HL7® FHIR® Te Aho o Te Kahu, Cancer Control Agency Implementation Guide
0.1.0 - CI Build

HL7® FHIR® Te Aho o Te Kahu, Cancer Control Agency Implementation Guide, published by Te Aho o Te Kahu, Cancer Control Agency. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7NZ/cca/ and changes regularly. See the Directory of published versions

Data Type Profile: CcaDosage - XML Profile

Active as of 2024-03-03

XML representation of the CcaDosage data type profile.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="CcaDosage"/>
  <text>
    <status value="additional"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Dosage</div>
  </text>
  <url value="http://hl7.org.nz/fhir/StructureDefinition/CcaDosage"/>
  <version value="0.1.0"/>
  <name value="CcaDosage"/>
  <title value="Dosage"/>
  <status value="active"/>
  <date value="2024-03-03T21:52:06+00:00"/>
  <publisher value="Te Aho o Te Kahu, Cancer Control Agency"/>
  <description value="CCA Regimen Dosage."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="NZ"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="complex-type"/>
  <abstract value="false"/>
  <type value="Dosage"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Dosage">
      <path value="Dosage"/>
      <short value="How the medication is/was taken or should be taken"/>
      <definition
                  value="Indicates how the medication is/was taken or should be taken by the patient."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Dosage"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/>
      </mapping>
    </element>
    <element id="Dosage.id">
      <path value="Dosage.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.extension">
      <path value="Dosage.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.modifierExtension">
      <path value="Dosage.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Dosage.sequence">
      <path value="Dosage.sequence"/>
      <short value="The order of the dosage instructions"/>
      <definition
                  value="Indicates the order in which the dosage instructions should be applied or interpreted."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.sequence"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="integer"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="Dosage.text">
      <path value="Dosage.text"/>
      <short value="Free text dosage instructions e.g. SIG"/>
      <definition value="Free text dosage instructions e.g. SIG."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-6; RXE-21"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="Dosage.additionalInstruction">
      <path value="Dosage.additionalInstruction"/>
      <short
             value="Supplemental instruction or warnings to the patient - e.g. &quot;with meals&quot;, &quot;may cause drowsiness&quot;"/>
      <definition
                  value="Supplemental instructions to the patient on how to take the medication  (e.g. &quot;with meals&quot; or&quot;take half to one hour before food&quot;) or warnings for the patient about the medication (e.g. &quot;may cause drowsiness&quot; or &quot;avoid exposure of skin to direct sunlight or sunlamps&quot;)."/>
      <comment
               value="Information about administration or preparation of the medication (e.g. &quot;infuse as rapidly as possibly via intraperitoneal port&quot; or &quot;immediately following drug x&quot;) should be populated in dosage.text."/>
      <requirements
                    value="Additional instruction is intended to be coded, but where no code exists, the element could include text.  For example, &quot;Swallow with plenty of water&quot; which might or might not be coded."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.additionalInstruction"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdditionalInstruction"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept identifying additional instructions such as &quot;take with water&quot; or &quot;avoid operating heavy machinery&quot;."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/additional-instruction-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="Dosage.patientInstruction">
      <path value="Dosage.patientInstruction"/>
      <short value="Patient or consumer oriented instructions"/>
      <definition
                  value="Instructions in terms that are understood by the patient or consumer."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.patientInstruction"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="Dosage.timing">
      <path value="Dosage.timing"/>
      <short value="When medication should be administered"/>
      <definition value="When medication should be administered."/>
      <comment
               value="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."/>
      <requirements
                    value="The timing schedule for giving the medication to the patient. This  data type allows many different expressions. For example: &quot;Every 8 hours&quot;; &quot;Three times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;; &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.  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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.timing"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Timing"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element id="Dosage.timing.id">
      <path value="Dosage.timing.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.timing.extension">
      <path value="Dosage.timing.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.timing.modifierExtension">
      <path value="Dosage.timing.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="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)."/>
      <comment
               value="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."/>
      <requirements
                    value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Dosage.timing.event">
      <path value="Dosage.timing.event"/>
      <short value="When the event occurs"/>
      <definition value="Identifies specific times when the event occurs."/>
      <requirements
                    value="In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Timing.event"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="QLIST&lt;TS&gt;"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat">
      <path value="Dosage.timing.repeat"/>
      <short value="When the event is to occur"/>
      <definition
                  value="A set of rules that describe when the event is scheduled."/>
      <requirements
                    value="Many timing schedules are determined by regular repetitions."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="tim-1"/>
        <severity value="error"/>
        <human
               value="if there's a duration, there needs to be duration units"/>
        <expression value="duration.empty() or durationUnit.exists()"/>
        <xpath value="not(exists(f:duration)) or exists(f:durationUnit)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-2"/>
        <severity value="error"/>
        <human value="if there's a period, there needs to be period units"/>
        <expression value="period.empty() or periodUnit.exists()"/>
        <xpath value="not(exists(f:period)) or exists(f:periodUnit)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-4"/>
        <severity value="error"/>
        <human value="duration SHALL be a non-negative value"/>
        <expression value="duration.exists() implies duration &gt;= 0"/>
        <xpath value="f:duration/@value &gt;= 0 or not(f:duration/@value)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-5"/>
        <severity value="error"/>
        <human value="period SHALL be a non-negative value"/>
        <expression value="period.exists() implies period &gt;= 0"/>
        <xpath value="f:period/@value &gt;= 0 or not(f:period/@value)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-6"/>
        <severity value="error"/>
        <human value="If there's a periodMax, there must be a period"/>
        <expression value="periodMax.empty() or period.exists()"/>
        <xpath value="not(exists(f:periodMax)) or exists(f:period)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-7"/>
        <severity value="error"/>
        <human value="If there's a durationMax, there must be a duration"/>
        <expression value="durationMax.empty() or duration.exists()"/>
        <xpath value="not(exists(f:durationMax)) or exists(f:duration)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-8"/>
        <severity value="error"/>
        <human value="If there's a countMax, there must be a count"/>
        <expression value="countMax.empty() or count.exists()"/>
        <xpath value="not(exists(f:countMax)) or exists(f:count)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-9"/>
        <severity value="error"/>
        <human
               value="If there's an offset, there must be a when (and not C, CM, CD, CV)"/>
        <expression
                    value="offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))"/>
        <xpath value="not(exists(f:offset)) or exists(f:when)"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <constraint>
        <key value="tim-10"/>
        <severity value="error"/>
        <human
               value="If there's a timeOfDay, there cannot be a when, or vice versa"/>
        <expression value="timeOfDay.empty() or when.empty()"/>
        <xpath value="not(exists(f:timeOfDay)) or not(exists(f:when))"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Dosage"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Implies PIVL or EIVL"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.id">
      <path value="Dosage.timing.repeat.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.extension">
      <path value="Dosage.timing.repeat.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.bounds[x]">
      <path value="Dosage.timing.repeat.bounds[x]"/>
      <short value="Length/Range of lengths, or (Start and/or end) limits"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.bounds[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Duration"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="IVL(TS) used in a QSI"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.count">
      <path value="Dosage.timing.repeat.count"/>
      <short value="Number of times to repeat"/>
      <definition
                  value="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."/>
      <comment
               value="If you have both bounds and count, then this should be understood as within the bounds period, until count times happens."/>
      <requirements
                    value="Repetitions may be limited by end time or total occurrences."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.count"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.count"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.countMax">
      <path value="Dosage.timing.repeat.countMax"/>
      <short value="Maximum number of times to repeat"/>
      <definition
                  value="If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.countMax"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.count"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.duration">
      <path value="Dosage.timing.repeat.duration"/>
      <short value="How long when it happens"/>
      <definition
                  value="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."/>
      <comment
               value="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)."/>
      <requirements
                    value="Some activities are not instantaneous and need to be maintained for a period of time."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.duration"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.durationMax">
      <path value="Dosage.timing.repeat.durationMax"/>
      <short value="How long when it happens (Max)"/>
      <definition
                  value="If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length."/>
      <comment
               value="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)."/>
      <requirements
                    value="Some activities are not instantaneous and need to be maintained for a period of time."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.durationMax"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.durationUnit">
      <path value="Dosage.timing.repeat.durationUnit"/>
      <short value="s | min | h | d | wk | mo | a - unit of time (UCUM)"/>
      <definition value="The units of time for the duration, in UCUM units."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.durationUnit"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="UnitsOfTime"/>
        </extension>
        <strength value="required"/>
        <description value="A unit of time (units from UCUM)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/units-of-time|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase.unit"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.frequency">
      <path value="Dosage.timing.repeat.frequency"/>
      <short value="Event occurs frequency times per period"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.frequency"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <meaningWhenMissing
                          value="If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.frequencyMax">
      <path value="Dosage.timing.repeat.frequencyMax"/>
      <short value="Event occurs up to frequencyMax times per period"/>
      <definition
                  value="If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.frequencyMax"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.period">
      <path value="Dosage.timing.repeat.period"/>
      <short value="Event occurs frequency times per period"/>
      <definition
                  value="Indicates the duration of time over which repetitions are to occur; e.g. to express &quot;3 times per day&quot;, 3 would be the frequency and &quot;1 day&quot; would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.periodMax">
      <path value="Dosage.timing.repeat.periodMax"/>
      <short value="Upper limit of period (3-4 hours)"/>
      <definition
                  value="If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as &quot;do this once every 3-5 days."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.periodMax"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="decimal"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.periodUnit">
      <path value="Dosage.timing.repeat.periodUnit"/>
      <short value="s | min | h | d | wk | mo | a - unit of time (UCUM)"/>
      <definition value="The units of time for the period in UCUM units."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.periodUnit"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="UnitsOfTime"/>
        </extension>
        <strength value="required"/>
        <description value="A unit of time (units from UCUM)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/units-of-time|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="PIVL.phase.unit"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.dayOfWeek">
      <path value="Dosage.timing.repeat.dayOfWeek"/>
      <short value="mon | tue | wed | thu | fri | sat | sun"/>
      <definition
                  value="If one or more days of week is provided, then the action happens only on the specified day(s)."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Timing.repeat.dayOfWeek"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DayOfWeek"/>
        </extension>
        <strength value="required"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/days-of-week|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.timeOfDay">
      <path value="Dosage.timing.repeat.timeOfDay"/>
      <short value="Time of day for action"/>
      <definition value="Specified time of day for action to take place."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Timing.repeat.timeOfDay"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="time"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.when">
      <path value="Dosage.timing.repeat.when"/>
      <short value="Code for time period of occurrence"/>
      <definition
                  value="An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur."/>
      <comment
               value="When more than one event is listed, the event is tied to the union of the specified events."/>
      <requirements
                    value="Timings are frequently determined by occurrences such as waking, eating and sleep."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Timing.repeat.when"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="EventTiming"/>
        </extension>
        <strength value="required"/>
        <description value="Real world event relating to the schedule."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/event-timing|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="EIVL.event"/>
      </mapping>
    </element>
    <element id="Dosage.timing.repeat.offset">
      <path value="Dosage.timing.repeat.offset"/>
      <short value="Minutes from event (before or after)"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.repeat.offset"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="EIVL.offset"/>
      </mapping>
    </element>
    <element id="Dosage.timing.code">
      <path value="Dosage.timing.code"/>
      <short value="BID | TID | QID | AM | PM | QD | QOD | +"/>
      <definition
                  value="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)."/>
      <comment
               value="BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is &quot;always at 7am and 6pm&quot;.  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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Timing.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://standards.digital.health.nz/fhir/ValueSet/sact-dose-administration-frequency"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="QSC.code"/>
      </mapping>
    </element>
    <element id="Dosage.asNeeded[x]">
      <path value="Dosage.asNeeded[x]"/>
      <short value="Take &quot;as needed&quot; (for x)"/>
      <definition
                  value="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)."/>
      <comment
               value="Can express &quot;as needed&quot; without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express &quot;as needed&quot; 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 &quot;prn&quot; or &quot;as needed&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.asNeeded[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAsNeededReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30 minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-9"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=&quot;as needed&quot;].value=boolean or codable concept"/>
      </mapping>
    </element>
    <element id="Dosage.site">
      <path value="Dosage.site"/>
      <short value="Body site to administer to"/>
      <definition value="Body site to administer to."/>
      <comment
               value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both."/>
      <requirements
                    value="A coded specification of the anatomic site where the medication first enters the body."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.site"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationSite"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing the site location the medicine enters into or onto the body."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".approachSiteCode"/>
      </mapping>
    </element>
    <element id="Dosage.route">
      <path value="Dosage.route"/>
      <short value="How drug should enter body"/>
      <definition value="How drug should enter body."/>
      <requirements
                    value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.route"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://standards.digital.health.nz/fhir/ValueSet/sact-route"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".routeCode"/>
      </mapping>
    </element>
    <element id="Dosage.method">
      <path value="Dosage.method"/>
      <short value="Technique for administering medication"/>
      <definition value="Technique for administering medication."/>
      <comment
               value="Terminologies used often pre-coordinate this term with the route and or form of administration."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.method"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationMethod"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing the technique by which the medicine is administered."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/administration-method-codes"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".doseQuantity"/>
      </mapping>
    </element>
    <element id="Dosage.doseAndRate">
      <path value="Dosage.doseAndRate"/>
      <short value="Amount of medication administered"/>
      <definition value="The amount of medication administered."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Dosage.doseAndRate"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Element"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-2"/>
      </mapping>
    </element>
    <element id="Dosage.doseAndRate.id">
      <path value="Dosage.doseAndRate.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.doseAndRate.extension">
      <path value="Dosage.doseAndRate.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Dosage.doseAndRate.type">
      <path value="Dosage.doseAndRate.type"/>
      <short value="The kind of dose or rate specified"/>
      <definition
                  value="The kind of dose or rate specified, for example, ordered or calculated."/>
      <requirements
                    value="If the type is not populated, assume to be &quot;ordered&quot;."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.doseAndRate.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DoseAndRateType"/>
        </extension>
        <strength value="example"/>
        <description value="The kind of dose or rate specified."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/dose-rate-type"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-21; RXE-23"/>
      </mapping>
    </element>
    <element id="Dosage.doseAndRate.dose[x]">
      <path value="Dosage.doseAndRate.dose[x]"/>
      <short value="Amount of medication per dose"/>
      <definition value="Amount of medication per dose."/>
      <comment
               value="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."/>
      <requirements
                    value="The amount of therapeutic or other substance given at one administration event."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.doseAndRate.dose[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-2, RXE-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".doseQuantity"/>
      </mapping>
    </element>
    <element id="Dosage.doseAndRate.rate[x]">
      <path value="Dosage.doseAndRate.rate[x]"/>
      <short value="Amount of medication per unit of time"/>
      <definition value="Amount of medication per unit of time."/>
      <comment
               value="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."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.doseAndRate.rate[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE22, RXE23, RXE-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".rateQuantity"/>
      </mapping>
    </element>
    <element id="Dosage.maxDosePerPeriod">
      <path value="Dosage.maxDosePerPeriod"/>
      <short value="Upper limit on medication per unit of time"/>
      <definition value="Upper limit on medication per unit of time."/>
      <comment
               value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example &quot;2 tablets every 4 hours to a maximum of 8/day&quot;."/>
      <requirements
                    value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.maxDosePerPeriod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Ratio"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-23, RXE-19"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".maxDoseQuantity"/>
      </mapping>
    </element>
    <element id="Dosage.maxDosePerAdministration">
      <path value="Dosage.maxDosePerAdministration"/>
      <short value="Upper limit on medication per administration"/>
      <definition value="Upper limit on medication per administration."/>
      <comment
               value="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."/>
      <requirements
                    value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Dosage.maxDosePerAdministration"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="not supported"/>
      </mapping>
    </element>
    <element id="Dosage.maxDosePerLifetime">
      <path value="Dosage.maxDosePerLifetime"/>
      <short value="Upper limit on medication per lifetime of the patient"/>
      <definition
                  value="Upper limit on medication per lifetime of the patient."/>
      <requirements
                    value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Dosage.maxDosePerLifetime"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="not supported"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Dosage">
      <path value="Dosage"/>
    </element>
    <element id="Dosage.additionalInstruction">
      <path value="Dosage.additionalInstruction"/>
      <max value="0"/>
    </element>
    <element id="Dosage.patientInstruction">
      <path value="Dosage.patientInstruction"/>
      <max value="0"/>
    </element>
    <element id="Dosage.timing.code">
      <path value="Dosage.timing.code"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://standards.digital.health.nz/fhir/ValueSet/sact-dose-administration-frequency"/>
      </binding>
    </element>
    <element id="Dosage.site">
      <path value="Dosage.site"/>
      <max value="0"/>
    </element>
    <element id="Dosage.route">
      <path value="Dosage.route"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://standards.digital.health.nz/fhir/ValueSet/sact-route"/>
      </binding>
    </element>
    <element id="Dosage.method">
      <path value="Dosage.method"/>
      <max value="0"/>
    </element>
    <element id="Dosage.doseAndRate.type">
      <path value="Dosage.doseAndRate.type"/>
      <max value="0"/>
    </element>
    <element id="Dosage.maxDosePerPeriod">
      <path value="Dosage.maxDosePerPeriod"/>
      <max value="0"/>
    </element>
    <element id="Dosage.maxDosePerLifetime">
      <path value="Dosage.maxDosePerLifetime"/>
      <max value="0"/>
    </element>
  </differential>
</StructureDefinition>