
Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. |
Control | 0..0 |
Binding | For example codes, see SNOMEDCTAdditionalDosageInstructions (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes )A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
14. Dosage.patientInstruction | |
Definition | Instructions in terms that are understood by the patient or consumer. |
Short | Patient or consumer oriented instructions |
Control | 0..0 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
16. Dosage.timing | |
Definition | When medication should be administered. |
Short | When medication should be administered |
Comments | This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. |
Control | 1..1 |
Type | Timing |
Is Modifier | false |
Summary | true |
Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
18. Dosage.timing.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
20. Dosage.timing.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on Dosage.timing.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
22. Dosage.timing.modifierExtension | |
Definition | An Extension |
Short | Extension |
Comments | All modifiers SHALL be documented in the profile, in order to be usable. |
Control | 0..0 |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Invariants | ele-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. Dosage.timing.event | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Control | 0..* |
Type | dateTime |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Standard Status | Draft (from Trial Use) |
Summary | true |
Requirements | In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
26. Dosage.timing.repeat | |
Definition | A set of rules that describe when the event is scheduled. |
Short | When the event is to occur |
Control | 1..1 |
Type | Element |
Is Modifier | false |
Summary | true |
Requirements | Many timing schedules are determined by regular repetitions. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )tim-1: if there's a duration, there needs to be duration units ( duration.empty() or durationUnit.exists() )tim-2: if there's a period, there needs to be period units ( period.empty() or periodUnit.exists() )tim-4: duration SHALL be a non-negative value ( duration.exists() implies duration >= 0 )tim-5: period SHALL be a non-negative value ( period.exists() implies period >= 0 )tim-6: If there's a periodMax, there must be a period ( periodMax.empty() or period.exists() )tim-7: If there's a durationMax, there must be a duration ( durationMax.empty() or duration.exists() )tim-8: If there's a countMax, there must be a count ( countMax.empty() or count.exists() )tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) ( offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) )tim-10: If there's a timeOfDay, there cannot be a when, or vice versa ( timeOfDay.empty() or when.empty() ) |
28. Dosage.timing.repeat.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
30. Dosage.timing.repeat.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on Dosage.timing.repeat.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
32. Dosage.timing.repeat.bounds[x] | |
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. |
Short | Length/Range of lengths, or (Start and/or end) limits |
Control | 0..0 |
Type | Choice of: Duration, Range |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
Slicing | This element introduces a set of slices on Dosage.timing.repeat.bounds[x] . The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
34. Dosage.timing.repeat.bounds[x]:boundsPeriod | |
Slice Name | boundsPeriod |
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. |
Short | Length/Range of lengths, or (Start and/or end) limits |
Control | 0..0 |
Type | Period |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
36. Dosage.timing.repeat.count | |
Definition | A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. |
Short | Number of times to repeat |
Comments | If you have both bounds and count, then this should be understood as within the bounds period, until count times happens. |
Control | 0..1 |
Type | positiveInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Repetitions may be limited by end time or total occurrences. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
38. Dosage.timing.repeat.countMax | |
Definition | If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. |
Short | Maximum number of times to repeat |
Control | 0..1 |
Type | positiveInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
40. Dosage.timing.repeat.duration | |
Definition | How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. |
Short | How long when it happens |
Comments | For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). |
Control | 0..1 |
Type | decimal |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Some activities are not instantaneous and need to be maintained for a period of time. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
42. Dosage.timing.repeat.durationMax | |
Definition | If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. |
Short | How long when it happens (Max) |
Comments | For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). |
Control | 0..1 |
Type | decimal |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Some activities are not instantaneous and need to be maintained for a period of time. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
44. Dosage.timing.repeat.durationUnit | |
Definition | The units of time for the duration, in UCUM units. |
Short | s | min | h | d | wk | mo | a - unit of time (UCUM) |
Control | 0..1 |
Binding | The codes SHALL be taken from UnitsOfTime (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 )A unit of time (units from UCUM). |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
46. Dosage.timing.repeat.frequency | |
Definition | The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. |
Short | Event occurs frequency times per period |
Control | 0..1 |
Type | positiveInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Meaning if Missing | If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
48. Dosage.timing.repeat.frequencyMax | |
Definition | If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. |
Short | Event occurs up to frequencyMax times per period |
Control | 0..1 |
Type | positiveInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
50. Dosage.timing.repeat.period | |
Definition | Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. |
Short | Event occurs frequency times per period |
Control | 0..1 |
Type | decimal |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
52. Dosage.timing.repeat.periodMax | |
Definition | If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. |
Short | Upper limit of period (3-4 hours) |
Control | 0..1 |
Type | decimal |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
54. Dosage.timing.repeat.periodUnit | |
Definition | The units of time for the period in UCUM units. |
Short | s | min | h | d | wk | mo | a - unit of time (UCUM) |
Control | 0..1 |
Binding | The codes SHALL be taken from UnitsOfTime (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 )A unit of time (units from UCUM). |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
56. Dosage.timing.repeat.dayOfWeek | |
Definition | If one or more days of week is provided, then the action happens only on the specified day(s). |
Short | mon | tue | wed | thu | fri | sat | sun |
Comments | If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek. |
Control | 0..* |
Binding | The codes SHALL be taken from DaysOfWeek (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1 ) |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
58. Dosage.timing.repeat.timeOfDay | |
Definition | Specified time of day for action to take place. |
Short | Time of day for action |
Comments | When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay. |
Control | 0..* |
Type | time |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
60. Dosage.timing.repeat.when | |
Definition | An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. |
Short | ... It shall only contain values from Event Timings |
Comments | When more than one event is listed, the event is tied to the union of the specified events. |
Control | 1..* |
Binding | The codes SHALL be taken from EventTiming (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1 )Real world event relating to the schedule. |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Requirements | Timings are frequently determined by occurrences such as waking, eating and sleep. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ch-emed-event-timing: For the representation of the time of administration according to the 1-1-1-1 scheme, the values MORN-NOON-EVE-NIGHT are highly recommended. ( $this='MORN' or $this='NOON' or $this='EVE' or $this='NIGHT' )only-standard-event-timings: The timing event shall only be 'MORN', 'NOON', 'EVE' or 'NIGHT'. ( $this = 'MORN' or $this = 'NOON' or $this = 'EVE' or $this = 'NIGHT' ) |
62. Dosage.timing.repeat.offset | |
Definition | The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. |
Short | Minutes from event (before or after) |
Control | 0..1 |
Type | unsignedInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
64. Dosage.timing.code | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Comments | BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). |
Control | 0..1 |
Binding | The codes SHOULD be taken from TimingAbbreviation (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation )Code for a known / defined timing pattern. |
Type | CodeableConcept |
Is Modifier | false |
Standard Status | Draft (from Trial Use) |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
66. Dosage.asNeeded[x] | |
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). |
Short | Take "as needed" (for x) |
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". |
Control | 0..0 |
Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason )A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
Type | Choice of: boolean, CodeableConcept |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
68. Dosage.site | |
Definition | Body site to administer to. |
Short | Body site to administer to |
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. |
Control | 0..0 |
Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example to http://hl7.org/fhir/ValueSet/approach-site-codes )A coded concept describing the site location the medicine enters into or onto the body. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | A coded specification of the anatomic site where the medication first enters the body. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
70. Dosage.route | |
Definition | How drug should enter body. |
Short | How drug should enter body |
Control | 0..0 |
Binding | The codes SHOULD be taken from EDQM - RouteOfAdministration (preferred to http://fhir.ch/ig/ch-term/ValueSet/edqm-routeofadministration ) |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
72. Dosage.method | |
Definition | Technique for administering medication. |
Short | Technique for administering medication |
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. |
Control | 0..0 |
Binding | The codes SHOULD be taken from EDQM - Administration Method (preferred to http://fhir.ch/ig/ch-term/ValueSet/edqm-administrationmethod ) |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
74. Dosage.doseAndRate | |
Definition | The amount of medication administered. |
Short | Amount of medication administered |
Control | 1..1 |
Type | Element |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
76. Dosage.doseAndRate.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
78. Dosage.doseAndRate.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on Dosage.doseAndRate.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
80. Dosage.doseAndRate.type | |
Definition | Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile. |
Short | ✕ This element is not supported |
Control | 0..1 |
Binding | For example codes, see DoseAndRateType (example to http://hl7.org/fhir/ValueSet/dose-rate-type )The kind of dose or rate specified. |
Type | CodeableConcept |
Is Modifier | false |
Standard Status | Draft (from Trial Use) |
Summary | true |
Requirements | If the type is not populated, assume to be "ordered". |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
82. Dosage.doseAndRate.dose[x] | |
Definition | Amount of medication per dose. |
Short | Amount of medication per dose |
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
Control | 1..1 |
Type | Choice of: Range(CH Core Range with EMED Units), Quantity(CH Core Quantity with EMED Units) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Summary | true |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
Slicing | This element introduces a set of slices on Dosage.doseAndRate.dose[x] . The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
84. Dosage.doseAndRate.dose[x]:doseQuantity | |
Slice Name | doseQuantity |
Definition | The comparator is not used on a SimpleQuantity |
Short | A fixed quantity (no comparator) |
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Quantity(Amount Quantity) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )qty-3: If a code for the unit is present, the system SHALL also be present ( code.empty() or system.exists() )sqty-1: The comparator is not used on a SimpleQuantity ( comparator.empty() ) |
86. Dosage.doseAndRate.dose[x]:doseRange | |
Slice Name | doseRange |
Definition | A set of ordered Quantities defined by a low and high limit. |
Short | Set of values bounded by low and high |
Comments | The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Range(Amount Range) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Must Support | true |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )rng-2: If present, low SHALL have a lower value than high ( low.empty() or high.empty() or (low <= high) ) |
88. Dosage.doseAndRate.rate[x] | |
Definition | A relationship of two Quantity values - expressed as a numerator and a denominator. |
Short | A ratio of two Quantity values - a numerator and a denominator |
Comments | The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Ratio(Ratio (Amount / Time)) |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Requirements | 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. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ( (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()) ) |
90. Dosage.maxDosePerPeriod | |
Definition | Upper limit on medication per unit of time. |
Short | Upper limit on medication per unit of time |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". |
Control | 0..0 |
Type | Ratio |
Is Modifier | false |
Summary | true |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
92. Dosage.maxDosePerAdministration | |
Definition | Upper limit on medication per administration. |
Short | Upper limit on medication per administration |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. |
Control | 0..0 |
Type | Quantity(SimpleQuantity) |
Is Modifier | false |
Summary | true |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
94. Dosage.maxDosePerLifetime | |
Definition | Upper limit on medication per lifetime of the patient. |
Short | Upper limit on medication per lifetime of the patient |
Control | 0..0 |
Type | Quantity(SimpleQuantity) |
Is Modifier | false |
Summary | true |
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |