Medication IG DE
1.0.1 - STU1

Medication IG DE - Downloaded Version 1.0.1 See the Directory of published versions

## Data Type Profile: DosageDgMP - Detailed Descriptions

Active as of 2025-10-20

Definitions for the DosageDgMP data type profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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())) )` ) DosageRequiresGeneratedText: Unabhängig von der Art der Dosierungsangabe (strukturiert oder Freitext) müssen die Extensions GeneratedDosageInstructionsMeta und renderedDosageInstruction vorhanden sein. (`%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 )`) FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer), muss der Wert in dosageInstruction.text mit dem Wert in der Extension renderedDosageInstruction übereinstimmen. (`( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) or ( %resource.ofType(MedicationDispense).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) or ( %resource.ofType(MedicationStatement).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) )`)
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 SNOMEDCTAdditionalDosageInstructions http://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 SNOMEDCTMedicationAsNeededReasonCodes http://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 SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://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 SNOMEDCTRouteCodes http://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 SNOMEDCTAdministrationMethodCodes http://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 DoseAndRateType http://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: type @ $this
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 QuantityComparator http://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())) )` ) DosageRequiresGeneratedText: Unabhängig von der Art der Dosierungsangabe (strukturiert oder Freitext) müssen die Extensions GeneratedDosageInstructionsMeta und renderedDosageInstruction vorhanden sein. (`%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 )`) FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer), muss der Wert in dosageInstruction.text mit dem Wert in der Extension renderedDosageInstruction übereinstimmen. (`( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) or ( %resource.ofType(MedicationDispense).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) or ( %resource.ofType(MedicationStatement).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) )`)
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())) )` ) DosageRequiresGeneratedText: Unabhängig von der Art der Dosierungsangabe (strukturiert oder Freitext) müssen die Extensions GeneratedDosageInstructionsMeta und renderedDosageInstruction vorhanden sein. (`%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 )`) FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer), muss der Wert in dosageInstruction.text mit dem Wert in der Extension renderedDosageInstruction übereinstimmen. (`( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) or ( %resource.ofType(MedicationDispense).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) or ( %resource.ofType(MedicationStatement).exists() and %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) )`)
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: value @ url
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: value @ url
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: type @ $this
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: value @ url
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()`)