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
Active as of 2022-07-07 |
Definitions for the ch-emed-dosage-structured data type profile.
1. Dosage | |
Definition | Indicates how the medication is/was taken or should be taken by the patient. |
Control | 0..* |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
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. |
Control | 0..1 |
Type | string |
3. Dosage.extension | |
Definition | An Extension |
Control | 0..* |
Type | Extension |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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4. 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). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
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 Names | extensions, user content, modifiers |
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. |
Invariants | Defined on this element ele-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()) |
5. Dosage.sequence | |
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
Control | 0..1 |
Type | integer |
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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
6. Dosage.text | |
Definition | Free text dosage instructions e.g. SIG. |
Control | 0..0 |
Type | string |
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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
7. 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"). |
Control | 0..* |
Binding | For example codes, see SNOMEDCTAdditionalDosageInstructions A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
Type | CodeableConcept |
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. |
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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
8. Dosage.patientInstruction | |
Definition | Instructions in terms that are understood by the patient or consumer. |
Control | 0..1 |
Type | string |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
9. Dosage.timing | |
Definition | When medication should be administered. |
Control | 0..1 |
Type | Timing |
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. |
Comments | 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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
10. Dosage.timing.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
11. Dosage.timing.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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
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. |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.timing.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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12. Dosage.timing.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). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
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 Names | extensions, user content, modifiers |
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. |
Invariants | Defined on this element ele-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()) |
13. Dosage.timing.event | |
Definition | Identifies specific times when the event occurs. |
Control | 0..* |
Type | dateTime |
Requirements | In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
14. Dosage.timing.repeat | |
Definition | A set of rules that describe when the event is scheduled. |
Control | 0..1 |
Type | Element |
Requirements | Many timing schedules are determined by regular repetitions. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) tim-1: if there's a duration, there needs to be duration units (: duration.empty() or durationUnit.exists()) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (: timeOfDay.empty() or when.empty()) tim-2: if there's a period, there needs to be period units (: period.empty() or periodUnit.exists()) tim-4: duration SHALL be a non-negative value (: duration.exists() implies duration >= 0) tim-5: period SHALL be a non-negative value (: period.exists() implies period >= 0) tim-6: If there's a periodMax, there must be a period (: periodMax.empty() or period.exists()) tim-7: If there's a durationMax, there must be a duration (: durationMax.empty() or duration.exists()) tim-8: If there's a countMax, there must be a count (: countMax.empty() or count.exists()) tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))) |
15. Dosage.timing.repeat.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
16. Dosage.timing.repeat.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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
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. |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.timing.repeat.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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17. Dosage.timing.repeat.bounds[x] | |
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. |
Control | 0..1 |
Type | Period |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Dosage.timing.repeat.bounds[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
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18. Dosage.timing.repeat.bounds[x]:boundsPeriod | |
SliceName | boundsPeriod |
Definition | Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule. |
Control | 0..1 |
Type | Period |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
19. Dosage.timing.repeat.bounds[x]:boundsPeriod.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
20. Dosage.timing.repeat.bounds[x]:boundsPeriod.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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
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. |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.timing.repeat.bounds[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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21. Dosage.timing.repeat.bounds[x]:boundsPeriod.start | |
Definition | The start of the period. The boundary is inclusive. |
Control | 0..1 This element is affected by the following invariants: per-1 |
Type | dateTime |
Comments | If the low element is missing, the meaning is that the low boundary is not known. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
22. Dosage.timing.repeat.bounds[x]:boundsPeriod.end | |
Definition | The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. |
Control | 0..1 This element is affected by the following invariants: per-1 |
Type | dateTime |
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. |
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
23. Dosage.timing.repeat.count | |
Definition | A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. |
Control | 0..1 |
Type | positiveInt |
Requirements | Repetitions may be limited by end time or total occurrences. |
Comments | If you have both bounds and count, then this should be understood as within the bounds period, until count times happens. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
24. Dosage.timing.repeat.countMax | |
Definition | If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. |
Control | 0..1 |
Type | positiveInt |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
25. Dosage.timing.repeat.duration | |
Definition | How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. |
Control | 0..1 |
Type | decimal |
Requirements | Some activities are not instantaneous and need to be maintained for a period of time. |
Comments | For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
26. Dosage.timing.repeat.durationMax | |
Definition | If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. |
Control | 0..1 |
Type | decimal |
Requirements | Some activities are not instantaneous and need to be maintained for a period of time. |
Comments | For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
27. Dosage.timing.repeat.durationUnit | |
Definition | The units of time for the duration, in UCUM units. |
Control | 0..1 |
Binding | The codes SHALL be taken from UnitsOfTime A unit of time (units from UCUM). |
Type | code |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
28. Dosage.timing.repeat.frequency | |
Definition | The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. |
Control | 0..1 |
Type | positiveInt |
Meaning if Missing | If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
29. Dosage.timing.repeat.frequencyMax | |
Definition | If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. |
Control | 0..1 |
Type | positiveInt |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
30. Dosage.timing.repeat.period | |
Definition | Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. |
Control | 0..1 |
Type | decimal |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
31. Dosage.timing.repeat.periodMax | |
Definition | If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. |
Control | 0..1 |
Type | decimal |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
32. Dosage.timing.repeat.periodUnit | |
Definition | The units of time for the period in UCUM units. |
Control | 0..1 |
Binding | The codes SHALL be taken from UnitsOfTime A unit of time (units from UCUM). |
Type | code |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
33. Dosage.timing.repeat.dayOfWeek | |
Definition | If one or more days of week is provided, then the action happens only on the specified day(s). |
Control | 0..* |
Binding | The codes SHALL be taken from DaysOfWeek |
Type | code |
Comments | If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
34. Dosage.timing.repeat.timeOfDay | |
Definition | Specified time of day for action to take place. |
Control | 0..* |
Type | time |
Comments | When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
35. Dosage.timing.repeat.when | |
Definition | An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. |
Control | 0..* |
Binding | The codes SHALL be taken from EventTiming Real world event relating to the schedule. |
Type | code |
Must Support | true |
Requirements | Timings are frequently determined by occurrences such as waking, eating and sleep. |
Comments | When more than one event is listed, the event is tied to the union of the specified events. |
Invariants | Defined on this element ch-emed-event-timing: For the representation of the time of administration according to the 1-1-1-1 scheme, the values MORN-NOON-EVE-NIGHT are highly recommended. (: $this='MORN' or $this='NOON' or $this='EVE' or $this='NIGHT') ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
36. Dosage.timing.repeat.offset | |
Definition | The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. |
Control | 0..1 |
Type | unsignedInt |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
37. Dosage.timing.code | |
Definition | A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). |
Control | 0..1 |
Binding | The codes SHOULD be taken from TimingAbbreviation Code for a known / defined timing pattern. |
Type | CodeableConcept |
Comments | BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
38. 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). |
Control | 0..1 |
Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes 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. |
Type | Choice of: boolean, CodeableConcept |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Comments | 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". |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
39. Dosage.site | |
Definition | Body site to administer to. |
Control | 0..1 |
Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes A coded concept describing the site location the medicine enters into or onto the body. |
Type | CodeableConcept |
Requirements | A coded specification of the anatomic site where the medication first enters the body. |
Comments | 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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
40. Dosage.route | |
Definition | How drug should enter body. |
Control | 0..1 |
Binding | The codes SHALL be taken from EDQM - RouteOfAdministration |
Type | CodeableConcept |
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
41. Dosage.route.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
42. Dosage.route.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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
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. |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.route.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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43. Dosage.route.coding | |
Definition | A reference to a code defined by a terminology system. |
Control | 1..* |
Type | Coding |
Must Support | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
44. Dosage.route.coding.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
45. Dosage.route.coding.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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
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. |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.route.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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46. Dosage.route.coding.system | |
Definition | The identification of the code system that defines the meaning of the symbol in the code. |
Control | 1..1 |
Type | uri |
Requirements | Need to be unambiguous about the source of the definition of the symbol. |
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
47. Dosage.route.coding.version | |
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. |
Note | This is a business versionId, not a resource version id (see discussion) |
Control | 0..1 |
Type | string |
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
48. Dosage.route.coding.code | |
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
Control | 1..1 |
Type | code |
Requirements | Need to refer to a particular code in the system. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
49. Dosage.route.coding.display | |
Definition | A representation of the meaning of the code in the system, following the rules of the system. |
Control | 1..1 |
Type | string |
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
50. Dosage.route.coding.userSelected | |
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). |
Control | 0..1 |
Type | boolean |
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
51. Dosage.route.text | |
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
Control | 0..1 |
Type | string |
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
Comments | Very often the text is the same as a displayName of one of the codings. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
52. Dosage.method | |
Definition | Technique for administering medication. |
Control | 0..1 |
Binding | For example codes, see SNOMEDCTAdministrationMethodCodes A coded concept describing the technique by which the medicine is administered. |
Type | CodeableConcept |
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. |
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
53. Dosage.doseAndRate | |
Definition | The amount of medication administered. |
Control | 0..1 |
Type | Element |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
54. 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. |
Control | 0..1 |
Type | string |
55. 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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
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. |
Invariants | Defined on this element ele-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()) |
Slicing | This element introduces a set of slices on Dosage.doseAndRate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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56. Dosage.doseAndRate.type | |
Definition | The kind of dose or rate specified, for example, ordered or calculated. |
Control | 0..1 |
Binding | For example codes, see DoseAndRateType The kind of dose or rate specified. |
Type | CodeableConcept |
Requirements | If the type is not populated, assume to be "ordered". |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
57. Dosage.doseAndRate.dose[x] | |
Definition | Amount of medication per dose. |
Control | 0..1 |
Type | Choice of: Range(CHEMEDRangeWithEmedUnits), Quantity(CHEMEDQuantityWithEmedUnits) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Comments | 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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
58. Dosage.doseAndRate.rate[x] | |
Definition | Amount of medication per unit of time. |
Control | 0..1 |
Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
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. |
Comments | 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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
59. Dosage.maxDosePerPeriod | |
Definition | Upper limit on medication per unit of time. |
Control | 0..1 |
Type | Ratio |
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. |
Comments | 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". |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
60. Dosage.maxDosePerAdministration | |
Definition | Upper limit on medication per administration. |
Control | 0..1 |
Type | Quantity(SimpleQuantity) |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
Comments | 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. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
61. Dosage.maxDosePerLifetime | |
Definition | Upper limit on medication per lifetime of the patient. |
Control | 0..1 |
Type | Quantity(SimpleQuantity) |
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |