US Quality Core Implementation Guide
0.1.0 - cibuild

US Quality Core Implementation Guide, published by ASTP. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## Resource Profile: US Quality Core MedicationAdministration Not Done

Official URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone | Version: 0.1.0
Active as of 2026-03-31 | Computable Name: USQualityCoreMedicationAdministrationNotDone

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

Usage

See the patterns page for implementation and usage patterns.

### Examples

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

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

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

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

USCDI+ Quality Elements:

- status: (USCDI+ Quality) in-progress \| not-done \| on-hold \| completed \| entered-in-error \| stopped \| unknown
- statusReason: (USCDI+ Quality) Reason administration not performed
- medication[x].extension:notDoneValueSet: (USCDI+ Quality) Url of a value set of activities not requested or performed

Usages:

- Examples for this Profile: MedicationAdministration/negation-example and MedicationAdministration/negation-with-code-example
- CapabilityStatements using this Profile: US Quality Core Client CapabilityStatement and US Quality Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | MedicationAdministration | Administration of medication to a patient Constraints: mna-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:recorded |  | 1..1 | dateTime | Extension URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..* | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
medication[x] | Σ C | 1..1 | CodeableConcept | What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of activities not requested or performed URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] | Σ | 1..1 |  | Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage | C | 0..1 | BackboneElement | Details of how medication was taken Constraints: mad-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
route |  | 0..1 | CodeableConcept | Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
dose |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | USQualityCore Negation Reason Codes | 📦0.1.0 | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.11
MedicationAdministration.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`
mna-1 | error | MedicationAdministration | To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided | `medication.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()`

This structure is derived from MedicationAdministration

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | MedicationAdministration | Administration of medication to a patient Constraints: mna-1
implicitRules |  | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:recorded |  | 1..1 | dateTime | Extension URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
status |  | 1..1 | code | (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Fixed Value: not-done
statusReason |  | 1..* | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
medication[x] | C | 1..1 | CodeableConcept | What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of activities not requested or performed URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject |  | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] |  | 1..1 | dateTime, Period | Start and end time of administration
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage |  | 0..1 | BackboneElement | Details of how medication was taken
route |  | 0..1 | CodeableConcept | Path of substance into body
dose |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication per dose
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​statusReason | Base | extensible | USQualityCore Negation Reason Codes | 📦0.1.0 | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.11

#### Constraints

Id | Grade | Path(s) | Description | Expression
mna-1 | error | MedicationAdministration | To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided | `medication.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | MedicationAdministration | Administration of medication to a patient Constraints: mna-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:recorded |  | 1..1 | dateTime | Extension URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External identifier
instantiates | Σ | 0..* | uri | Instantiates protocol or definition
partOf | Σ | 0..* | Reference(MedicationAdministration | Procedure) | Part of referenced event
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..* | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
category |  | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
medication[x] | Σ C | 1..1 | CodeableConcept | What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of activities not requested or performed URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
supportingInformation |  | 0..* | Reference(Resource) | Additional information to support administration
effective[x] | Σ | 1..1 |  | Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | Σ | 0..* | BackboneElement | Who performed the medication administration and what they did
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | Who performed the medication administration
reasonCode |  | 0..* | CodeableConcept | Reason administration performed Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication was administered
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
device |  | 0..* | Reference(Device) | Device used to administer
note |  | 0..* | Annotation | Information about the administration
dosage | C | 0..1 | BackboneElement | Details of how medication was taken Constraints: mad-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text |  | 0..1 | string | Free text dosage instructions e.g. SIG
site |  | 0..1 | CodeableConcept | Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route |  | 0..1 | CodeableConcept | Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method |  | 0..1 | CodeableConcept | How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dose |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication per dose
rate[x] |  | 0..1 |  | Dose quantity per unit of time
rateRatio |  |  | Ratio |
rateQuantity |  |  | Quantity(SimpleQuantity) |
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | USQualityCore Negation Reason Codes | 📦0.1.0 | This IG
MedicationAdministration.​category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.11
MedicationAdministration.​performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`
mna-1 | error | MedicationAdministration | To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided | `medication.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()`

This structure is derived from MedicationAdministration

Summary

Mandatory: 2 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Encounter (http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter)
- US Quality Core MedicationRequest (http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
- http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | MedicationAdministration | Administration of medication to a patient Constraints: mna-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:recorded |  | 1..1 | dateTime | Extension URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..* | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
medication[x] | Σ C | 1..1 | CodeableConcept | What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of activities not requested or performed URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] | Σ | 1..1 |  | Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage | C | 0..1 | BackboneElement | Details of how medication was taken Constraints: mad-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
route |  | 0..1 | CodeableConcept | Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
dose |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | USQualityCore Negation Reason Codes | 📦0.1.0 | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.11
MedicationAdministration.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`
mna-1 | error | MedicationAdministration | To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided | `medication.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()`

Differential View

This structure is derived from MedicationAdministration

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | MedicationAdministration | Administration of medication to a patient Constraints: mna-1
implicitRules |  | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:recorded |  | 1..1 | dateTime | Extension URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
status |  | 1..1 | code | (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Fixed Value: not-done
statusReason |  | 1..* | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
medication[x] | C | 1..1 | CodeableConcept | What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of activities not requested or performed URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject |  | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] |  | 1..1 | dateTime, Period | Start and end time of administration
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage |  | 0..1 | BackboneElement | Details of how medication was taken
route |  | 0..1 | CodeableConcept | Path of substance into body
dose |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication per dose
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​statusReason | Base | extensible | USQualityCore Negation Reason Codes | 📦0.1.0 | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.11

#### Constraints

Id | Grade | Path(s) | Description | Expression
mna-1 | error | MedicationAdministration | To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided | `medication.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration | C | 0..* | MedicationAdministration | Administration of medication to a patient Constraints: mna-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:recorded |  | 1..1 | dateTime | Extension URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External identifier
instantiates | Σ | 0..* | uri | Instantiates protocol or definition
partOf | Σ | 0..* | Reference(MedicationAdministration | Procedure) | Part of referenced event
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done
statusReason |  | 1..* | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
category |  | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
medication[x] | Σ C | 1..1 | CodeableConcept | What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of activities not requested or performed URL: http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
supportingInformation |  | 0..* | Reference(Resource) | Additional information to support administration
effective[x] | Σ | 1..1 |  | Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | Σ | 0..* | BackboneElement | Who performed the medication administration and what they did
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | Who performed the medication administration
reasonCode |  | 0..* | CodeableConcept | Reason administration performed Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication was administered
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
device |  | 0..* | Reference(Device) | Device used to administer
note |  | 0..* | Annotation | Information about the administration
dosage | C | 0..1 | BackboneElement | Details of how medication was taken Constraints: mad-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text |  | 0..1 | string | Free text dosage instructions e.g. SIG
site |  | 0..1 | CodeableConcept | Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route |  | 0..1 | CodeableConcept | Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method |  | 0..1 | CodeableConcept | How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dose |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication per dose
rate[x] |  | 0..1 |  | Dose quantity per unit of time
rateRatio |  |  | Ratio |
rateQuantity |  |  | Quantity(SimpleQuantity) |
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationAdministration.​status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​statusReason | Base | extensible | USQualityCore Negation Reason Codes | 📦0.1.0 | This IG
MedicationAdministration.​category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.11
MedicationAdministration.​performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`
mna-1 | error | MedicationAdministration | To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided | `medication.extension('http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()`

This structure is derived from MedicationAdministration

Summary

Mandatory: 2 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Encounter (http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter)
- US Quality Core MedicationRequest (http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationrequest)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-recorded
- http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Other representations of profile: CSV, Excel, Schematron