Medication Scheme Implementation Guide
1.0.0 - draft
Medication Scheme Implementation Guide
1.0.0 - draft
Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions
| Official URL: https://fhir.ee/StructureDefinition/ee-tis-dosage | Version: 1.0.0 | |||
| Draft as of 2024-01-31 | Computable Name: EETISDosage | |||
Annustamisjuhis. Dosage is for exact representation of what quantity in which units and how often should medication be taken by patient.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Dosage |
C | 0..* | Dosage | Dosage dos-1: AsNeededFor can only be set if AsNeeded is empty or true ele-1: All FHIR elements must have a @value or children |
  modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
 sequence |
Σ | 0..1 | integer | The order of the dosage instructions ele-1: All FHIR elements must have a @value or children |
| text |
Σ | 0..1 | string | Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children Max Length:1000 |
 additionalInstruction |
Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". ele-1: All FHIR elements must have a @value or children |
| patientInstruction |
Σ | 0..1 | string | Patient or consumer oriented instructions ele-1: All FHIR elements must have a @value or children |
 timing |
Σ | 0..1 | Timing | When medication should be administered ele-1: All FHIR elements must have a @value or children |
 modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
 repeat |
ΣC | 0..1 | Element | When the event is to occur. ele-1: All FHIR elements must have a @value or children tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa |
  bounds[x] |
Σ | 0..1 | Length/Range of lengths, or (Start and/or end) limits. Slice: Unordered, Open by type:$this ele-1: All FHIR elements must have a @value or children | |
 boundsDuration |
Duration | |||
| boundsRange |
Range | |||
 boundsPeriod |
Period | |||
| count |
ΣC | 0..1 | positiveInt | Number of times to repeat ele-1: All FHIR elements must have a @value or children |
| countMax |
ΣC | 0..1 | positiveInt | Maximum number of times to repeat ele-1: All FHIR elements must have a @value or children |
| duration |
ΣC | 0..1 | decimal | How long when it happens ele-1: All FHIR elements must have a @value or children |
| durationMax |
ΣC | 0..1 | decimal | How long when it happens (Max) ele-1: All FHIR elements must have a @value or children |
| durationUnit |
ΣC | 0..1 | code | The units of time for the duration. Binding: UnitsOfTime (required): A unit of time (units from UCUM). ele-1: All FHIR elements must have a @value or children |
| frequency |
Σ | 0..1 | positiveInt | Indicates the number of repetitions that should occur within a period. I.e. Event occurs frequency times per period ele-1: All FHIR elements must have a @value or children |
| frequencyMax |
Σ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period ele-1: All FHIR elements must have a @value or children |
| period |
ΣC | 0..1 | decimal | The duration to which the frequency applies. I.e. Event occurs frequency times per period ele-1: All FHIR elements must have a @value or children |
| periodMax |
ΣC | 0..1 | decimal | Upper limit of period (3-4 hours) ele-1: All FHIR elements must have a @value or children |
| dayOfWeek |
Σ | 0..* | code | If one or more days of week is provided, then the action happens only on the specified day(s). Binding: DaysOfWeek (required) ele-1: All FHIR elements must have a @value or children |
| timeOfDay |
ΣC | 0..* | time | Specified time of day for action to take place. ele-1: All FHIR elements must have a @value or children |
| when |
ΣC | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real-world event relating to the schedule. ele-1: All FHIR elements must have a @value or children |
 offset |
ΣC | 0..1 | unsignedInt | Minutes from event (before or after) ele-1: All FHIR elements must have a @value or children |
| asNeeded |
ΣC | 0..1 | boolean | Take "as needed" ele-1: All FHIR elements must have a @value or children |
| asNeededFor |
ΣC | 0..1 | CodeableConcept | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. ele-1: All FHIR elements must have a @value or children |
| site |
Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureAdministrationSites (example): A coded concept describing the site location the medicine enters into or onto the body. ele-1: All FHIR elements must have a @value or children |
| route |
Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. ele-1: All FHIR elements must have a @value or children |
| method |
Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. ele-1: All FHIR elements must have a @value or children |
| doseAndRate |
Σ | 0..* | Element | Amount of medication administered, to be administered or typical amount to be administered ele-1: All FHIR elements must have a @value or children |
 dose[x] |
Σ | 0..1 | Amount of medication per dose ele-1: All FHIR elements must have a @value or children | |
| doseRange |
Range | |||
| doseQuantity |
Quantity(SimpleQuantity) | |||
| rate[x] |
Σ | 0..1 | Amount of medication per unit of time ele-1: All FHIR elements must have a @value or children | |
| rateRatio |
Ratio | |||
| rateRange |
Range | |||
| rateQuantity |
Quantity(SimpleQuantity) | |||
| maxDosePerPeriod |
Σ | 0..* | Ratio | Upper limit on medication per unit of time ele-1: All FHIR elements must have a @value or children |
| maxDosePerAdministration |
Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration ele-1: All FHIR elements must have a @value or children |
| maxDosePerLifetime |
Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Dosage.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesfrom the FHIR Standard | |
| Dosage.timing.repeat.durationUnit | required | UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|5.0.0from the FHIR Standard | |
| Dosage.timing.repeat.dayOfWeek | required | DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|5.0.0from the FHIR Standard | |
| Dosage.timing.repeat.when | required | EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|5.0.0from the FHIR Standard | |
| Dosage.asNeededFor | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonfrom the FHIR Standard | |
| Dosage.site | example | SNOMEDCTAnatomicalStructureAdministrationSiteshttp://hl7.org/fhir/ValueSet/approach-site-codesfrom the FHIR Standard | |
| Dosage.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesfrom the FHIR Standard | |
| Dosage.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dos-1 | error | Dosage | AsNeededFor can only be set if AsNeeded is empty or true : asNeededFor.empty() or asNeeded.empty() or asNeeded | |
| 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() | |
| tim-1 | error | Dosage.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | Dosage.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | Dosage.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | Dosage.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | Dosage.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | Dosage.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | Dosage.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | Dosage.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and when.select($this in ('C' | 'CM' | 'CD' | 'CV')).allFalse()) | |
| tim-10 | error | Dosage.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() |
Other representations of profile: CSV, Excel, Schematron
