Medication IG DE
1.0.0 - STU1

Medication IG DE, published by HL7 Deutschland e.V.. 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/hl7germany/medication-ig-de-r4/ and changes regularly. See the Directory of published versions

Data Type Profile: DosageDgMP - Detailed Descriptions

Active as of 2025-09-17

Definitions for the DosageDgMP data type profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Dosage
Definition

Indicates how the medication is/was taken or should be taken by the patient.

ShortHow the medication is/was taken or should be taken
Control0..*
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies timing.exists()) ) )
DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies %resource.dosageInstruction.doseAndRate.dose.ofType(Quantity).code.distinct().count() = 1 ))
DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. (text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())
FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ) )
FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
2. Dosage.modifierExtension
Definition

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).

ShortExtensions that cannot be ignored even if unrecognized
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
4. Dosage.sequence
Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

ShortThe order of the dosage instructions
Comments

Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

Control0..01
Typeinteger
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Dosage.text
Definition

Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker


Free text dosage instructions e.g. SIG.

ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'Free text dosage instructions e.g. SIG
Comments

Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

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.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Dosage.additionalInstruction
Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Control0..0*
BindingFor example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Dosage.patientInstruction
Definition

Instructions in terms that are understood by the patient or consumer.

ShortPatient or consumer oriented instructions
Control0..01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Dosage.timing
Definition

Wann das Medikament verabreicht werden soll.


When medication should be administered.

ShortWann das Medikament verabreicht werden sollWhen medication should be administered
Comments

Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.


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.

Control0..1
TypeTiming(Timing dgMP)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". 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.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Dosage.asNeeded[x]
Definition

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).

ShortTake "as needed" (for x)
Comments

Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" 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 "prn" or "as needed".

Control0..01
BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1
(example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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.

TypeChoice of: boolean, CodeableConcept
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Dosage.site
Definition

Body site to administer to.

ShortBody site to administer to
Comments

Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Control0..01
BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

A coded concept describing the site location the medicine enters into or onto the body.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

A coded specification of the anatomic site where the medication first enters the body.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Dosage.route
Definition

How drug should enter body.

ShortHow drug should enter body
Comments

Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

Control0..01
BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Dosage.method
Definition

Technique for administering medication.

ShortTechnique for administering medication
Comments

Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


Terminologies used often pre-coordinate this term with the route and or form of administration.

Control0..01
BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

A coded concept describing the technique by which the medicine is administered.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Dosage.doseAndRate
Definition

Die verabreichte Menge des Medikaments.


The amount of medication administered.

ShortMenge des verabreichten MedikamentsAmount of medication administered
Comments

Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

Control0..1*
TypeElement
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Dosage.doseAndRate.type
Definition

The kind of dose or rate specified, for example, ordered or calculated.

ShortThe kind of dose or rate specified
Comments

Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

Control0..01
BindingFor example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1
(example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

The kind of dose or rate specified.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

If the type is not populated, assume to be "ordered".

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Dosage.doseAndRate.dose[x]
Definition

Amount of medication per dose.

ShortAmount of medication per dose
Comments

Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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.

Control0..1
TypeQuantity(SimpleQuantity, SimpleQuantity), Range
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summarytrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 28. Dosage.doseAndRate.dose[x]:doseQuantity
    Slice NamedoseQuantity
    Definition

    Menge des Medikaments pro Dosis.


    Amount of medication per dose.

    ShortMenge des Medikaments pro DosisAmount of medication per dose
    Comments

    Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.


    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.

    Control0..1
    BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
    (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
    TypeQuantity(SimpleQuantity, SimpleQuantity), Range
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    The amount of therapeutic or other substance given at one administration event.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Dosage.doseAndRate.dose[x]:doseQuantity.comparator
    Definition

    Not allowed to be used in this context


    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

    Short< | <= | >= | > - how to understand the value
    Control0..01
    BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

    How the Quantity should be understood and represented.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

    Meaning if MissingIf there is no comparator, then there is no modification of the value
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Dosage.doseAndRate.dose[x]:doseQuantity.unit
    Definition

    A human-readable form of the unit.

    ShortUnit representation
    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Dosage.doseAndRate.dose[x]:doseQuantity.system
    Definition

    The identification of the system that provides the coded form of the unit.

    ShortSystem that defines coded unit form
    Control10..1
    This element is affected by the following invariants: qty-3
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to know the system that defines the coded form of the unit.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Dosage.doseAndRate.dose[x]:doseQuantity.code
    Definition

    A computer processable form of the unit in some unit representation system.

    ShortCoded form of the unit
    Comments

    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

    Control10..1
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Dosage.doseAndRate.rate[x]
    Definition

    Amount of medication per unit of time.

    ShortAmount of medication per unit of time
    Comments

    Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


    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.

    Control0..01
    TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
    Is Modifierfalse
    Summarytrue
    Requirements

    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Dosage.maxDosePerPeriod
    Definition

    Upper limit on medication per unit of time.

    ShortUpper limit on medication per unit of time
    Comments

    Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


    This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

    Control0..01
    TypeRatio
    Is Modifierfalse
    Summarytrue
    Requirements

    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Dosage.maxDosePerAdministration
    Definition

    Upper limit on medication per administration.

    ShortUpper limit on medication per administration
    Comments

    Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


    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.

    Control0..01
    TypeQuantity(SimpleQuantity)
    Is Modifierfalse
    Summarytrue
    Requirements

    The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Dosage.maxDosePerLifetime
    Definition

    Upper limit on medication per lifetime of the patient.

    ShortUpper limit on medication per lifetime of the patient
    Comments

    Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..01
    TypeQuantity(SimpleQuantity)
    Is Modifierfalse
    Summarytrue
    Requirements

    The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. Dosage
    InvariantsDosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
    DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ) )
    FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
    2. Dosage.sequence
    Comments

    Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    4. Dosage.additionalInstruction
    Control0..0
    6. Dosage.patientInstruction
    Control0..0
    8. Dosage.timing
    TypeTiming(Timing dgMP)
    10. Dosage.asNeeded[x]
    Comments

    Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    12. Dosage.site
    Comments

    Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    14. Dosage.route
    Comments

    Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    16. Dosage.method
    Comments

    Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    18. Dosage.doseAndRate
    Comments

    Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..1
    20. Dosage.doseAndRate.type
    Comments

    Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    22. Dosage.doseAndRate.dose[x]
    Comments

    Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    TypeQuantity(SimpleQuantity), Range
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    24. Dosage.doseAndRate.dose[x]:doseQuantity
    Slice NamedoseQuantity
    BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
    (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
    TypeQuantity(SimpleQuantity)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    26. Dosage.doseAndRate.dose[x]:doseQuantity.unit
    Control1..?
    Must Supporttrue
    28. Dosage.doseAndRate.dose[x]:doseQuantity.system
    Control1..?
    Must Supporttrue
    30. Dosage.doseAndRate.dose[x]:doseQuantity.code
    Control1..?
    Must Supporttrue
    32. Dosage.doseAndRate.rate[x]
    Comments

    Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    34. Dosage.maxDosePerPeriod
    Comments

    Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    36. Dosage.maxDosePerAdministration
    Comments

    Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0
    38. Dosage.maxDosePerLifetime
    Comments

    Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

    Control0..0

    Guidance on how to interpret the contents of this table can be foundhere

    0. Dosage
    Definition

    Indicates how the medication is/was taken or should be taken by the patient.

    ShortHow the medication is/was taken or should be taken
    Control0..*
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
    DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies timing.exists()) ) )
    DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies %resource.dosageInstruction.doseAndRate.dose.ofType(Quantity).code.distinct().count() = 1 ))
    DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. (text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())
    FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
    DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
    DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ) )
    FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
    2. Dosage.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    4. Dosage.extension
    Definition

    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.

    ShortAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. Dosage.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      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.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Dosage.sequence
      Definition

      Indicates the order in which the dosage instructions should be applied or interpreted.

      ShortThe order of the dosage instructions
      Comments

      Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

      Control0..0
      Typeinteger
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Dosage.text
      Definition

      Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker

      ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'
      Comments

      Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Dosage.additionalInstruction
      Definition

      Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

      ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
      Comments

      Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

      Control0..0
      BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
      (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

      A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Dosage.patientInstruction
      Definition

      Instructions in terms that are understood by the patient or consumer.

      ShortPatient or consumer oriented instructions
      Control0..0
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Dosage.timing
      Definition

      Wann das Medikament verabreicht werden soll.

      ShortWann das Medikament verabreicht werden soll
      Comments

      Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.

      Control0..1
      TypeTiming(Timing dgMP)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". 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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Dosage.asNeeded[x]
      Definition

      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).

      ShortTake "as needed" (for x)
      Comments

      Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

      Control0..0
      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
      (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

      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.

      TypeChoice of: boolean, CodeableConcept
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Dosage.site
      Definition

      Body site to administer to.

      ShortBody site to administer to
      Comments

      Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

      Control0..0
      BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
      (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

      A coded concept describing the site location the medicine enters into or onto the body.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      A coded specification of the anatomic site where the medication first enters the body.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Dosage.route
      Definition

      How drug should enter body.

      ShortHow drug should enter body
      Comments

      Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

      Control0..0
      BindingFor example codes, see SNOMEDCTRouteCodes
      (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

      A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Dosage.method
      Definition

      Technique for administering medication.

      ShortTechnique for administering medication
      Comments

      Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

      Control0..0
      BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
      (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

      A coded concept describing the technique by which the medicine is administered.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Dosage.doseAndRate
      Definition

      Die verabreichte Menge des Medikaments.

      ShortMenge des verabreichten Medikaments
      Comments

      Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

      Control0..1
      TypeElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Dosage.doseAndRate.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      30. Dosage.doseAndRate.extension
      Definition

      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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 32. Dosage.doseAndRate.type
        Definition

        The kind of dose or rate specified, for example, ordered or calculated.

        ShortThe kind of dose or rate specified
        Comments

        Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

        Control0..0
        BindingFor example codes, see DoseAndRateType
        (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

        The kind of dose or rate specified.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        If the type is not populated, assume to be "ordered".

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Dosage.doseAndRate.dose[x]
        Definition

        Amount of medication per dose.

        ShortAmount of medication per dose
        Comments

        Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

        Control0..1
        TypeQuantity(SimpleQuantity)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Requirements

        The amount of therapeutic or other substance given at one administration event.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 36. Dosage.doseAndRate.dose[x]:doseQuantity
          Slice NamedoseQuantity
          Definition

          Menge des Medikaments pro Dosis.

          ShortMenge des Medikaments pro Dosis
          Comments

          Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.

          Control0..1
          BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          TypeQuantity(SimpleQuantity)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          The amount of therapeutic or other substance given at one administration event.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Dosage.doseAndRate.dose[x]:doseQuantity.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          40. Dosage.doseAndRate.dose[x]:doseQuantity.extension
          Definition

          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.

          ShortAdditional content defined by implementations
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 42. Dosage.doseAndRate.dose[x]:doseQuantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

            Control0..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. Dosage.doseAndRate.dose[x]:doseQuantity.comparator
            Definition

            Not allowed to be used in this context

            Short< | <= | >= | > - how to understand the value
            Control0..0
            BindingThe codes SHALL be taken from QuantityComparator
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. Dosage.doseAndRate.dose[x]:doseQuantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Dosage.doseAndRate.dose[x]:doseQuantity.system
            Definition

            The identification of the system that provides the coded form of the unit.

            ShortSystem that defines coded unit form
            Control1..1
            This element is affected by the following invariants: qty-3
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to know the system that defines the coded form of the unit.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Dosage.doseAndRate.dose[x]:doseQuantity.code
            Definition

            A computer processable form of the unit in some unit representation system.

            ShortCoded form of the unit
            Comments

            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

            Control1..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Dosage.doseAndRate.rate[x]
            Definition

            Amount of medication per unit of time.

            ShortAmount of medication per unit of time
            Comments

            Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

            Control0..0
            TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
            Is Modifierfalse
            Summarytrue
            Requirements

            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.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Dosage.maxDosePerPeriod
            Definition

            Upper limit on medication per unit of time.

            ShortUpper limit on medication per unit of time
            Comments

            Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

            Control0..0
            TypeRatio
            Is Modifierfalse
            Summarytrue
            Requirements

            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.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Dosage.maxDosePerAdministration
            Definition

            Upper limit on medication per administration.

            ShortUpper limit on medication per administration
            Comments

            Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

            Control0..0
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Summarytrue
            Requirements

            The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Dosage.maxDosePerLifetime
            Definition

            Upper limit on medication per lifetime of the patient.

            ShortUpper limit on medication per lifetime of the patient
            Comments

            Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

            Control0..0
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Summarytrue
            Requirements

            The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))