CH EMED (R4)
2.1.0 - STU 3 Ballot
CH EMED (R4)
2.1.0 - STU 3 Ballot
This page is part of the CH EMED (R4) (v2.1.0: STU 3) based on FHIR R4. . For a full list of available versions, see the Directory of published versions 
This implementation guide currently describes the unstructured and the structured dosage. For the unstructured form, the dosage is given as free text. With structured dosing, the format 1-1-1-1, meaning the administration time in the morning, at noon, in the evening, at night, is supported. In this case, an additional differentiation is made whether it is a normal or split dosing. For normal dosing, the dose quantity is the same at the defined administration times (e.g. 1-0-0-0, 1-0-1-0). For split dosing, the dose quantity varies depending on the administration time (e.g. 1-0-2-0, 2-1-2-0).
If possible, the structured dosage should be provided. If no structured dosage is available or for complex dosages, the unstructured dosage can be used. To avoid discrepancies between information of the structured and unstructured dosage, it is not possible to indicate both.
The dosage instruction is based on the 6.3.4.6 Dosage Instructions Content Module (1.3.6.1.4.1.19376.1.9.1.3.6) in the IHE Pharmacy Technical Framework Supplement: Community Prescription (PRE).
For the representation of the time of administration according to the 1-1-1-1 scheme, the values MORN-NOON-EVE-NIGHT from the ValueSet EventTiming are highly recommended for the Swiss use.
A code for specifying the route of administration into or onto a patient’s body comes from the ValueSet EDQM - RouteOfAdministration.
The amount of medication administered is represented with SNOMED CT or UCUM codes, which are defined in the ValueSet UnitCode.
The current FHIR representation of the dosage within the defined documents for the exchange of medication information is shown here. The use case and the corresponding examples contain the so-called normal and split dosing.
The implementers are asked here to communicate other dosage forms that are relevant in their environment, so that any expansions can be made in a next step. Or feedback on whether these dosage forms are sufficient would be helpful.
Please add your feedback via the 'Propose a change'-link in the footer of the page.
The normal dosing is represented using one structured dosage element.
| Dosage morning | Dosage noon | Dosage evening | Dosage night | Route of administration |
|---|---|---|---|---|
| 1 | 0 | 1 | 0 | oral |
"dosage" : [
{
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2012-02-04"
},
"when" : [
"MORN",
"EVE"
]
}
},
"route" : {
"coding" : [
{
"system" : "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code" : "20053000",
"display" : "Oral use"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 1,
"unit" : "Tablet (unit of presentation)",
"system" : "http://snomed.info/sct",
"code" : "732936001"
}
}
]
}
]
See the full example: 2-5 Medication Treatment Plan document
The split dosing differs from the normal dosing in that the dosage element can be repeated. In contrast to normal dosing, where the dosage element can occur once, the dosage element can be repeated n times in split dosing. The order of the dosage instructions is defined by the required element sequence.
| Dosage morning | Dosage noon | Dosage evening | Dosage night | Route of administration |
|---|---|---|---|---|
| 1 | 0 | 0.5 | 0 | oral |
"dosage" : [
{
"sequence" : 1,
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2012-02-04"
},
"when" : [
"MORN"
]
}
},
"route" : {
"coding" : [
{
"system" : "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code" : "20053000",
"display" : "Oral use"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 1,
"unit" : "Tablet (unit of presentation)",
"system" : "http://snomed.info/sct",
"code" : "732936001"
}
}
]
},
{
"sequence" : 2,
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2012-02-04"
},
"when" : [
"EVE"
]
}
},
"route" : {
"coding" : [
{
"system" : "urn:oid:0.4.0.127.0.16.1.1.2.1",
"code" : "20053000",
"display" : "Oral use"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 0.5,
"unit" : "Tablet (unit of presentation)",
"system" : "http://snomed.info/sct",
"code" : "732936001"
}
}
]
}
]
See the full example: 2-3 Medication Treatment Plan document