US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone | Version: 1.0.0-ballot | ||||
| Standards status: Trial-use | Maturity Level: 4 | Computable Name: USQualityCoreMedicationAdministrationNotDone | |||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.27 | |||||
Negation profile of MedicationAdministration for decision support/quality metrics. Indicates that a medication was not administered for a reason.
The MedicationAdministration profile defines the conformance expectations for a MedicationAdministration event, regardless of whether it is a positive or negative statement. The MedicationAdministrationDone and MedicationAdministrationNotDone profiles represent the positive and negative statements for a MedicationAdministration event.
To create an expression indicating existence of a MedicationAdministration, use the profile USQualityCoreMedicationAdministrationDone; to specifically request information that a MedicationAdministration intentionally did not occur for a medical, patient or system reason, use the profile USQualityCoreMedicationAdministrationNotDone.
For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.
Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.
The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.
USCDI+ Quality Elements:
| Profile element | Description | USCDI+ Quality Data Element(s) |
|---|---|---|
dosage |
Details of how medication was taken | Medications: Medication Administration |
effective[x] |
Start and end time of administration | Medications: Date and Time Medication Administered |
medication[x] |
What was administered | Healthcare Information Attributes: Reason Not Performed, Medications: Medication Administration |
medication[x].extension:codeOptions |
Url of a value set of candidate medications | Healthcare Information Attributes: Reason Not Performed, Medications: Medication Administration |
performer.actor |
Who performed the medication administration | Provenance: Author |
status |
not-done | Healthcare Information Attributes: Reason Not Performed, Medications: Medication Administration |
statusReason |
Reason administration not performed | Healthcare Information Attributes: Reason Not Performed |
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
C | 0..* | USQualityCoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1 |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done |
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: US Quality Core Negation Reason Codes (extensible): The reason the event did not occur or was not performed | |
![]() ![]() |
ΣC | 1..1 | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications | |
![]() ![]() ![]() |
Content/Rules for all Types | |||
![]() ![]() ![]() ![]() |
Content/Rules for all slices | |||
![]() ![]() ![]() ![]() ![]() |
C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of candidate medications URL: http://hl7.org/fhir/StructureDefinition/codeOptions |
![]() ![]() ![]() |
CodeableConcept | |||
![]() ![]() ![]() |
Reference(US Quality Core Medication) | |||
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication |
![]() ![]() |
Σ | 1..1 | (USCDI+ Quality) Start and end time of administration | |
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Period | |||
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| MedicationAdministration.status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.statusReason | Base | extensible | US Quality Core Negation Reason Codes | 📦1.0.0-ballot | This IG |
| MedicationAdministration.medication[x] | Base | preferred |
Medication Clinical Drug
|
⏿20240606 | tx.fhir.org |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| qma-1 | error | MedicationAdministration | To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided |
(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()
|
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | USQualityCoreMedicationAdministration | Administration of medication to a patient | |
![]() ![]() |
1..1 | code | (USCDI+ Quality) not-done Fixed Value: not-done | |
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: US Quality Core Negation Reason Codes (extensible): The reason the event did not occur or was not performed | |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| MedicationAdministration.statusReason | Base | extensible | US Quality Core Negation Reason Codes | 📦1.0.0-ballot | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
C | 0..* | USQualityCoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1 | ||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
0..* | Identifier | External identifier | |||||
![]() ![]() |
Σ | 0..* | uri | Instantiates protocol or definition | ||||
![]() ![]() |
Σ | 0..* | Reference(MedicationAdministration | Procedure) | Part of referenced event | ||||
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done | ||||
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: US Quality Core Negation Reason Codes (extensible): The reason the event did not occur or was not performed | |||||
![]() ![]() |
0..1 | CodeableConcept | Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur. | |||||
![]() ![]() |
ΣC | 1..1 | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications | |||||
![]() ![]() ![]() |
Content/Rules for all Types | |||||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() ![]() ![]() |
C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of candidate medications URL: http://hl7.org/fhir/StructureDefinition/codeOptions | ||||
![]() ![]() ![]() |
CodeableConcept | |||||||
![]() ![]() ![]() |
Reference(US Quality Core Medication) | |||||||
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication | ||||
![]() ![]() |
0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of | |||||
![]() ![]() |
0..* | Reference(Resource) | Additional information to support administration | |||||
![]() ![]() |
Σ | 1..1 | (USCDI+ Quality) Start and end time of administration | |||||
![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() |
Period | |||||||
![]() ![]() |
Σ | 0..* | BackboneElement | Who performed the medication administration and what they did | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication. | |||||
![]() ![]() ![]() |
Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | (USCDI+ Quality) Who performed the medication administration | ||||
![]() ![]() |
0..* | CodeableConcept | Reason administration performed Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made. | |||||
![]() ![]() |
0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication was administered | |||||
![]() ![]() |
0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against | |||||
![]() ![]() |
0..* | Reference(Device) | Device used to administer | |||||
![]() ![]() |
0..* | Annotation | Information about the administration | |||||
![]() ![]() |
C | 0..1 | BackboneElement | (USCDI+ Quality) Details of how medication was taken Constraints: mad-1 | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
0..1 | string | Free text dosage instructions e.g. SIG | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred) | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | |||||
![]() ![]() ![]() |
0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose | |||||
![]() ![]() ![]() |
0..1 | Dose quantity per unit of time | ||||||
![]() ![]() ![]() ![]() |
Ratio | |||||||
![]() ![]() ![]() ![]() |
Quantity(SimpleQuantity) | |||||||
![]() ![]() |
0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |||||
Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| MedicationAdministration.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.statusReason | Base | extensible | US Quality Core Negation Reason Codes | 📦1.0.0-ballot | This IG |
| MedicationAdministration.category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.medication[x] | Base | preferred |
Medication Clinical Drug
|
⏿20240606 | tx.fhir.org |
| MedicationAdministration.performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std. |
| MedicationAdministration.dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] |
dose.exists() or rate.exists()
|
| qma-1 | error | MedicationAdministration | To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided |
(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()
|
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
C | 0..* | USQualityCoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1 |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done |
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: US Quality Core Negation Reason Codes (extensible): The reason the event did not occur or was not performed | |
![]() ![]() |
ΣC | 1..1 | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications | |
![]() ![]() ![]() |
Content/Rules for all Types | |||
![]() ![]() ![]() ![]() |
Content/Rules for all slices | |||
![]() ![]() ![]() ![]() ![]() |
C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of candidate medications URL: http://hl7.org/fhir/StructureDefinition/codeOptions |
![]() ![]() ![]() |
CodeableConcept | |||
![]() ![]() ![]() |
Reference(US Quality Core Medication) | |||
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication |
![]() ![]() |
Σ | 1..1 | (USCDI+ Quality) Start and end time of administration | |
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Period | |||
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| MedicationAdministration.status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.statusReason | Base | extensible | US Quality Core Negation Reason Codes | 📦1.0.0-ballot | This IG |
| MedicationAdministration.medication[x] | Base | preferred |
Medication Clinical Drug
|
⏿20240606 | tx.fhir.org |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| qma-1 | error | MedicationAdministration | To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided |
(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()
|
Differential View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | USQualityCoreMedicationAdministration | Administration of medication to a patient | |
![]() ![]() |
1..1 | code | (USCDI+ Quality) not-done Fixed Value: not-done | |
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: US Quality Core Negation Reason Codes (extensible): The reason the event did not occur or was not performed | |
Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| MedicationAdministration.statusReason | Base | extensible | US Quality Core Negation Reason Codes | 📦1.0.0-ballot | This IG |
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
C | 0..* | USQualityCoreMedicationAdministration | Administration of medication to a patient Constraints: qma-1 | ||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
0..* | Identifier | External identifier | |||||
![]() ![]() |
Σ | 0..* | uri | Instantiates protocol or definition | ||||
![]() ![]() |
Σ | 0..* | Reference(MedicationAdministration | Procedure) | Part of referenced event | ||||
![]() ![]() |
?!Σ | 1..1 | code | (USCDI+ Quality) not-done Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration. Fixed Value: not-done | ||||
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Reason administration not performed Binding: US Quality Core Negation Reason Codes (extensible): The reason the event did not occur or was not performed | |||||
![]() ![]() |
0..1 | CodeableConcept | Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur. | |||||
![]() ![]() |
ΣC | 1..1 | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications | |||||
![]() ![]() ![]() |
Content/Rules for all Types | |||||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() ![]() ![]() |
C | 0..1 | canonical(ValueSet) | (USCDI+ Quality) Url of a value set of candidate medications URL: http://hl7.org/fhir/StructureDefinition/codeOptions | ||||
![]() ![]() ![]() |
CodeableConcept | |||||||
![]() ![]() ![]() |
Reference(US Quality Core Medication) | |||||||
![]() ![]() |
Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication | ||||
![]() ![]() |
0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of | |||||
![]() ![]() |
0..* | Reference(Resource) | Additional information to support administration | |||||
![]() ![]() |
Σ | 1..1 | (USCDI+ Quality) Start and end time of administration | |||||
![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() |
Period | |||||||
![]() ![]() |
Σ | 0..* | BackboneElement | Who performed the medication administration and what they did | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication. | |||||
![]() ![]() ![]() |
Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | (USCDI+ Quality) Who performed the medication administration | ||||
![]() ![]() |
0..* | CodeableConcept | Reason administration performed Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made. | |||||
![]() ![]() |
0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication was administered | |||||
![]() ![]() |
0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against | |||||
![]() ![]() |
0..* | Reference(Device) | Device used to administer | |||||
![]() ![]() |
0..* | Annotation | Information about the administration | |||||
![]() ![]() |
C | 0..1 | BackboneElement | (USCDI+ Quality) Details of how medication was taken Constraints: mad-1 | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
0..1 | string | Free text dosage instructions e.g. SIG | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred) | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | |||||
![]() ![]() ![]() |
0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose | |||||
![]() ![]() ![]() |
0..1 | Dose quantity per unit of time | ||||||
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Ratio | |||||||
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Quantity(SimpleQuantity) | |||||||
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0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |||||
Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| MedicationAdministration.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.status | Base | required | Medication administration status codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.statusReason | Base | extensible | US Quality Core Negation Reason Codes | 📦1.0.0-ballot | This IG |
| MedicationAdministration.category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.medication[x] | Base | preferred |
Medication Clinical Drug
|
⏿20240606 | tx.fhir.org |
| MedicationAdministration.performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std. |
| MedicationAdministration.dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std. |
| MedicationAdministration.dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | MedicationAdministration | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] |
dose.exists() or rate.exists()
|
| qma-1 | error | MedicationAdministration | To indicate what medication, either a reference to a Medication or at least one coding in the medication or a codeOptions extension shall be provided |
(medication is Reference).not() implies medication.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor medication.coding.exists()
|
Other representations of profile: CSV, Excel, Schematron
Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.
| Profile element | FHIR | US Quality Core |
|---|---|---|
status |
Mandatory | USCDI+ Quality |
statusReason |
Mandatory USCDI+ Quality | |
medication[x] |
Mandatory | USCDI+ Quality |
medication[x].extension:codeOptions |
USCDI+ Quality | |
subject |
Mandatory | |
effective[x] |
Mandatory | USCDI+ Quality |
performer.actor |
Mandatory | USCDI+ Quality |
dosage |
USCDI+ Quality | |
dosage.route |
USCDI+ Quality | |
dosage.dose |
USCDI+ Quality |
Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.
The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.
See the US Quality Core Server CapabilityStatement for complete requirements for the underlying MedicationAdministration resource and Search Requirement Selection for how this focused set was selected.
Servers supporting this profile SHALL support the following search parameters and search parameter combinations:
SHALL support searching for all MedicationAdministration resources for a patient using the patient search parameter.
GET [base]/MedicationAdministration?patient={Patient/}[id]
Example:
GET [base]/MedicationAdministration?patient=Patient/example
Implementation Notes: Fetches a bundle of US Quality Core MedicationAdministration Not Done resources matching the specified search criteria. See how to search by reference.
Rationale for inclusion: Supports patient-scoped retrieval of MedicationAdministration resources for USCDI+ Quality workflows.
SHALL support searching for all MedicationAdministration resources for a patient using the combination of the patient and status search parameters.
status (e.g.status=[status],[status],...).GET [base]/MedicationAdministration?patient={Patient/}[id]&status=[status]
Example:
GET [base]/MedicationAdministration?patient=Patient/example&status=not-done
Implementation Notes: Fetches a bundle of US Quality Core MedicationAdministration Not Done resources matching the specified search criteria. See how to search by reference and how to search by token.
Rationale for inclusion: Supports patient-scoped retrieval of MedicationAdministration resources filtered by status; status is used to indicate negation.
SHALL support searching for all MedicationAdministration resources for a patient using the combination of the patient and code search parameters.
code (e.g.code={system|}[search_code],{system|}[search_code],...).GET [base]/MedicationAdministration?patient={Patient/}[id]&code={system|}[search_code]
Example:
GET [base]/MedicationAdministration?patient=Patient/example&code=http://www.nlm.nih.gov/research/umls/rxnorm|1594663
Implementation Notes: Fetches a bundle of US Quality Core MedicationAdministration Not Done resources matching the specified search criteria. See how to search by reference and how to search by token.
Rationale for inclusion: Supports patient-scoped retrieval of MedicationAdministration resources filtered by code for USCDI+ Quality workflows.
SHALL support searching for all MedicationAdministration resources for a patient using the combination of the patient and effective-time search parameters.
Including optional support for AND search on effective-time (e.g.effective-time=[date]&effective-time=[date]&...).
Including support for these effective-time comparators: "gt", "lt", "ge", "le".
GET [base]/MedicationAdministration?patient={Patient/}[id]&effective-time={gt|lt|ge|le}[dateTime]
Example:
GET [base]/MedicationAdministration?patient=Patient/example&effective-time=ge2020-01-01T00:00:00Z
Implementation Notes: Fetches a bundle of US Quality Core MedicationAdministration Not Done resources matching the specified search criteria. See how to search by reference and how to search by date.
Rationale for inclusion: Supports patient-scoped retrieval of MedicationAdministration resources filtered by effective time so quality workflows can constrain results to relevant reporting periods.