Medication IG DE
1.0.0 - STU1
Medication IG DE
1.0.0 - STU1
This page is part of the Medication IG DE (v1.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
| Active as of 2025-09-17 |
Definitions for the DosageDgMP data type profile.
Guidance on how to interpret the contents of this table can be foundhere
| 0. Dosage | |
| Definition | Indicates how the medication is/was taken or should be taken by the patient. |
| Short | How the medication is/was taken or should be taken |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ( (%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(text.exists() and timing.empty() and doseAndRate.empty()) or
(text.empty() and (timing.exists() or doseAndRate.exists()))
)
)DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ( (%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(timing.exists() implies doseAndRate.exists()) and
(doseAndRate.exists() implies timing.exists())
)
)DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ( (%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all(
doseAndRate.exists() implies
%resource.dosageInstruction.doseAndRate.dose.ofType(Quantity).code.distinct().count() = 1
))DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. ( text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(text.exists() and timing.empty() and doseAndRate.empty())
)
implies
(
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).count() = 1
))DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ( (%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(text.exists() and timing.empty() and doseAndRate.empty()) or
(text.empty() and (timing.exists() or doseAndRate.exists()))
)
)DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(timing.exists() and doseAndRate.exists() and text.empty())
)
implies
(
%resource.extension.where(
url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta'
).exists() and
(
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction'
).exists() or
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction'
).exists() or
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction'
).exists()
)
)
)FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(text.exists() and timing.empty() and doseAndRate.empty())
)
implies
(
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).count() = 1
)) |
| 2. Dosage.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 4. Dosage.sequence | |
| Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
| Short | The order of the dosage instructions |
| Comments | Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. 32 bit number; for values larger than this, use decimal |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 6. Dosage.text | |
| Definition | Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker Free text dosage instructions e.g. SIG. |
| Short | Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'Free text dosage instructions e.g. SIG |
| Comments | Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden. Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 8. Dosage.additionalInstruction | |
| Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). |
| Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" |
| Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. |
| Control | 0..0* This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1 (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
| Type | CodeableConcept |
| Summary | true |
| Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 10. Dosage.patientInstruction | |
| Definition | Instructions in terms that are understood by the patient or consumer. |
| Short | Patient or consumer oriented instructions |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 12. Dosage.timing | |
| Definition | Wann das Medikament verabreicht werden soll. When medication should be administered. |
| Short | Wann das Medikament verabreicht werden sollWhen medication should be administered |
| Comments | Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden. This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Timing(Timing dgMP) |
| Must Support | true |
| Summary | true |
| Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 14. Dosage.asNeeded[x] | |
| Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). |
| Short | Take "as needed" (for x) |
| Comments | Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1 (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
| Type | Choice of: boolean, CodeableConcept |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 16. Dosage.site | |
| Definition | Body site to administer to. |
| Short | Body site to administer to |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1 (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)A coded concept describing the site location the medicine enters into or onto the body. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | A coded specification of the anatomic site where the medication first enters the body. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 18. Dosage.route | |
| Definition | How drug should enter body. |
| Short | How drug should enter body |
| Comments | Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. 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. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1 (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 20. Dosage.method | |
| Definition | Technique for administering medication. |
| Short | Technique for administering medication |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. Terminologies used often pre-coordinate this term with the route and or form of administration. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1 (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)A coded concept describing the technique by which the medicine is administered. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 22. Dosage.doseAndRate | |
| Definition | Die verabreichte Menge des Medikaments. The amount of medication administered. |
| Short | Menge des verabreichten MedikamentsAmount of medication administered |
| Comments | Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..1* This element is affected by the following invariants: ele-1 |
| Type | Element |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 24. Dosage.doseAndRate.type | |
| Definition | The kind of dose or rate specified, for example, ordered or calculated. |
| Short | The kind of dose or rate specified |
| Comments | Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. 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. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1 (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)The kind of dose or rate specified. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | If the type is not populated, assume to be "ordered". |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 26. Dosage.doseAndRate.dose[x] | |
| Definition | Amount of medication per dose. |
| Short | Amount of medication per dose |
| Comments | Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Quantity(SimpleQuantity, SimpleQuantity), Range |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Summary | true |
| Requirements | The amount of therapeutic or other substance given at one administration event. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
| 28. Dosage.doseAndRate.dose[x]:doseQuantity | |
| Slice Name | doseQuantity |
| Definition | Menge des Medikaments pro Dosis. Amount of medication per dose. |
| Short | Menge des Medikaments pro DosisAmount of medication per dose |
| Comments | Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Binding | The codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT) |
| Type | Quantity(SimpleQuantity, SimpleQuantity), Range |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Must Support | true |
| Summary | true |
| Requirements | The amount of therapeutic or other substance given at one administration event. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 30. Dosage.doseAndRate.dose[x]:doseQuantity.comparator | |
| Definition | Not allowed to be used in this context How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. |
| Short | < | <= | >= | > - how to understand the value |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Binding | The codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)How the Quantity should be understood and represented. |
| Type | code |
| Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. |
| Meaning if Missing | If there is no comparator, then there is no modification of the value |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 32. Dosage.doseAndRate.dose[x]:doseQuantity.unit | |
| Definition | A human-readable form of the unit. |
| Short | Unit representation |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 10..1 This element is affected by the following invariants: ele-1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 34. Dosage.doseAndRate.dose[x]:doseQuantity.system | |
| Definition | The identification of the system that provides the coded form of the unit. |
| Short | System that defines coded unit form |
| Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
| Control | 10..1 This element is affected by the following invariants: ele-1, qty-3 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to know the system that defines the coded form of the unit. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 36. Dosage.doseAndRate.dose[x]:doseQuantity.code | |
| Definition | A computer processable form of the unit in some unit representation system. |
| Short | Coded form of the unit |
| Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. |
| Control | 10..1 This element is affected by the following invariants: ele-1 |
| Type | code |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 38. Dosage.doseAndRate.rate[x] | |
| Definition | Amount of medication per unit of time. |
| Short | Amount of medication per unit of time |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) |
| Summary | true |
| Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 40. Dosage.maxDosePerPeriod | |
| Definition | Upper limit on medication per unit of time. |
| Short | Upper limit on medication per unit of time |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Type | Ratio |
| Summary | true |
| Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())) |
| 42. Dosage.maxDosePerAdministration | |
| Definition | Upper limit on medication per administration. |
| Short | Upper limit on medication per administration |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Type | Quantity(SimpleQuantity) |
| Is Modifier | false |
| Summary | true |
| Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists()) sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty()) |
| 44. Dosage.maxDosePerLifetime | |
| Definition | Upper limit on medication per lifetime of the patient. |
| Short | Upper limit on medication per lifetime of the patient |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. 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. |
| Control | 0..01 This element is affected by the following invariants: ele-1 |
| Type | Quantity(SimpleQuantity) |
| Is Modifier | false |
| Summary | true |
| Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists()) sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty()) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Dosage | |
| Invariants | DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(text.exists() and timing.empty() and doseAndRate.empty()) or
(text.empty() and (timing.exists() or doseAndRate.exists()))
)
)DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(timing.exists() and doseAndRate.exists() and text.empty())
)
implies
(
%resource.extension.where(
url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta'
).exists() and
(
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction'
).exists() or
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction'
).exists() or
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction'
).exists()
)
)
)FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(text.exists() and timing.empty() and doseAndRate.empty())
)
implies
(
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).count() = 1
)) |
| 2. Dosage.sequence | |
| Comments | Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 4. Dosage.additionalInstruction | |
| Control | 0..0 |
| 6. Dosage.patientInstruction | |
| Control | 0..0 |
| 8. Dosage.timing | |
| Type | Timing(Timing dgMP) |
| 10. Dosage.asNeeded[x] | |
| Comments | Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 12. Dosage.site | |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 14. Dosage.route | |
| Comments | Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 16. Dosage.method | |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 18. Dosage.doseAndRate | |
| Comments | Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..1 |
| 20. Dosage.doseAndRate.type | |
| Comments | Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 22. Dosage.doseAndRate.dose[x] | |
| Comments | Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Type | Quantity(SimpleQuantity), Range |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 24. Dosage.doseAndRate.dose[x]:doseQuantity | |
| Slice Name | doseQuantity |
| Binding | The codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT) |
| Type | Quantity(SimpleQuantity) |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 26. Dosage.doseAndRate.dose[x]:doseQuantity.unit | |
| Control | 1..? |
| Must Support | true |
| 28. Dosage.doseAndRate.dose[x]:doseQuantity.system | |
| Control | 1..? |
| Must Support | true |
| 30. Dosage.doseAndRate.dose[x]:doseQuantity.code | |
| Control | 1..? |
| Must Support | true |
| 32. Dosage.doseAndRate.rate[x] | |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 34. Dosage.maxDosePerPeriod | |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 36. Dosage.maxDosePerAdministration | |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
| 38. Dosage.maxDosePerLifetime | |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Dosage | |
| Definition | Indicates how the medication is/was taken or should be taken by the patient. |
| Short | How the medication is/was taken or should be taken |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ( (%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(text.exists() and timing.empty() and doseAndRate.empty()) or
(text.empty() and (timing.exists() or doseAndRate.exists()))
)
)DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ( (%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(timing.exists() implies doseAndRate.exists()) and
(doseAndRate.exists() implies timing.exists())
)
)DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ( (%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all(
doseAndRate.exists() implies
%resource.dosageInstruction.doseAndRate.dose.ofType(Quantity).code.distinct().count() = 1
))DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. ( text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(text.exists() and timing.empty() and doseAndRate.empty())
)
implies
(
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).count() = 1
))DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ( (%resource.ofType(MedicationRequest).dosageInstruction |
ofType(MedicationDispense).dosageInstruction |
ofType(MedicationStatement).dosage).all(
(text.exists() and timing.empty() and doseAndRate.empty()) or
(text.empty() and (timing.exists() or doseAndRate.exists()))
)
)DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(timing.exists() and doseAndRate.exists() and text.empty())
)
implies
(
%resource.extension.where(
url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta'
).exists() and
(
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction'
).exists() or
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction'
).exists() or
%resource.extension.where(
url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction'
).exists()
)
)
)FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. ( (
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).exists(text.exists() and timing.empty() and doseAndRate.empty())
)
implies
(
(%resource.ofType(MedicationRequest).dosageInstruction |
%resource.ofType(MedicationDispense).dosageInstruction |
%resource.ofType(MedicationStatement).dosage
).count() = 1
)) |
| 2. Dosage.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| XML Format | In the XML format, this property is represented as an attribute. |
| 4. Dosage.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension |
| Standard Status | Normative (from Trial Use) |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Dosage.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 8. Dosage.sequence | |
| Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
| Short | The order of the dosage instructions |
| Comments | Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 10. Dosage.text | |
| Definition | Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker |
| Short | Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf' |
| Comments | Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 12. Dosage.additionalInstruction | |
| Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). |
| Short | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" |
| Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTAdditionalDosageInstructions (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
| Type | CodeableConcept |
| Summary | true |
| Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 14. Dosage.patientInstruction | |
| Definition | Instructions in terms that are understood by the patient or consumer. |
| Short | Patient or consumer oriented instructions |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 16. Dosage.timing | |
| Definition | Wann das Medikament verabreicht werden soll. |
| Short | Wann das Medikament verabreicht werden soll |
| Comments | Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Timing(Timing dgMP) |
| Must Support | true |
| Summary | true |
| Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 18. Dosage.asNeeded[x] | |
| Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). |
| Short | Take "as needed" (for x) |
| Comments | Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
| Type | Choice of: boolean, CodeableConcept |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 20. Dosage.site | |
| Definition | Body site to administer to. |
| Short | Body site to administer to |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)A coded concept describing the site location the medicine enters into or onto the body. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | A coded specification of the anatomic site where the medication first enters the body. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 22. Dosage.route | |
| Definition | How drug should enter body. |
| Short | How drug should enter body |
| Comments | Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTRouteCodes (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 24. Dosage.method | |
| Definition | Technique for administering medication. |
| Short | Technique for administering medication |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see SNOMEDCTAdministrationMethodCodes (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)A coded concept describing the technique by which the medicine is administered. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 26. Dosage.doseAndRate | |
| Definition | Die verabreichte Menge des Medikaments. |
| Short | Menge des verabreichten Medikaments |
| Comments | Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Element |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 28. Dosage.doseAndRate.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| XML Format | In the XML format, this property is represented as an attribute. |
| 30. Dosage.doseAndRate.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension |
| Standard Status | Normative (from Trial Use) |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 32. Dosage.doseAndRate.type | |
| Definition | The kind of dose or rate specified, for example, ordered or calculated. |
| Short | The kind of dose or rate specified |
| Comments | Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | For example codes, see DoseAndRateType (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)The kind of dose or rate specified. |
| Type | CodeableConcept |
| Summary | true |
| Requirements | If the type is not populated, assume to be "ordered". |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 34. Dosage.doseAndRate.dose[x] | |
| Definition | Amount of medication per dose. |
| Short | Amount of medication per dose |
| Comments | Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Quantity(SimpleQuantity) |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Summary | true |
| Requirements | The amount of therapeutic or other substance given at one administration event. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators: |
| 36. Dosage.doseAndRate.dose[x]:doseQuantity | |
| Slice Name | doseQuantity |
| Definition | Menge des Medikaments pro Dosis. |
| Short | Menge des Medikaments pro Dosis |
| Comments | Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Binding | The codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT) |
| Type | Quantity(SimpleQuantity) |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Must Support | true |
| Summary | true |
| Requirements | The amount of therapeutic or other substance given at one administration event. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 38. Dosage.doseAndRate.dose[x]:doseQuantity.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| XML Format | In the XML format, this property is represented as an attribute. |
| 40. Dosage.doseAndRate.dose[x]:doseQuantity.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension |
| Standard Status | Normative (from Trial Use) |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 42. Dosage.doseAndRate.dose[x]:doseQuantity.value | |
| Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value. |
| Short | Numerical value (with implicit precision) |
| Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | decimal |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Precision is handled implicitly in almost all cases of measurement. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 44. Dosage.doseAndRate.dose[x]:doseQuantity.comparator | |
| Definition | Not allowed to be used in this context |
| Short | < | <= | >= | > - how to understand the value |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Binding | The codes SHALL be taken from QuantityComparator (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)How the Quantity should be understood and represented. |
| Type | code |
| Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. |
| Meaning if Missing | If there is no comparator, then there is no modification of the value |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 46. Dosage.doseAndRate.dose[x]:doseQuantity.unit | |
| Definition | A human-readable form of the unit. |
| Short | Unit representation |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 1..1 This element is affected by the following invariants: ele-1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 48. Dosage.doseAndRate.dose[x]:doseQuantity.system | |
| Definition | The identification of the system that provides the coded form of the unit. |
| Short | System that defines coded unit form |
| Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier |
| Control | 1..1 This element is affected by the following invariants: ele-1, qty-3 |
| Type | uri |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to know the system that defines the coded form of the unit. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 50. Dosage.doseAndRate.dose[x]:doseQuantity.code | |
| Definition | A computer processable form of the unit in some unit representation system. |
| Short | Coded form of the unit |
| Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. |
| Control | 1..1 This element is affected by the following invariants: ele-1 |
| Type | code |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 52. Dosage.doseAndRate.rate[x] | |
| Definition | Amount of medication per unit of time. |
| Short | Amount of medication per unit of time |
| Comments | Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Type | Choice of: Ratio, Range, Quantity(SimpleQuantity) |
| Summary | true |
| Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 54. Dosage.maxDosePerPeriod | |
| Definition | Upper limit on medication per unit of time. |
| Short | Upper limit on medication per unit of time |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Type | Ratio |
| Summary | true |
| Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ( (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())) |
| 56. Dosage.maxDosePerAdministration | |
| Definition | Upper limit on medication per administration. |
| Short | Upper limit on medication per administration |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Type | Quantity(SimpleQuantity) |
| Is Modifier | false |
| Summary | true |
| Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))qty-3: If a code for the unit is present, the system SHALL also be present ( code.empty() or system.exists())sqty-1: The comparator is not used on a SimpleQuantity ( comparator.empty()) |
| 58. Dosage.maxDosePerLifetime | |
| Definition | Upper limit on medication per lifetime of the patient. |
| Short | Upper limit on medication per lifetime of the patient |
| Comments | Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen. |
| Control | 0..0 This element is affected by the following invariants: ele-1 |
| Type | Quantity(SimpleQuantity) |
| Is Modifier | false |
| Summary | true |
| Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))qty-3: If a code for the unit is present, the system SHALL also be present ( code.empty() or system.exists())sqty-1: The comparator is not used on a SimpleQuantity ( comparator.empty()) |
IG © 2025+ HL7 Deutschland e.V.. Package de.fhir.medication#1.0.0 based on FHIR 4.0.1. Generated 2025-09-17
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