Canonical URL: http://fhir.de/StructureDefinition/medication-de-basis/0.2
| Medication | 0..* | Medication | Short description Definition of a Medication DefinitionThis resource is primarily used for the identification and definition of a medication. It covers the ingredients and the packaging for a medication.
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| code | Σ | 1..1 | CodeableConcept | Short description Codes that identify this medication DefinitionA code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems. Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc.
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| coding | Σ | 0..* | Coding | Short description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. Unordered, Open, by system(Value) Constraints
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| pzn | Σ | 0..* | CodingBinding | Short description PZN (Pharmazentralnummer) DefinitionDie Verwendung der PZN ist in Deutschland z.T. verpflichtend. Die Codes können jedoch nicht validiert werden, da der gesamte Katalog der Codes nicht vorliegt. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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.
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| system | Σ | 1..1 | uriFixed Value | Short description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 de-reference to some definition that establish the system clearly and unambiguously.
http://fhir.de/CodeSystem/ifa/pzn
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| version | Σ | 0..1 | string | Short description Version of the system - if relevant DefinitionThe 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. 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.
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| code | Σ | 1..1 | code | Short description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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| display | Σ | 0..1 | string | Short description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | Short description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). 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. 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.
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| text | Σ | 0..1 | string | Short description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| status | Σ | 0..1 | codeBinding | Short description active | inactive | entered-in-error DefinitionA code to indicate if the medication is in active use. This status is not intended to specify if a medication is part of a formulary.
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| isBrand | Σ | 0..1 | boolean | Short description True if a brand DefinitionSet to true if the item is attributable to a specific manufacturer.
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| isOverTheCounter | Σ | 0..1 | boolean | Short description True if medication does not require a prescription DefinitionSet to true if the medication can be obtained without an order from a prescriber.
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| manufacturer | Σ | 0..1 | Reference(Organization) | Short description Manufacturer of the item DefinitionDescribes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| form | 0..1 | CodeableConcept | Short description Darreichungsform DefinitionBeschreibt die Form des Medikaments (Tablette, Tropfen, ...) When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form. medication-form-codes (example) Constraints
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| coding | Σ | 0..* | Coding | Short description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. Unordered, Open, by system(Value) Constraints
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| EDQMDoseForm | Σ | 0..* | CodingBinding | Short description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. edqm-darreichungsform (required) Constraints
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| system | Σ | 1..1 | uriFixed Value | Short description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 de-reference to some definition that establish the system clearly and unambiguously.
urn:oid:0.4.0.127.0.16.1.1.2.1
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| version | Σ | 0..1 | string | Short description Version of the system - if relevant DefinitionThe 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. 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.
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| code | Σ | 1..1 | code | Short description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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| display | Σ | 0..1 | string | Short description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | Short description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). 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. 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.
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| BMP-Darreichungsform | Σ | 0..* | CodingBinding | Short description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. kbv-s-bmp-darreichungsform (required) Constraints
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| system | Σ | 1..1 | uriFixed Value | Short description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 de-reference to some definition that establish the system clearly and unambiguously.
http://fhir.de/CodeSystem/kbv/s-bmp-darreichungsform
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| version | Σ | 0..1 | string | Short description Version of the system - if relevant DefinitionThe 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. 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.
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| code | Σ | 1..1 | code | Short description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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| display | Σ | 0..1 | string | Short description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | Short description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). 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. 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.
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| text | Σ | 0..1 | string | Short description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| ingredient | 0..* | BackboneElement | Short description Wirkstoff DefinitionIdentifies a particular constituent of interest in the product. The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.
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| itemCodeableConcept | 1..1 | CodeableConcept | Short description The product contained DefinitionThe actual ingredient - either a substance (simple ingredient) or another medication. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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| coding | Σ | 0..* | Coding | Short description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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. Unordered, Open, by system(Value) Constraints
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| atc | Σ | 0..* | Coding | Short description ATC-Code DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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.
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| system | Σ | 1..1 | uriFixed Value | Short description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 de-reference to some definition that establish the system clearly and unambiguously.
http://www.whocc.no/atc
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| version | Σ | 0..1 | string | Short description Version of the system - if relevant DefinitionThe 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. 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.
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| code | Σ | 1..1 | code | Short description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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| display | Σ | 0..1 | string | Short description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | Short description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). 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. 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.
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| edqm | Σ | 0..* | Coding | Short description EDQM-Code DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. 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.
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| system | Σ | 1..1 | uriFixed Value | Short description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 de-reference to some definition that establish the system clearly and unambiguously.
urn:oid:0.4.0.127.0.16.1.1.2.1
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| version | Σ | 0..1 | string | Short description Version of the system - if relevant DefinitionThe 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. 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.
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| code | Σ | 1..1 | code | Short description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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| display | Σ | 0..1 | string | Short description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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| userSelected | Σ | 0..1 | boolean | Short description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). 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. 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.
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| text | Σ | 0..1 | string | Short description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| isActive | 0..1 | boolean | Short description Active ingredient indicator DefinitionIndication of whether this ingredient affects the therapeutic action of the drug. True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).
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| amount | 0..1 | Ratio | Short description Quantity of ingredient present DefinitionSpecifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.
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| numerator | Σ | 0..1 | Quantity | Short description Numerator value DefinitionThe value of the numerator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| value | Σ | 0..1 | decimal | Short description Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
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| comparator | Σ ?! | 0..1 | codeBinding | Short description < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. quantity-comparator (required) Constraints
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| unit | Σ | 0..1 | string | Short description Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings may not exceed 1MB in size
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| system | Σ | 0..1 | uriFixed Value | Short description System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
http://unitsofmeasure.org
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| code | Σ | 0..1 | code | Short description Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
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| denominator | Σ | 0..1 | Quantity | Short description Denominator value DefinitionThe value of the denominator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| value | Σ | 0..1 | decimal | Short description Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
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| comparator | Σ ?! | 0..1 | codeBinding | Short description < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. quantity-comparator (required) Constraints
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| unit | Σ | 0..1 | string | Short description Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings may not exceed 1MB in size
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| system | Σ | 0..1 | uriFixed Value | Short description System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
http://unitsofmeasure.org
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| code | Σ | 0..1 | code | Short description Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
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| package | 0..1 | BackboneElement | Short description Details about packaged medications DefinitionInformation that only applies to packages (not products).
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| container | 0..1 | CodeableConcept | Short description E.g. box, vial, blister-pack DefinitionThe kind of container that this package comes as. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. medication-package-form (example) Constraints
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| content | 0..* | BackboneElement | Short description What is in the package DefinitionA set of components that go to make up the described item.
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| item[x] | 1..1 | Short description The item in the package DefinitionIdentifies one of the items in the package. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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| itemCodeableConcept | CodeableConcept | Data Type | ||
| itemReference | Reference(Medication) | Data Type | ||
| amount | 0..1 | SimpleQuantity | Short description Quantity present in the package DefinitionThe amount of the product that is in the package. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| batch | 0..* | BackboneElement | Short description Identifies a single production run DefinitionInformation about a group of medication produced or packaged from one production run.
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| lotNumber | 0..1 | string | Short description Identifier assigned to batch DefinitionThe assigned lot number of a batch of the specified product. Note that FHIR strings may not exceed 1MB in size
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| expirationDate | 0..1 | dateTime | Short description When batch will expire DefinitionWhen this specific batch of product will expire.
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| image | 0..* | Attachment | Short description Picture of the medication DefinitionPhoto(s) or graphic representation(s) of the medication. Note that "image" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg). When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment".
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<Medication> <meta> <profile value="http://fhir.de/StructureDefinition/medication-de-basis/0.2" /> </meta> <code> <coding> <system value="http://fhir.de/CodeSystem/ifa/pzn" /> <code value="87776663" /> </coding> </code> <form> <coding> <system value="urn:oid:0.4.0.127.0.16.1.1.2.1" /> <code value="12200" /> </coding> <coding> <system value="http://fhir.de/CodeSystem/kbv/s-bmp-darreichungsform" /> <code value="TAB" /> </coding> </form> </Medication>
{ "resourceType":"Medication", "meta":{ "profile": [ "http://fhir.de/StructureDefinition/medication-de-basis/0.2" ] }, "code":{ "coding": [ { "system":"http://fhir.de/CodeSystem/ifa/pzn", "code":"87776663" } ] }, "form":{ "coding": [ { "system":"urn:oid:0.4.0.127.0.16.1.1.2.1", "code":"12200" }, { "system":"http://fhir.de/CodeSystem/kbv/s-bmp-darreichungsform", "code":"TAB" } ] } }
Canonical URL: http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2
| MedicationStatement | 0..* | MedicationStatement | Short description Record of medication being taken by a patient DefinitionA record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now, or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information. When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.
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| identifier | Σ | 0..* | Identifier | Short description External identifier DefinitionExternal identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.
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| basedOn | Σ | 0..* | Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest) | Short description Fulfils plan, proposal or order DefinitionA plan, proposal or order that is fulfilled in whole or in part by this event. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationRequest | CarePlan | ProcedureRequest | ReferralRequest) Constraints
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| partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation | MedicationStatement, deutsches Basisprofil (Version 0.2)) | Short description Part of referenced event DefinitionA larger event of which this particular event is a component or step. This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation | MedicationStatement, deutsches Basisprofil (Version 0.2)) Constraints
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| context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | Short description Encounter / Episode associated with MedicationStatement DefinitionThe encounter or episode of care that establishes the context for this MedicationStatement. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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| status | Σ ?! | 1..1 | codeBinding | Short description active | completed | entered-in-error | intended | stopped | on-hold DefinitionA code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally this will be active or completed. MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error). This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. medication-statement-status (required) Constraints
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| category | Σ | 0..1 | CodeableConceptBinding | Short description Type of medication usage DefinitionIndicates where type of medication statement and where the medication is expected to be consumed or administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. medication-statement-category (preferred) Constraints
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| medication[x] | Σ | 1..1 | Short description What medication was taken DefinitionIdentifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example if you require form or lot number, then you must reference the Medication resource. .
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| medicationCodeableConcept | CodeableConcept | Data Type | ||
| medicationReference | Reference(Medication | Medication, deutsches Basisprofil (Version 0.2)) | Data Type Reference(Medication | Medication, deutsches Basisprofil (Version 0.2)) | ||
| effective[x] | Σ | 0..1 | Short description The date/time or interval when the medication was taken DefinitionThe interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true). This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted.
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| effectiveDateTime | dateTime | Data Type | ||
| effectivePeriod | Period | Data Type | ||
| dateAsserted | Σ | 0..1 | dateTime | Short description When the statement was asserted? DefinitionThe date when the medication statement was asserted by the information source.
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| informationSource | 0..1 | Reference(Patient | Practitioner | RelatedPerson | Organization | Patient, deutsches Basisprofil (Version 0.2) | Practitioner, deutsches Basisprofil (Version 0.2)) | Short description Person or organization that provided the information about the taking of this medication DefinitionThe person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g Claim or MedicationRequest. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Practitioner | RelatedPerson | Organization | Patient, deutsches Basisprofil (Version 0.2) | Practitioner, deutsches Basisprofil (Version 0.2)) Constraints
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| subject | Σ | 1..1 | Reference(Patient | Group | Patient, deutsches Basisprofil (Version 0.2)) | Short description Who is/was taking the medication DefinitionThe person, animal or group who is/was taking the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Group | Patient, deutsches Basisprofil (Version 0.2)) Constraints
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| derivedFrom | 0..* | Reference(Resource) | Short description Additional supporting information DefinitionAllows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.
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| taken | Σ ?! | 1..1 | codeBinding | Short description y | n | unk | na DefinitionIndicator of the certainty of whether the medication was taken by the patient. This element is labeled as a modifier because it indicates that the medication was not taken. medication-statement-taken (required) Constraints
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| reasonNotTaken | 0..* | CodeableConcept | Short description True if asserting medication was not given DefinitionA code indicating why the medication was not taken. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. reason-medication-not-taken-codes (example) Constraints
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| reasonCode | 0..* | CodeableConcept | Short description Reason for why the medication is being/was taken DefinitionA reason for why the medication is being/was taken. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.
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| reasonReference | 0..* | Reference(Condition | Observation | Deutsches Basisprofil einer Condition (Version 0.2) | Observation, deutsches Basisprofil (Version 0.2)) | Short description Condition or observation that supports why the medication is being/was taken DefinitionCondition or observation that supports why the medication is being/was taken. This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode. Reference(Condition | Observation | Deutsches Basisprofil einer Condition (Version 0.2) | Observation, deutsches Basisprofil (Version 0.2)) Constraints
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| note | 0..* | Annotation | Short description Further information about the statement DefinitionProvides extra information about the medication statement that is not conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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| dosage | 0..* | Dosage | Short description Details of how medication is/was taken or should be taken DefinitionIndicates how the medication is/was or should be taken by the patient. The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.
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| sequence | Σ | 0..1 | integer | Short description The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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. 32 bit number; for values larger than this, use decimal
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| text | Σ | 0..1 | string | Short description Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. 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. Note that FHIR strings may not exceed 1MB in size
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| additionalInstruction | Σ | 0..* | CodeableConcept | Short description Supplemental instruction - e.g. "with meals" DefinitionSupplemental instruction - e.g. "with meals". Additional instruction such as "Swallow with plenty of water" which may or may not be coded. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. additional-instruction-codes (example) Constraints
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| patientInstruction | Σ | 0..1 | string | Short description Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings may not exceed 1MB in size
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| timing | Σ | 0..1 | Timing | Short description When medication should be administered DefinitionWhen medication should be administered. The timing schedule for giving the medication to the patient. The Schedule 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. This attribute may 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.
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| event | Σ | 0..* | dateTime | Short description When the event occurs DefinitionIdentifies specific times when the event occurs. In an MAR, for instance, you need to take a general specification, and turn it into a precise specification.
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| repeat | Σ | 0..1 | Element | Short description When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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| bounds[x] | Σ | 0..1 | Short description Length/Range of lengths, or (Start and/or end) limits DefinitionEither 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. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| boundsDuration | Duration | Data Type | ||
| boundsRange | Range | Data Type | ||
| boundsPeriod | Period | Data Type | ||
| count | Σ | 0..1 | integer | Short description Number of times to repeat DefinitionA total count of the desired number of repetitions. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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| countMax | Σ | 0..1 | integer | Short description Maximum number of times to repeat DefinitionA maximum value for the count of the desired repetitions (e.g. do something 6-8 times). 32 bit number; for values larger than this, use decimal
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| duration | Σ | 0..1 | decimal | Short description How long when it happens DefinitionHow long this thing happens for when it happens. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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| durationMax | Σ | 0..1 | decimal | Short description How long when it happens (Max) DefinitionThe upper limit of how long this thing happens for when it happens. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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| durationUnit | Σ | 0..1 | codeBinding | Short description s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings may not exceed 1MB in size
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| frequency | Σ | 0..1 | integer | Short description Event occurs frequency times per period DefinitionThe number of times to repeat the action within the specified period / period range (i.e. both period and periodMax provided). 32 bit number; for values larger than this, use decimal
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| frequencyMax | Σ | 0..1 | integer | Short description Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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| period | Σ | 0..1 | decimal | Short description Event occurs frequency times per period DefinitionIndicates 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. Do not use a IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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| periodMax | Σ | 0..1 | decimal | Short description Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Do not use a IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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| periodUnit | Σ | 0..1 | codeBinding | Short description s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings may not exceed 1MB in size
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| dayOfWeek | Σ | 0..* | codeBinding | Short description mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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| timeOfDay | Σ | 0..* | time | Short description Time of day for action DefinitionSpecified time of day for action to take place. 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.
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| when | Σ | 0..* | codeBinding | Short description Regular life events the event is tied to DefinitionReal world events that the occurrence of the event should be tied to. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events.
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| offset | Σ | 0..1 | unsignedInt | Short description Minutes from event (before or after) DefinitionThe 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. 32 bit number; for values larger than this, use decimal
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| code | Σ | 0..1 | CodeableConceptBinding | Short description Einnahmezeitpunkt DefinitionEinnahmezeitpunkt (morgens, mittags, ...) 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 the a structured representation should be used (in this case, specifying the two event times). einnahmezeitpunkte (extensible) Constraints
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| asNeeded[x] | Σ | 0..1 | Short description Take "as needed" (for x) DefinitionIndicates 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). 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". medication-as-needed-reason (example) Constraints
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| asNeededBoolean | boolean | Data Type | ||
| asNeededCodeableConcept | CodeableConcept | Data Type | ||
| site | Σ | 0..1 | CodeableConcept | Short description Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both.
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| route | Σ | 0..1 | CodeableConcept | Short description How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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| method | Σ | 0..1 | CodeableConcept | Short description Technique for administering medication DefinitionTechnique for administering medication. 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. Terminologies used often pre-coordinate this term with the route and or form of administration. administration-method-codes (example) Constraints
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| dose[x] | Σ | 0..1 | Short description Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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| doseRange | Range | Data Type | ||
| doseQuantity | SimpleQuantity | Data Type | ||
| maxDosePerPeriod | Σ | 0..1 | Ratio | Short description Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. 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".
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| maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Short description Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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| maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Short description Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| rate[x] | Σ | 0..1 | Short description Amount of medication per unit of time DefinitionAmount of medication per unit of time. 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. 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.
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| rateRatio | Ratio | Data Type | ||
| rateRange | Range | Data Type | ||
| rateQuantity | SimpleQuantity | Data Type |
<MedicationStatement> <meta> <profile value="http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2" /> </meta> <status value="active" /> <medicationReference> <reference value="/Medication/987654" /> </medicationReference> <effectivePeriod> <start value="2017-08-08" /> </effectivePeriod> <dateAsserted value="2017-08-01" /> <subject> <reference value="Patient/13345" /> </subject> <taken value="y" /> <dosage> <timing> <code> <coding> <system value="http://hl7.org/fhir/v3/TimingEvent" /> <code value="CV" /> </coding> </code> </timing> <doseQuantity> <value value="1" /> <system value="http://fhir.de/CodeSystem/kbv/s-bmp-dosiereinheit" /> <code value="1" /> </doseQuantity> </dosage> </MedicationStatement>
{ "resourceType":"MedicationStatement", "meta":{ "profile": [ "http://fhir.de/StructureDefinition/medicationstatement-de-basis/0.2" ] }, "status":"active", "medicationReference":{ "reference":"/Medication/987654" }, "effectivePeriod":{ "start":"2017-08-08" }, "dateAsserted":"2017-08-01", "subject":{ "reference":"Patient/13345" }, "taken":"y", "dosage": [ { "timing":{ "code":{ "coding": [ { "system":"http://hl7.org/fhir/v3/TimingEvent", "code":"CV" } ] } }, "doseQuantity":{ "value":"1", "system":"http://fhir.de/CodeSystem/kbv/s-bmp-dosiereinheit", "code":"1" } } ] }
Canonical URL: http://fhir.de/StructureDefinition/medicationrequest-de-basis/0.2
| MedicationRequest | 0..* | MedicationRequest | Short description Ordering of medication for patient or group Alternate namesPrescription, Order DefinitionAn order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.
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| extension | 0..* | Extension | Short description Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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| rezept-zusatzinfos | 0..1 | Extension(Complex) | Short description Rezept-Zusatzinformationen Alternate namesextensions, user content DefinitionZusatzinformationen im Kontext von Rezepten (Medikations-Verordnungen) 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. Extension(Complex) Extension URLhttp://fhir.de/StructureDefinition/rezept-zusatzinfos/0.2 Constraints
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| identifier | 0..* | Identifier | Short description External ids for this request DefinitionThis records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.
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| definition | Σ | 0..* | Reference(ActivityDefinition | PlanDefinition) | Short description Protocol or definition DefinitionProtocol or definition followed by this request. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(ActivityDefinition | PlanDefinition) Constraints
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| basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest | MedicationRequest, deutsches Basisprofil (Version 0.2)) | Short description What request fulfills DefinitionA plan or request that is fulfilled in whole or in part by this medication request. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(CarePlan | MedicationRequest | ProcedureRequest | ReferralRequest | MedicationRequest, deutsches Basisprofil (Version 0.2)) Constraints
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| groupIdentifier | Σ | 0..1 | Identifier | Short description gruppierender (zusammenfassender) Identifikator DefinitionEin Identifikator, der allen MedicationRequests gemeinsam ist, die annähernd zur selben Zeit vom selben Autor für den selben Patienten erstellt wurden. Dies kann beispielsweise zur Gruppierung für die in Deutschland üblichen 1..3 Verordnungen auf einem (Papier-)Rezept verwendet werden. Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
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| status | Σ ?! | 0..1 | codeBinding | Short description active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown DefinitionA code specifying the current state of the order. Generally this will be active or completed state. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. medication-request-status (required) Constraints
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| intent | Σ ?! | 1..1 | codeBinding | Short description proposal | plan | order | instance-order DefinitionWhether the request is a proposal, plan, or an original order. It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. medication-request-intent (required) Constraints
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| category | 0..1 | CodeableConceptBinding | Short description Type of medication usage DefinitionIndicates the type of medication order and where the medication is expected to be consumed or administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. medication-request-category (preferred) Constraints
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| priority | Σ | 0..1 | codeBinding | Short description routine | urgent | stat | asap DefinitionIndicates how quickly the Medication Request should be addressed with respect to other requests. Note that FHIR strings may not exceed 1MB in size medication-request-priority (required) Constraints
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| medication[x] | Σ | 1..1 | Short description Medication to be taken DefinitionIdentifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .
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| medicationCodeableConcept | CodeableConcept | Data Type | ||
| medicationReference | Reference(Medication | Medication, deutsches Basisprofil (Version 0.2)) | Data Type Reference(Medication | Medication, deutsches Basisprofil (Version 0.2)) | ||
| subject | Σ | 1..1 | Reference(Patient | Group | Patient, deutsches Basisprofil (Version 0.2)) | Short description Who or group medication request is for DefinitionA link to a resource representing the person or set of individuals to whom the medication will be given. The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified. Reference(Patient | Group | Patient, deutsches Basisprofil (Version 0.2)) Constraints
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| context | 0..1 | Reference(Encounter | EpisodeOfCare) | Short description Created during encounter/admission/stay DefinitionA link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider. SubstanceAdministration->component->EncounterEvent. Reference(Encounter | EpisodeOfCare) Constraints
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| supportingInformation | 0..* | Reference(Resource) | Short description Information to support ordering of the medication DefinitionInclude additional information (for example, patient height and weight) that supports the ordering of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| authoredOn | Σ | 0..1 | dateTime | Short description When request was initially authored DefinitionThe date (and perhaps time) when the prescription was initially written or authored on.
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| requester | Σ | 0..1 | BackboneElement | Short description Who/What requested the Request DefinitionThe individual, organization or device that initiated the request and has responsibility for its activation.
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| agent | Σ | 1..1 | Reference(Practitioner | Organization | Patient | RelatedPerson | Device | Practitioner, deutsches Basisprofil (Version 0.2) | Organisation, deutsches Basisprofil (Version 0.2) | Patient, deutsches Basisprofil (Version 0.2)) | Short description Who ordered the initial medication(s) DefinitionThe healthcare professional responsible for authorizing the initial prescription. It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only. Reference(Practitioner | Organization | Patient | RelatedPerson | Device | Practitioner, deutsches Basisprofil (Version 0.2) | Organisation, deutsches Basisprofil (Version 0.2) | Patient, deutsches Basisprofil (Version 0.2)) Constraints
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| onBehalfOf | Σ | 0..1 | Reference(Organization) | Short description Organization agent is acting for DefinitionThe organization the device or practitioner was acting on behalf of. Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| recorder | 0..1 | Reference(Practitioner | Practitioner, deutsches Basisprofil (Version 0.2)) | Short description Person who entered the request DefinitionThe person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | Practitioner, deutsches Basisprofil (Version 0.2)) Constraints
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| reasonCode | 0..* | CodeableConcept | Short description Reason or indication for writing the prescription DefinitionThe reason or the indication for ordering the medication. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.
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| reasonReference | 0..* | Reference(Condition | Observation | Observation, deutsches Basisprofil (Version 0.2) | Deutsches Basisprofil einer Condition (Version 0.2)) | Short description Condition or Observation that supports why the prescription is being written DefinitionCondition or observation that supports why the medication was ordered. This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode. Reference(Condition | Observation | Observation, deutsches Basisprofil (Version 0.2) | Deutsches Basisprofil einer Condition (Version 0.2)) Constraints
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| note | 0..* | Annotation | Short description Information about the prescription DefinitionExtra information about the prescription that could not be conveyed by the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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| dosageInstruction | 0..* | Dosage | Short description How the medication should be taken DefinitionIndicates how the medication is to be used by the patient. There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.
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| dispenseRequest | 0..1 | BackboneElement | Short description Medication supply authorization DefinitionIndicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.
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| validityPeriod | 0..1 | Period | Short description Time period supply is authorized for DefinitionThis indicates the validity period of a prescription (stale dating the Prescription). Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription. It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.
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| numberOfRepeatsAllowed | 0..1 | positiveInt | Short description Number of refills authorized DefinitionAn integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. If displaying "number of authorized fills", add 1 to this number.
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| quantity | 0..1 | SimpleQuantity | Short description Amount of medication to supply per dispense DefinitionThe amount that is to be dispensed for one fill. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| expectedSupplyDuration | 0..1 | Duration | Short description Number of days supply per dispense DefinitionIdentifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last. In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.
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| performer | 0..1 | Reference(Organization | Organisation, deutsches Basisprofil (Version 0.2)) | Short description Intended dispenser DefinitionIndicates the intended dispensing Organization specified by the prescriber. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Organization | Organisation, deutsches Basisprofil (Version 0.2)) Constraints
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| substitution | 0..1 | BackboneElement | Short description aut-idem-Regelung DefinitionGibt an, ob ein alternatives Präparat (identischer Wirkstoff, Dosis, Form) angegegeben werden darf. Vgl. Definition des allowed-Elements
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| allowed | ?! | 1..1 | boolean | Short description aut-idem Definitionaut-idem-Regelung. false === aut-idem := KEIN Ersetzen durch Produkt eines anderen Herstellers erlaubt true === NICHT aut-idem := Ersetzen durch Produkt eines anderen Herstellers erlaubt This element is labeled as a modifer because whether substitution is allow or not cannot be ignored.
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| reason | 0..1 | CodeableConcept | Short description Why should (not) substitution be made DefinitionIndicates the reason for the substitution, or why substitution must or must not be performed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. HL7 v3 Value Set SubstanceAdminSubstitutionReason (example) Constraints
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| priorPrescription | 0..1 | Reference(MedicationRequest | MedicationRequest, deutsches Basisprofil (Version 0.2)) | Short description An order/prescription that is being replaced DefinitionA link to a resource representing an earlier order related order or prescription. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationRequest | MedicationRequest, deutsches Basisprofil (Version 0.2)) Constraints
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| detectedIssue | 0..* | Reference(DetectedIssue) | Short description Clinical Issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| eventHistory | 0..* | Reference(Provenance) | Short description A list of events of interest in the lifecycle DefinitionLinks to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
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<MedicationRequest> <meta> <profile value="http://fhir.de/StructureDefinition/medicationrequest-de-basis/0.2" /> </meta> <extension url="http://fhir.de/StructureDefinition/rezept-zusatzinfos/0.2"> <extension url="unfall"> <valueBoolean value="true" /> </extension> </extension> <status value="active" /> <intent value="order" /> <medicationReference> <reference value="/Medication/987654" /> </medicationReference> <subject> <reference value="Patient/12345" /> </subject> <requester> <agent> <reference value="Pracitioner/9876" /> </agent> <onBehalfOf> <reference value="Organization/5432" /> </onBehalfOf> </requester> <substitution> <allowed value="true" /> </substitution> </MedicationRequest>
{ "resourceType":"MedicationRequest", "meta":{ "profile": [ "http://fhir.de/StructureDefinition/medicationrequest-de-basis/0.2" ] }, "extension": [ { "url":"http://fhir.de/StructureDefinition/rezept-zusatzinfos/0.2", "extension": [ { "url":"unfall", "valueBoolean":true } ] } ], "status":"active", "intent":"order", "medicationReference":{ "reference":"/Medication/987654" }, "subject":{ "reference":"Patient/12345" }, "requester":{ "agent":{ "reference":"Pracitioner/9876" }, "onBehalfOf":{ "reference":"Organization/5432" } }, "substitution":{ "allowed":true } }
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