Profile Comparison between http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity vs http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity

Left:Medication Activity (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity)
Right:Medication Activity (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity)

Messages

ErrorStructureDefinition.versionValues for version differ: '3.0.0' vs '4.0.0-ballot'
InformationStructureDefinition.dateValues for date differ: '2024-05-18T00:16:25-05:00' vs '2024-11-21T20:34:36+00:00'
InformationStructureDefinition.commentValues for comment differ: 'The routeCode, if present, SHOULD contain zero or more [0..*] translation, which SHOULD be selected from ValueSet Medication Route urn:oid:2.16.840.1.113762.1.4.1099.12 DYNAMIC (CONF:1098-32950).' vs 'The routeCode, if present, SHOULD contain zero or more [0..*] translation, which SHALL be selected from ValueSet Medication Route urn:oid:2.16.840.1.113762.1.4.1099.12 DYNAMIC (CONF:1098-32950).'
InformationStructureDefinition.shortValues for short differ: '(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units' vs '𝗨𝗦𝗖𝗗𝗜: Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units'
InformationSubstanceAdministration.doseQuantity.unitExample/preferred bindings differ at SubstanceAdministration.doseQuantity.unit using binding from MedicationActivity
InformationStructureDefinition.shortValues for short differ: '(USCDI) Medications' vs '𝗨𝗦𝗖𝗗𝗜: Medications'

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      .copyright
        .date2024-05-18T00:16:25-05:002024-11-21T20:34:36+00:00
        • Values Differ
        .descriptionA Medication Activity describes substance administrations that have actually occurred (e.g., pills ingested or injections given) or are intended to occur (e.g., "take 2 tablets twice a day for the next 10 days"). Medication activities in "INT" mood are reflections of what a clinician intends a patient to be taking. For example, a clinician may intend that a patient be administered Lisinopril 20 mg PO for blood pressure control. If what was actually administered was Lisinopril 10 mg., then the Medication activities in the "EVN" mood would reflect actual use. A moodCode of INT is allowed, but it is recommended that the Planned Medication Activity template be used for moodCodes other than EVN if the document type contains a section that includes Planned Medication Activity (for example a Care Plan document with Plan of Treatment, Intervention, or Goal sections). At a minimum, a Medication Activity shall include an effectiveTime indicating the duration of the administration (or single-administration timestamp). Ambulatory medication lists generally provide a summary of use for a given medication over time - a medication activity in event mood with the duration reflecting when the medication started and stopped. Ongoing medications will not have a stop date (or will have a stop date with a suitable NULL value). Ambulatory medication lists will generally also have a frequency (e.g., a medication is being taken twice a day). Inpatient medications generally record each administration as a separate act. The dose (doseQuantity) represents how many of the consumables are to be administered at each administration event. As a result, the dose is always relative to the consumable and the interval of administration. Thus, a patient consuming a single "metoprolol 25mg tablet" per administration will have a doseQuantity of "1", whereas a patient consuming "metoprolol Oral Product" (RxCUI 1163523) will have a dose of "25 mg".
          .experimental
            .fhirVersion5.0.0
              .jurisdiction
                ..jurisdiction[0]urn:iso:std:iso:3166#US
                  .kindlogical
                    .nameMedicationActivity
                      .publisherHealth Level Seven
                        .purpose
                          .statusdraft
                            .titleMedication Activity
                              .typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
                                .urlhttp://hl7.org/cda/us/ccda/StructureDefinition/MedicationActivity
                                  .version3.0.04.0.0-ballot
                                  • Values Differ

                                  Structure

                                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.R TypeR Description & ConstraintsCommentsdoco
                                  .. SubstanceAdministration C1..1SubstanceAdministrationBase for all types and resources
                                  Instance of this type are validated by templateId
                                  Logical Container: ClinicalDocument (CDA Class)
                                  should-text-ref-value: SHOULD contain text/reference/@value
                                  1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499).
                                  should-routeCode: SHOULD contain routeCode
                                  dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
                                  should-author: SHOULD contain author
                                  C1..1SubstanceAdministrationBase for all types and resources
                                  Instance of this type are validated by templateId
                                  Logical Container: ClinicalDocument (CDA Class)
                                  should-text-ref-value: SHOULD contain text/reference/@value
                                  1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499).
                                  should-routeCode: SHOULD contain routeCode
                                  dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
                                  should-author: SHOULD contain author
                                    ... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                      ... realmCode 0..*CS0..*CS
                                        ... typeId 0..1II0..1II
                                          .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                            .... assigningAuthorityName 0..1??0..1??
                                              .... displayable 0..1??0..1??
                                                .... root 1..1??, ??, ??Fixed Value: 2.16.840.1.113883.1.31..1??, ??, ??Fixed Value: 2.16.840.1.113883.1.3
                                                  .... st-simple 1..1stringPrimitive Type string
                                                  URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
                                                  1..1stringPrimitive Type string
                                                  URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
                                                    ... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
                                                    1..*IISlice: Unordered, Open by value:root, value:extension
                                                      ... classCode 1..1??Binding: ?? (required)
                                                      Fixed Value: SBADM
                                                      1..1??Binding: ?? (required)
                                                      Fixed Value: SBADM
                                                        ... moodCode 1..1??Binding: ?? (required)1..1??Binding: ?? (required)
                                                          ... id 1..*II1..*II
                                                            ... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set.
                                                            Binding: ?? (example)
                                                            0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set.
                                                            Binding: ?? (example)
                                                              ... negationInd 0..1??0..1??
                                                                ... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
                                                                  .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                    .... compression 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                      .... integrityCheck 0..1??0..1??
                                                                        .... integrityCheckAlgorithm 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                          .... language 0..1??0..1??
                                                                            .... mediaType 0..1??Binding: ?? (example)0..1??Binding: ?? (example)
                                                                              .... representation 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                .... xmlText 0..1??Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.0..1??Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
                                                                                  .... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrativeC0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
                                                                                    .... thumbnail 0..1ED0..1ED
                                                                                      ... statusCode 1..1CSBinding: ?? (required)1..1CSBinding: ?? (required)
                                                                                        .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                          .... code 1..1??The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included.
                                                                                          Binding: ?? (required)
                                                                                          1..1??The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included.
                                                                                          Binding: ?? (required)
                                                                                            .... codeSystem 0..00..0
                                                                                              .... codeSystemName 0..00..0
                                                                                                .... codeSystemVersion 0..00..0
                                                                                                  .... displayName 0..00..0
                                                                                                    .... sdtcValueSet 0..1??XML: valueSet (urn:hl7-org:sdtc)0..1??XML: valueSet (urn:hl7-org:sdtc)
                                                                                                      .... sdtcValueSetVersion 0..1??XML: valueSetVersion (urn:hl7-org:sdtc)0..1??XML: valueSetVersion (urn:hl7-org:sdtc)
                                                                                                        .... originalText 0..00..0
                                                                                                          .... qualifier 0..00..0
                                                                                                            .... translation 0..00..0
                                                                                                              ... Slices for effectiveTime 1..*SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TSSlice: Unordered, Open by type:$this
                                                                                                              1..*SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TSSlice: Unordered, Open by type:$this
                                                                                                                ... priorityCode 0..1CEBinding: ?? (example)0..1CEBinding: ?? (example)
                                                                                                                  ... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
                                                                                                                    ... routeCode C0..1CEBinding: ?? (required)
                                                                                                                    should-translation: SHOULD contain translation
                                                                                                                    C0..1CE𝗨𝗦𝗖𝗗𝗜: Route Code - SPL
                                                                                                                    Binding: ?? (required)
                                                                                                                    should-translation: SHOULD contain translation
                                                                                                                      .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                        .... code 0..1??0..1??
                                                                                                                          .... codeSystem 0..1??, ??, ??0..1??, ??, ??
                                                                                                                            .... codeSystemName 0..1??0..1??
                                                                                                                              .... codeSystemVersion 0..1??0..1??
                                                                                                                                .... displayName 0..1??0..1??
                                                                                                                                  .... sdtcValueSet 0..1??XML: valueSet (urn:hl7-org:sdtc)0..1??XML: valueSet (urn:hl7-org:sdtc)
                                                                                                                                    .... sdtcValueSetVersion 0..1??XML: valueSetVersion (urn:hl7-org:sdtc)0..1??XML: valueSetVersion (urn:hl7-org:sdtc)
                                                                                                                                      .... originalText 0..1ED0..1ED
                                                                                                                                        .... qualifier 0..00..0
                                                                                                                                          .... translation 0..*CDBinding: ?? (preferred)
                                                                                                                                          0..*CD𝗨𝗦𝗖𝗗𝗜: Route Code - SNOMED
                                                                                                                                          Binding: ?? (required)
                                                                                                                                            ... approachSiteCode 0..1CDBinding: ?? (required)
                                                                                                                                            0..1CDBinding: ?? (required)
                                                                                                                                              ... doseQuantity C1..1IVL_PQIf the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878).
                                                                                                                                              should-unit: SHOULD contain @unit
                                                                                                                                              C1..1IVL_PQIf the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878).
                                                                                                                                              should-unit: SHOULD contain @unit
                                                                                                                                                .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                  .... unit 0..1??(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
                                                                                                                                                  Binding: ?? (preferred)
                                                                                                                                                  0..1??𝗨𝗦𝗖𝗗𝗜: Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
                                                                                                                                                  Binding: ?? (preferred)
                                                                                                                                                  • Example/preferred bindings differ at SubstanceAdministration.doseQuantity.unit using binding from MedicationActivity
                                                                                                                                                  .... value 0..1??0..1??
                                                                                                                                                    .... translation 0..*PQR0..*PQR
                                                                                                                                                      .... operator 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                        .... low 0..1IVXB_PQ0..1IVXB_PQ
                                                                                                                                                          .... center 0..1PQ0..1PQ
                                                                                                                                                            .... width 0..1PQ0..1PQ
                                                                                                                                                              .... high 0..1IVXB_PQ0..1IVXB_PQ
                                                                                                                                                                ... rateQuantity 0..1IVL_PQ0..1IVL_PQ
                                                                                                                                                                  .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                                    .... unit 1..1??NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
                                                                                                                                                                    Binding: ?? (required)
                                                                                                                                                                    1..1??NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
                                                                                                                                                                    Binding: ?? (required)
                                                                                                                                                                      .... value 0..1??0..1??
                                                                                                                                                                        .... translation 0..*PQR0..*PQR
                                                                                                                                                                          .... operator 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                                            .... low 0..1IVXB_PQ0..1IVXB_PQ
                                                                                                                                                                              .... center 0..1PQ0..1PQ
                                                                                                                                                                                .... width 0..1PQ0..1PQ
                                                                                                                                                                                  .... high 0..1IVXB_PQ0..1IVXB_PQ
                                                                                                                                                                                    ... maxDoseQuantity 0..1RTO_PQ_PQ0..1RTO_PQ_PQ
                                                                                                                                                                                      ... administrationUnitCode 0..1CEadministrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value.
                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                      0..1CEadministrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value.
                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                        ... consumable 1..1InfrastructureRoot(USCDI) Medications1..1InfrastructureRoot𝗨𝗦𝗖𝗗𝗜: Medications
                                                                                                                                                                                          .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                                                            .... realmCode 0..*CS0..*CS
                                                                                                                                                                                              .... typeId 0..1II0..1II
                                                                                                                                                                                                ..... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                                                                  ..... assigningAuthorityName 0..1??0..1??
                                                                                                                                                                                                    ..... displayable 0..1??0..1??
                                                                                                                                                                                                      ..... root 1..1??, ??, ??Fixed Value: 2.16.840.1.113883.1.31..1??, ??, ??Fixed Value: 2.16.840.1.113883.1.3
                                                                                                                                                                                                        ..... st-simple 1..1stringPrimitive Type string
                                                                                                                                                                                                        URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
                                                                                                                                                                                                        1..1stringPrimitive Type string
                                                                                                                                                                                                        URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
                                                                                                                                                                                                          .... templateId 0..*II0..*II
                                                                                                                                                                                                            .... typeCode 0..1??Binding: ?? (required)
                                                                                                                                                                                                            Fixed Value: CSM
                                                                                                                                                                                                            0..1??Binding: ?? (required)
                                                                                                                                                                                                            Fixed Value: CSM
                                                                                                                                                                                                              .... manufacturedProduct C1..1??Base for all types and resources
                                                                                                                                                                                                              product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
                                                                                                                                                                                                              C1..1??Base for all types and resources
                                                                                                                                                                                                              product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
                                                                                                                                                                                                                ... subject 0..1Subject0..1Subject
                                                                                                                                                                                                                  ... specimen 0..*Specimen0..*Specimen
                                                                                                                                                                                                                    ... performer 0..1Performer20..1Performer2
                                                                                                                                                                                                                      ... author 0..*??Base for all types and resources
                                                                                                                                                                                                                      0..*??Base for all types and resources
                                                                                                                                                                                                                        ... informant 0..*Informant0..*Informant
                                                                                                                                                                                                                          ... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
                                                                                                                                                                                                                          0..*Participant2Slice: Unordered, Open by value:typeCode
                                                                                                                                                                                                                            ... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
                                                                                                                                                                                                                            0..*EntryRelationshipSlice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
                                                                                                                                                                                                                              ... reference 0..*Reference0..*Reference
                                                                                                                                                                                                                                ... precondition 0..*Precondition0..*Precondition
                                                                                                                                                                                                                                  .... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                                                                                                    .... realmCode 0..*CS0..*CS
                                                                                                                                                                                                                                      .... typeId 0..1II0..1II
                                                                                                                                                                                                                                        ..... nullFlavor 0..1??Binding: ?? (required)0..1??Binding: ?? (required)
                                                                                                                                                                                                                                          ..... assigningAuthorityName 0..1??0..1??
                                                                                                                                                                                                                                            ..... displayable 0..1??0..1??
                                                                                                                                                                                                                                              ..... root 1..1??, ??, ??Fixed Value: 2.16.840.1.113883.1.31..1??, ??, ??Fixed Value: 2.16.840.1.113883.1.3
                                                                                                                                                                                                                                                ..... st-simple 1..1stringPrimitive Type string
                                                                                                                                                                                                                                                URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
                                                                                                                                                                                                                                                1..1stringPrimitive Type string
                                                                                                                                                                                                                                                URL: http://hl7.org/cda/stds/core/StructureDefinition/st-simple
                                                                                                                                                                                                                                                  .... templateId 0..*II0..*II
                                                                                                                                                                                                                                                    .... typeCode 1..1??Binding: ?? (required)
                                                                                                                                                                                                                                                    Fixed Value: PRCN
                                                                                                                                                                                                                                                    1..1??Binding: ?? (required)
                                                                                                                                                                                                                                                    Fixed Value: PRCN
                                                                                                                                                                                                                                                      .... criterion 1..1??Base for all types and resources1..1??Base for all types and resources
                                                                                                                                                                                                                                                        ... sdtcInFulfillmentOf1 0..*InFulfillmentOf1XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
                                                                                                                                                                                                                                                        0..*InFulfillmentOf1XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

                                                                                                                                                                                                                                                          doco Documentation for this format