QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.0)

QI-Core Implementation Guide, Clinical Quality Improvement WG - CI build for vesion 4.0.0). This version is based on the current content of https://github.com/cqframework/qi-core/ and changes regularly. See the Directory of published versions

D.4.1 StructureDefinition-qicore-medicationadministration

Introduction:

See the patterns page for implementation and usage patterns.

Examples:

Inhalant Example

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationadministration

Profile of MedicationAdministration for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

This profile builds on MedicationAdministration.

This profile was published on Wed Aug 22 00:00:00 UTC 2018 as a draft by Health Level Seven, Inc. - CQI WG.

Description of Profiles, Differentials, and Snapshots.

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration I0..*Administration of medication to a patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... instantiates Σ0..*uriInstantiates protocol or definition
... partOf Σ0..*Reference(MedicationAdministration | Procedure)Part of referenced event
... status ?!SΣ1..1codein-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required)
... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example)
... category 0..1CodeableConceptType of medication usage
Binding: MedicationAdministration Category Codes (preferred)
... medication[x] SΣ1..1What was administered
Binding: US Core Medication Codes (RxNorm) (preferred)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(StructureDefinition-qicore-medication.html)
... subject SΣ1..1Reference(QICorePatient)Who received medication
... context S0..1Reference(QICoreEncounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... supportingInformation 0..*Reference(Resource)Additional information to support administration
... effective[x] SΣ1..1Start and end time of administration
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer ΣI0..*BackboneElementWho performed the medication administration and what they did
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptType of performance
Binding: MedicationAdministration Performer Function Codes (example)
.... actor Σ1..1Reference(QICorePractitioner | QICorePatient | QICoreRelatedPerson | QICoreDevice)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (example)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication was administered
... request 0..1Reference(QICoreMedicationRequest)Request administration performed against
... device 0..*Reference(QICoreDevice)Device used to administer
... note 0..*AnnotationInformation about the administration
... dosage I0..1BackboneElementDetails of how medication was taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)
.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (example)
.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example)
.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration I0..*Administration of medication to a patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... instantiates Σ0..*uriInstantiates protocol or definition
... partOf Σ0..*Reference(MedicationAdministration | Procedure)Part of referenced event
... status ?!SΣ1..1codein-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required)
... statusReason S0..*CodeableConceptReason administration not performed
Binding: SNOMEDCTReasonMedicationNotGivenCodes (example)
... category 0..1CodeableConceptType of medication usage
Binding: MedicationAdministration Category Codes (preferred)
... medication[x] SΣ1..1What was administered
Binding: US Core Medication Codes (RxNorm) (preferred)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(StructureDefinition-qicore-medication.html)
... subject SΣ1..1Reference(QICorePatient)Who received medication
... context S0..1Reference(QICoreEncounter | EpisodeOfCare)Encounter or Episode of Care administered as part of
... supportingInformation 0..*Reference(Resource)Additional information to support administration
... effective[x] SΣ1..1Start and end time of administration
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer ΣI0..*BackboneElementWho performed the medication administration and what they did
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptType of performance
Binding: MedicationAdministration Performer Function Codes (example)
.... actor Σ1..1Reference(QICorePractitioner | QICorePatient | QICoreRelatedPerson | QICoreDevice)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
Binding: ReasonMedicationGivenCodes (example)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication was administered
... request 0..1Reference(QICoreMedicationRequest)Request administration performed against
... device 0..*Reference(QICoreDevice)Device used to administer
... note 0..*AnnotationInformation about the administration
... dosage I0..1BackboneElementDetails of how medication was taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)
.... route S0..1CodeableConceptPath of substance into body
Binding: SNOMEDCTRouteCodes (example)
.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example)
.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity
... eventHistory 0..*Reference(Provenance)A list of events of interest in the lifecycle

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet
MedicationAdministration.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationAdministration.statusrequiredMedicationAdministration Status Codes
MedicationAdministration.statusReasonexampleSNOMEDCTReasonMedicationNotGivenCodes
MedicationAdministration.categorypreferredMedicationAdministration Category Codes
MedicationAdministration.medication[x]preferredUSCoreMedicationCodes
MedicationAdministration.performer.functionexampleMedicationAdministration Performer Function Codes
MedicationAdministration.reasonCodeexampleReasonMedicationGivenCodes
MedicationAdministration.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationAdministration.dosage.routeexampleSNOMEDCTRouteCodes
MedicationAdministration.dosage.methodexampleSNOMEDCTAdministrationMethodCodes

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2MedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-4MedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3MedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6MedicationAdministrationA resource should have narrative for robust management
: text.div.exists()
dom-5MedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
ele-1MedicationAdministration.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationAdministration.dosageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
mad-1MedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()