HL7 Czech Hospital Discharge Report Implementation Guide
0.0.2 - ci-build Czechia flag

HL7 Czech Hospital Discharge Report Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/hdr/ and changes regularly. See the Directory of published versions

Data Type Profile: CZ_DosageHospitalStayObligationsHdr - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the cz-dosage-hospitalstay-obl-hdr data type profile.

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

0. Dosage
Definition

Indicates how the medication is/was taken or should be taken by the patient.

ShortHow the medication is/was taken or should be taken
Control0..*
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
2. Dosage.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

How drug should enter body.

ShortHow drug should enter body
Control0..1
BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

TypeCodeableConcept
Is Modifierfalse
Obligations
    ObligationsActor
    SHOULD:populate-if-knownHdrCreator-L2
    SHOULD:displayHdrConsumer-L2
    SHOULD:populate-if-knownHdrCreator-L3
    SHOULD:displayHdrConsumer-L3
    Summarytrue
    Requirements

    A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

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

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

    0. Dosage
    2. Dosage.timing
    4. Dosage.timing.repeat
    6. Dosage.timing.repeat.duration
    Obligations
      ObligationsActor
      SHALL:able-to-populateHdrCreator-L2
      SHALL:displayHdrConsumer-L2
      SHALL:able-to-populateHdrCreator-L3
      SHALL:displayHdrConsumer-L3
      8. Dosage.route
      Obligations
        ObligationsActor
        SHOULD:populate-if-knownHdrCreator-L2
        SHOULD:displayHdrConsumer-L2
        SHOULD:populate-if-knownHdrCreator-L3
        SHOULD:displayHdrConsumer-L3

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

        0. Dosage
        Definition

        Indicates how the medication is/was taken or should be taken by the patient.

        ShortHow the medication is/was taken or should be taken
        Control0..*
        Is Modifierfalse
        Invariantsele-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.

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

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          Indicates the order in which the dosage instructions should be applied or interpreted.

          ShortThe order of the dosage instructions
          Control0..1
          Typeinteger
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          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.

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

          Free text dosage instructions e.g. SIG.

          ShortFree text dosage instructions e.g. SIG
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          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.

          Invariantsele-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").

          ShortSupplemental 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.

          Control0..*
          BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
          (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

          A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          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.

          Invariantsele-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.

          ShortPatient or consumer oriented instructions
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Dosage.timing
          Definition

          When medication should be administered.

          ShortWhen 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.

          Control0..1
          TypeTiming
          Is Modifierfalse
          Summarytrue
          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.

          Invariantsele-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.

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

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            Identifies specific times when the event occurs.

            ShortWhen the event occurs
            Control0..*
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

            Invariantsele-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.

            ShortWhen the event is to occur
            Control0..1
            TypeElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Many timing schedules are determined by regular repetitions.

            Invariantsele-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.

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

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

              ShortLength/Range of lengths, or (Start and/or end) limits
              Control0..1
              TypeChoice of: Duration, Range, Period
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. 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.

              ShortNumber 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.

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

              Repetitions may be limited by end time or total occurrences.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. Dosage.timing.repeat.countMax
              Definition

              If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

              ShortMaximum number of times to repeat
              Control0..1
              TypepositiveInt
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. 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.

              ShortHow 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).

              Control0..1
              Typedecimal
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Obligations
                ObligationsActor
                SHALL:able-to-populateHdrCreator-L2
                SHALL:displayHdrConsumer-L2
                SHALL:able-to-populateHdrCreator-L3
                SHALL:displayHdrConsumer-L3
                Summarytrue
                Requirements

                Some activities are not instantaneous and need to be maintained for a period of time.

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

                ShortHow 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).

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

                Some activities are not instantaneous and need to be maintained for a period of time.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. Dosage.timing.repeat.durationUnit
                Definition

                The units of time for the duration, in UCUM units.

                Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                Control0..1
                BindingThe 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).

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. 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.

                ShortEvent occurs frequency times per period
                Control0..1
                TypepositiveInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. 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.

                ShortEvent occurs up to frequencyMax times per period
                Control0..1
                TypepositiveInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                48. 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.

                ShortEvent occurs frequency times per period
                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. 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.

                ShortUpper limit of period (3-4 hours)
                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. Dosage.timing.repeat.periodUnit
                Definition

                The units of time for the period in UCUM units.

                Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                Control0..1
                BindingThe 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).

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. Dosage.timing.repeat.dayOfWeek
                Definition

                If one or more days of week is provided, then the action happens only on the specified day(s).

                Shortmon | 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.

                Control0..*
                BindingThe codes SHALL be taken from DaysOfWeek
                (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. Dosage.timing.repeat.timeOfDay
                Definition

                Specified time of day for action to take place.

                ShortTime 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.

                Control0..*
                Typetime
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. 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.

                ShortCode for time period of occurrence
                Comments

                When more than one event is listed, the event is tied to the union of the specified events.

                Control0..*
                BindingThe 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.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Timings are frequently determined by occurrences such as waking, eating and sleep.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. 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.

                ShortMinutes from event (before or after)
                Control0..1
                TypeunsignedInt
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. Dosage.timing.code
                Definition

                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).

                ShortBID | 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).

                Control0..1
                BindingThe codes SHOULD be taken from TimingAbbreviation
                (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1)

                Code for a known / defined timing pattern.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. 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).

                ShortTake "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".

                Control0..1
                BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

                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.

                TypeChoice of: boolean, CodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. Dosage.site
                Definition

                Body site to administer to.

                ShortBody 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.

                Control0..1
                BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

                A coded concept describing the site location the medicine enters into or onto the body.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                A coded specification of the anatomic site where the medication first enters the body.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. Dosage.route
                Definition

                How drug should enter body.

                ShortHow drug should enter body
                Control0..1
                BindingFor example codes, see SNOMEDCTRouteCodes
                (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                TypeCodeableConcept
                Is Modifierfalse
                Obligations
                  ObligationsActor
                  SHOULD:populate-if-knownHdrCreator-L2
                  SHOULD:displayHdrConsumer-L2
                  SHOULD:populate-if-knownHdrCreator-L3
                  SHOULD:displayHdrConsumer-L3
                  Summarytrue
                  Requirements

                  A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  70. Dosage.method
                  Definition

                  Technique for administering medication.

                  ShortTechnique for administering medication
                  Comments

                  Terminologies used often pre-coordinate this term with the route and or form of administration.

                  Control0..1
                  BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                  (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

                  A coded concept describing the technique by which the medicine is administered.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. Dosage.doseAndRate
                  Definition

                  The amount of medication administered.

                  ShortAmount of medication administered
                  Control0..*
                  TypeElement
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. 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.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  76. 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.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                    The kind of dose or rate specified, for example, ordered or calculated.

                    ShortThe kind of dose or rate specified
                    Control0..1
                    BindingFor example codes, see DoseAndRateType
                    (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                    The kind of dose or rate specified.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    If the type is not populated, assume to be "ordered".

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. Dosage.doseAndRate.dose[x]
                    Definition

                    Amount of medication per dose.

                    ShortAmount 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.

                    Control0..1
                    TypeChoice of: Range, Quantity(SimpleQuantity)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    The amount of therapeutic or other substance given at one administration event.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    82. Dosage.doseAndRate.rate[x]
                    Definition

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

                    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.

                    Control0..1
                    TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. Dosage.maxDosePerPeriod
                    Definition

                    Upper limit on medication per unit of time.

                    ShortUpper 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".

                    Control0..1
                    TypeRatio
                    Is Modifierfalse
                    Summarytrue
                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. Dosage.maxDosePerAdministration
                    Definition

                    Upper limit on medication per administration.

                    ShortUpper 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.

                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. Dosage.maxDosePerLifetime
                    Definition

                    Upper limit on medication per lifetime of the patient.

                    ShortUpper limit on medication per lifetime of the patient
                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

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