Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions

Resource Profile: InterweaveMedicationAdministration

Official URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-MedicationAdministration Version: 0.1.0
Active as of 2024-06-10 Computable Name: InterweaveMedicationAdministration

Interweave Medication Administration resource profile.

Status: Active: Approved (STU)

Introduction

Describes the event of a patient consuming or otherwise being administered a medication. This may be as simple as swallowing a tablet or it may be a long running infusion. Related resources tie this event to the authorizing prescription, and the specific encounter between patient and health care practitioner.

Mandatory fields

The following fields are mandatory:

  • status - Will generally be set to show that the administration has been completed. For some long running administrations such as infusions it is possible for an administration to be started but not completed or it may be paused while some other process is under way.

  • medicationReference - Care connect have removed medication.codeableConcept in favour of referencing a medication resource, meaning that we have to model the medication resource. the reference.display field should be populated with the name of the medication which will be a DM&D description.

  • subject – A reference to the patient who the request is for. To aid the data consumer, the display element should contain the patient’s name.

  • effective – An important field to provide details of the time/time period during which the medication was administered.

Must Support fields

In addition, the following fields are “Must Support” - i.e. they must be populated if relevant and known:

  • category – We update the valueset used to populated this field, to include the additional code of “discharge”, which is present in R4. We also make this a required binding, as currently it is an example only.

  • identifier – a Local Id should be provided, such that could be quoted if manually getting in touch to find out more

  • context - This field is renamed to Encounter in R4. Here we limit the field to only allow references to an encounter resource. For a repeat prescriptions, this is the encounter where the repeat was authorised. For all others this is the encounter where the specific issue was authorised.

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Optional fields to note include:

  • performer - Required to populate if known. The main purpose would be to provide details of a Practitioner who can give more information about the condition. Therefore it should not be populated with details of purely admin staff who may have keyed in the data. If the asserter is not populated then an unknown Practitioner should be assumed.

    A further consideration is the possibility of a Condition being asserted by a non-care-professional, for example the Patient themselves or a relative. FHIR caters for this possibiity by allowing the asserter to be a Patient or RelatedPerson, and this option is left open here.

  • reasonReference – Option to provide more detailed information via Observation and/or a condition resource which represent the reason for the medication.

  • prescription - Link to the MedicationRequest that this MedicationAdministration is based on.

  • reasonNotGiven - A set of codes indicating the reason why the administration was not performed.

  • device - The device used in administering the medication to the patient. For example, a particular infusion pump.

  • note - Extra information about the medication administration that is not conveyed by the other attributes.

  • dosage - Details of how medication was taken, dosage information details e.g. dose (The amount of the medication given at one administration event.), rate (Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion), site, route, method (A coded value indicating the method by which the medication is intended to be or was introduced into or on the body(most commonly used for injections)) etc.

Discouraged or Removed fields

  • definition – This field has been removed in R4 and we have done the same in our specification to keep it inline.

  • partOf – It is not the intention to create a complex grouping or hierarchy of medication information, a simple flat structure is informative and preferred. Therefore,this fields have been removed.

  • supportingInformation – Removed. This field allows reference to any type of resource which is very open and may cause confusion to the consumer. GPC also do not use this field

  • eventHistory – Removed. Not required for the shared care record.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CareConnect-MedicationAdministration-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*CareConnect-MedicationAdministration-1Administration of medication to a patient
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... definition 0..0
... partOf 0..0
... status S1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
... category S1..1CodeableConceptType of medication usage
Binding: InterweaveMedicationRequestCategory (required)
.... coding
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... medication[x]:medicationReference S1..1Reference(CareConnect-Medication-1)Reference to the medicatin resource
... subject S1..1Reference(CareConnectPatient1)Who received medication
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Encounter or Episode of Care administered as part of
... supportingInformation 0..0
... effective[x] S1..1PeriodStart and end time of administration
.... start S1..1dateTimeStarting time with inclusive boundary
... performer
.... actor S1..1Reference(Device | CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)Individual who was performing
.... onBehalfOf 0..0
... reasonNotGiven 0..*CodeableConceptReason administration not performed.
Binding: SNOMED CT Reason Medication Not Given Codes (preferred)
... reasonCode 0..*CodeableConceptReason administration performed
Binding: Reason Medication Given Codes (preferred)
... eventHistory 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
MedicationAdministration.categoryrequiredInterweaveMedicationRequestCategory
MedicationAdministration.reasonNotGivenpreferredSNOMED CT Reason Medication Not Given Codes
MedicationAdministration.reasonCodepreferredReason Medication Given Codes
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C0..*CareConnect-MedicationAdministration-1Administration of medication to a patient
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministrationStatus (required): A set of codes indicating the current status of a MedicationAdministration.

... category S1..1CodeableConceptType of medication usage
Binding: InterweaveMedicationRequestCategory (required)
... Slices for medication[x] Σ1..1Reference()What was administered
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationReference SΣ1..1Reference(CareConnect-Medication-1)Reference to the medicatin resource
... subject SΣ1..1Reference(CareConnectPatient1)Who received medication
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Encounter or Episode of Care administered as part of
... effective[x] SΣ1..1PeriodStart and end time of administration
.... start SΣC1..1dateTimeStarting time with inclusive boundary
... performer Σ0..*BackboneElementWho administered substance
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... actor SΣ1..1Reference(Device | CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)Individual who was performing
... notGiven ?!Σ0..1booleanTrue if medication not administered
... reasonNotGiven C0..*CodeableConceptReason administration not performed.
Binding: SNOMED CT Reason Medication Not Given Codes (preferred)
... reasonCode C0..*CodeableConceptReason administration performed
Binding: Reason Medication Given Codes (preferred)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationAdministration.meta.securityextensibleAll Security Labels
MedicationAdministration.meta.tagexampleCommon Tags
MedicationAdministration.meta.tag:SourceexampleCommon Tags
MedicationAdministration.meta.tag:ProvenanceexampleCommon Tags
MedicationAdministration.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
MedicationAdministration.statusrequiredMedicationAdministrationStatus
MedicationAdministration.categoryrequiredInterweaveMedicationRequestCategory
MedicationAdministration.reasonNotGivenpreferredSNOMED CT Reason Medication Not Given Codes
MedicationAdministration.reasonCodepreferredReason Medication Given Codes

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
mad-2errorMedicationAdministrationReason not given is only permitted if NotGiven is true
: reasonNotGiven.empty() or notGiven = true
mad-3errorMedicationAdministrationReason given is only permitted if NotGiven is false
: reasonCode.empty() or notGiven.empty() or notGiven = 'false'
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C0..*CareConnect-MedicationAdministration-1Administration of medication to a patient
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ0..1stringThe value that is unique
Example General: 123456
.... period Σ0..1PeriodTime period when id is/was valid for use
.... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministrationStatus (required): A set of codes indicating the current status of a MedicationAdministration.

... category S1..1CodeableConceptType of medication usage
Binding: InterweaveMedicationRequestCategory (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ1..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... Slices for medication[x] Σ1..1Reference()What was administered
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationReference SΣ1..1Reference(CareConnect-Medication-1)Reference to the medicatin resource
... subject SΣ1..1Reference(CareConnectPatient1)Who received medication
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Encounter or Episode of Care administered as part of
... effective[x] SΣ1..1PeriodStart and end time of administration
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC1..1dateTimeStarting time with inclusive boundary
.... end ΣC0..1dateTimeEnd time with inclusive boundary, if not ongoing
... performer Σ0..*BackboneElementWho administered substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... actor SΣ1..1Reference(Device | CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)Individual who was performing
... notGiven ?!Σ0..1booleanTrue if medication not administered
... reasonNotGiven C0..*CodeableConceptReason administration not performed.
Binding: SNOMED CT Reason Medication Not Given Codes (preferred)
... reasonCode C0..*CodeableConceptReason administration performed
Binding: Reason Medication Given Codes (preferred)
... reasonReference 0..*Reference(CareConnect-Condition-1 | CareConnect-Observation-1)Condition or Observation that supports why the medication was administered
... prescription 0..1Reference(CareConnect-MedicationRequest-1)Request administration performed against
... device 0..*Reference(Device)Device used to administer
... note 0..*AnnotationInformation about the administration
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Individual responsible for the annotation
..... authorStringstring
..... authorReferenceReference(CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)
.... time Σ0..1dateTimeWhen the annotation was made
.... text 1..1stringThe annotation - text content
... dosage C0..1BackboneElementDetails of how medication was taken
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route 0..1CodeableConceptPath of substance into body
Binding: SNOMED CT Route Codes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
Binding: Care Connect Medication Dosage Route (example): A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.


....... id 0..1stringxml:id (or equivalent in JSON)
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... SnomedCTDescriptionId 0..1(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.

.... dose 0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity(SimpleQuantity)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationAdministration.meta.securityextensibleAll Security Labels
MedicationAdministration.meta.tagexampleCommon Tags
MedicationAdministration.meta.tag:SourceexampleCommon Tags
MedicationAdministration.meta.tag:ProvenanceexampleCommon Tags
MedicationAdministration.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
MedicationAdministration.identifier.userequiredIdentifierUse
MedicationAdministration.identifier.typeextensibleIdentifier Type Codes
MedicationAdministration.statusrequiredMedicationAdministrationStatus
MedicationAdministration.categoryrequiredInterweaveMedicationRequestCategory
MedicationAdministration.reasonNotGivenpreferredSNOMED CT Reason Medication Not Given Codes
MedicationAdministration.reasonCodepreferredReason Medication Given Codes
MedicationAdministration.dosage.siteexampleSNOMED CT Anatomical Structure for Administration Site Codes
MedicationAdministration.dosage.routeexampleSNOMED CT Route Codes
MedicationAdministration.dosage.route.coding:snomedCTexampleCare Connect Medication Dosage Route
MedicationAdministration.dosage.methodexampleSNOMED CT Administration Method Codes

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
mad-1errorMedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()

This structure is derived from CareConnect-MedicationAdministration-1

Summary

Mandatory: 5 elements (9 nested mandatory elements)
Must-Support: 18 elements
Fixed Value: 2 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element MedicationAdministration.meta.tag is sliced based on the value of value:system

Differential View

This structure is derived from CareConnect-MedicationAdministration-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*CareConnect-MedicationAdministration-1Administration of medication to a patient
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... definition 0..0
... partOf 0..0
... status S1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
... category S1..1CodeableConceptType of medication usage
Binding: InterweaveMedicationRequestCategory (required)
.... coding
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... medication[x]:medicationReference S1..1Reference(CareConnect-Medication-1)Reference to the medicatin resource
... subject S1..1Reference(CareConnectPatient1)Who received medication
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Encounter or Episode of Care administered as part of
... supportingInformation 0..0
... effective[x] S1..1PeriodStart and end time of administration
.... start S1..1dateTimeStarting time with inclusive boundary
... performer
.... actor S1..1Reference(Device | CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)Individual who was performing
.... onBehalfOf 0..0
... reasonNotGiven 0..*CodeableConceptReason administration not performed.
Binding: SNOMED CT Reason Medication Not Given Codes (preferred)
... reasonCode 0..*CodeableConceptReason administration performed
Binding: Reason Medication Given Codes (preferred)
... eventHistory 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
MedicationAdministration.categoryrequiredInterweaveMedicationRequestCategory
MedicationAdministration.reasonNotGivenpreferredSNOMED CT Reason Medication Not Given Codes
MedicationAdministration.reasonCodepreferredReason Medication Given Codes

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C0..*CareConnect-MedicationAdministration-1Administration of medication to a patient
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministrationStatus (required): A set of codes indicating the current status of a MedicationAdministration.

... category S1..1CodeableConceptType of medication usage
Binding: InterweaveMedicationRequestCategory (required)
... Slices for medication[x] Σ1..1Reference()What was administered
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationReference SΣ1..1Reference(CareConnect-Medication-1)Reference to the medicatin resource
... subject SΣ1..1Reference(CareConnectPatient1)Who received medication
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Encounter or Episode of Care administered as part of
... effective[x] SΣ1..1PeriodStart and end time of administration
.... start SΣC1..1dateTimeStarting time with inclusive boundary
... performer Σ0..*BackboneElementWho administered substance
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... actor SΣ1..1Reference(Device | CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)Individual who was performing
... notGiven ?!Σ0..1booleanTrue if medication not administered
... reasonNotGiven C0..*CodeableConceptReason administration not performed.
Binding: SNOMED CT Reason Medication Not Given Codes (preferred)
... reasonCode C0..*CodeableConceptReason administration performed
Binding: Reason Medication Given Codes (preferred)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationAdministration.meta.securityextensibleAll Security Labels
MedicationAdministration.meta.tagexampleCommon Tags
MedicationAdministration.meta.tag:SourceexampleCommon Tags
MedicationAdministration.meta.tag:ProvenanceexampleCommon Tags
MedicationAdministration.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
MedicationAdministration.statusrequiredMedicationAdministrationStatus
MedicationAdministration.categoryrequiredInterweaveMedicationRequestCategory
MedicationAdministration.reasonNotGivenpreferredSNOMED CT Reason Medication Not Given Codes
MedicationAdministration.reasonCodepreferredReason Medication Given Codes

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorMedicationAdministrationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationAdministrationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorMedicationAdministrationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
mad-2errorMedicationAdministrationReason not given is only permitted if NotGiven is true
: reasonNotGiven.empty() or notGiven = true
mad-3errorMedicationAdministrationReason given is only permitted if NotGiven is false
: reasonCode.empty() or notGiven.empty() or notGiven = 'false'

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration C0..*CareConnect-MedicationAdministration-1Administration of medication to a patient
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ0..1stringThe value that is unique
Example General: 123456
.... period Σ0..1PeriodTime period when id is/was valid for use
.... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... status ?!SΣ1..1codein-progress | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministrationStatus (required): A set of codes indicating the current status of a MedicationAdministration.

... category S1..1CodeableConceptType of medication usage
Binding: InterweaveMedicationRequestCategory (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ1..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... Slices for medication[x] Σ1..1Reference()What was administered
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationReference SΣ1..1Reference(CareConnect-Medication-1)Reference to the medicatin resource
... subject SΣ1..1Reference(CareConnectPatient1)Who received medication
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Encounter or Episode of Care administered as part of
... effective[x] SΣ1..1PeriodStart and end time of administration
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC1..1dateTimeStarting time with inclusive boundary
.... end ΣC0..1dateTimeEnd time with inclusive boundary, if not ongoing
... performer Σ0..*BackboneElementWho administered substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... actor SΣ1..1Reference(Device | CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)Individual who was performing
... notGiven ?!Σ0..1booleanTrue if medication not administered
... reasonNotGiven C0..*CodeableConceptReason administration not performed.
Binding: SNOMED CT Reason Medication Not Given Codes (preferred)
... reasonCode C0..*CodeableConceptReason administration performed
Binding: Reason Medication Given Codes (preferred)
... reasonReference 0..*Reference(CareConnect-Condition-1 | CareConnect-Observation-1)Condition or Observation that supports why the medication was administered
... prescription 0..1Reference(CareConnect-MedicationRequest-1)Request administration performed against
... device 0..*Reference(Device)Device used to administer
... note 0..*AnnotationInformation about the administration
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Individual responsible for the annotation
..... authorStringstring
..... authorReferenceReference(CareConnectPatient1 | CareConnect-RelatedPerson-1 | CareConnect-Practitioner-1)
.... time Σ0..1dateTimeWhen the annotation was made
.... text 1..1stringThe annotation - text content
... dosage C0..1BackboneElementDetails of how medication was taken
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... text 0..1stringFree text dosage instructions e.g. SIG
.... site 0..1CodeableConceptBody site administered to
Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route 0..1CodeableConceptPath of substance into body
Binding: SNOMED CT Route Codes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
Binding: Care Connect Medication Dosage Route (example): A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration.


....... id 0..1stringxml:id (or equivalent in JSON)
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... SnomedCTDescriptionId 0..1(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... method 0..1CodeableConceptHow drug was administered
Binding: SNOMED CT Administration Method Codes (example): A coded concept describing the technique by which the medicine is administered.

.... dose 0..1SimpleQuantityAmount of medication per dose
.... rate[x] 0..1Dose quantity per unit of time
..... rateRatioRatio
..... rateQuantityQuantity(SimpleQuantity)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationAdministration.meta.securityextensibleAll Security Labels
MedicationAdministration.meta.tagexampleCommon Tags
MedicationAdministration.meta.tag:SourceexampleCommon Tags
MedicationAdministration.meta.tag:ProvenanceexampleCommon Tags
MedicationAdministration.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
MedicationAdministration.identifier.userequiredIdentifierUse
MedicationAdministration.identifier.typeextensibleIdentifier Type Codes
MedicationAdministration.statusrequiredMedicationAdministrationStatus
MedicationAdministration.categoryrequiredInterweaveMedicationRequestCategory
MedicationAdministration.reasonNotGivenpreferredSNOMED CT Reason Medication Not Given Codes
MedicationAdministration.reasonCodepreferredReason Medication Given Codes
MedicationAdministration.dosage.siteexampleSNOMED CT Anatomical Structure for Administration Site Codes
MedicationAdministration.dosage.routeexampleSNOMED CT Route Codes
MedicationAdministration.dosage.route.coding:snomedCTexampleCare Connect Medication Dosage Route
MedicationAdministration.dosage.methodexampleSNOMED CT Administration Method Codes

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
mad-1errorMedicationAdministration.dosageSHALL have at least one of dosage.dose or dosage.rate[x]
: dose.exists() or rate.exists()

This structure is derived from CareConnect-MedicationAdministration-1

Summary

Mandatory: 5 elements (9 nested mandatory elements)
Must-Support: 18 elements
Fixed Value: 2 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element MedicationAdministration.meta.tag is sliced based on the value of value:system

 

Other representations of profile: CSV, Excel, Schematron