CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
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CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v2.0.0-cibuild) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AcuteCareHospitalMonthlyReportingMedicationAdministration - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the ach-monthly-medicationadministration resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationAdministration
Definition

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

Short Administration of medication to a patient
Control 0..*
Is Modifier false
Summary false
Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationAdministration.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Short (NHSN-MS) Logical id of this artifactLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control 10..1
Type idstring
Is Modifier false
Must Support true
Summary true
4. MedicationAdministration.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short A set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1
Type uri
Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
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()))
6. MedicationAdministration.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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
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..*
Type Extension
Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary false
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
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. MedicationAdministration.status
Definition

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

Short (NHSN-MS)(QI-Core) in-progress | on-hold | completed | entered-in-error | stopped | unknownin-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control 1..1
Binding The codes SHALL be taken from MedicationAdministration Status Codeshttp://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1)

A set of codes indicating the current status of a MedicationAdministration.

Type code
Is Modifier true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Must Support true
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. MedicationAdministration.statusReason
Definition

A code indicating why the administration was not performed.

Short (NHSN-MS) Reason administration not performedReason administration not performed
Control 0..*
Binding Unless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTReasonMedicationNotGivenCodeshttp://hl7.org/fhir/ValueSet/reason-medication-not-given-codes|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes)
Type CodeableConcept
Is Modifier false
Must Support true
Summary false
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. MedicationAdministration.category
Definition

Indicates where the medication is expected to be consumed or administered.

Short (NHSN-MS) Type of medication usageType of medication usage
Control 0..1
Binding Unless not suitable, these codes SHALL be taken from The codes SHOULD be taken from MedicationAdministration Category Codeshttp://hl7.org/fhir/ValueSet/medication-admin-category|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/medication-admin-category)
Type CodeableConcept
Is Modifier false
Must Support true
Summary false
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. MedicationAdministration.medication[x]
Definition

Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

Short (NHSN-MS)(QI-Core) What was administeredWhat was administered
Comments

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

Control 1..1
Binding For example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

Codes identifying substance or product that can be administered.

Type Choice of: CodeableConcept, Reference(Medication)
[x] Note SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier false
Must Support true
Must Support Types No must-support rules about the choice of types/profiles
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
not-done-extension-present: qicore-notDoneValueSet extension does not exist (extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not())
Slicing This element introduces a set of slices on MedicationAdministration.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 16. MedicationAdministration.medication[x]:medicationCodeableConcept
    Slice Name medicationCodeableConcept
    Definition

    Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

    Short What was administered
    Comments

    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

    Control 01..1
    Binding Unless not suitable, these codes SHALL be taken from For example codes, see MedicationClinicalDrug (20240606) .http://hl7.org/fhir/ValueSet/medication-codes|4.0.1
    (extensible to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4|20240606)
    Type CodeableConcept, Reference(Medication)
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. MedicationAdministration.medication[x]:medicationCodeableConcept.extension:notDoneValueSet
    Slice Name notDoneValueSet
    Definition

    A logical reference (e.g. a reference to ValueSet.url) to a value set/version that identifies a set of possible coded values representing activities that were not requested, ordered, or performed.

    Short (QI-Core) If not administered, Url of a value set of medications not administered
    Control 0..1
    Type Extension(QICore Not Done ValueSet) (Extension Type: canonical(ValueSet))
    Is Modifier false
    Summary false
    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())
    20. MedicationAdministration.medication[x]:medicationReference
    Slice Name medicationReference
    Definition

    Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

    Short What was administered
    Comments

    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

    Control 01..1
    Type Reference(ACH Monthly Event Medication, Medication), CodeableConcept
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. MedicationAdministration.medication[x]:medicationReference.reference
    Definition

    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

    Short Literal reference, Relative, internal or absolute URL
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control 10..1
    This element is affected by the following invariants: ref-1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. MedicationAdministration.subject
    Definition

    The person or animal or group receiving the medication.

    Short (NHSN-MS)(QI-Core) Who received medicationWho received medication
    Control 1..1
    Type Reference(Cross-Measure Patient Profile, Patient, Group)
    Is Modifier false
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. MedicationAdministration.subject.reference
    Definition

    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

    Short (NHSN-MS) Literal reference, Relative, internal or absolute URLLiteral reference, Relative, internal or absolute URL
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control 10..1
    This element is affected by the following invariants: ref-1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. MedicationAdministration.context
    Definition

    The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

    Short (NHSN-MS)(QI-Core) Encounter or Episode of Care administered as part ofEncounter or Episode of Care administered as part of
    Control 0..1
    Type Reference(Encounter, EpisodeOfCare)
    Is Modifier false
    Must Support true
    Must Support Types No must-support rules about the choice of types/profiles
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. MedicationAdministration.context.reference
    Definition

    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

    Short (NHSN-MS) Literal reference, Relative, internal or absolute URLLiteral reference, Relative, internal or absolute URL
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control 10..1
    This element is affected by the following invariants: ref-1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. MedicationAdministration.effective[x]
    Definition

    A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.

    Short (NHSN-MS)(QI-Core) Start and end time of administrationStart and end time of administration
    Control 1..1
    Type Choice of: dateTime, Period
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Must Support Types No must-support rules about the choice of types/profiles
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. MedicationAdministration.reasonCode
    Definition

    A code indicating why the medication was given.

    Short (NHSN-MS) Reason administration performedReason administration performed
    Control 0..*
    Binding For example codes, see ReasonMedicationGivenCodeshttp://hl7.org/fhir/ValueSet/reason-medication-given-codes|4.0.1
    (example to http://hl7.org/fhir/ValueSet/reason-medication-given-codes|4.0.1)

    A set of codes indicating the reason why the MedicationAdministration was made.

    Type CodeableConcept
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. MedicationAdministration.reasonReference
    Definition

    Condition or observation that supports why the medication was administered.

    Short (NHSN-MS) Condition or observation that supports why the medication was administeredCondition or observation that supports why the medication was administered
    Comments

    This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

    Control 0..*
    Type Reference(ACH Monthly Event Condition, Condition, Observation, DiagnosticReport)
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. MedicationAdministration.reasonReference.reference
    Definition

    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

    Short (NHSN-MS) Literal reference, Relative, internal or absolute URLLiteral reference, Relative, internal or absolute URL
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control 10..1
    This element is affected by the following invariants: ref-1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. MedicationAdministration.request
    Definition

    The original request, instruction or authority to perform the administration.

    Short (NHSN-MS)(QI-Core) Request administration performed againstRequest administration performed against
    Comments

    This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

    Control 0..1
    Type Reference(ACH Monthly Event MedicationRequest, MedicationRequest)
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. MedicationAdministration.request.reference
    Definition

    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

    Short (NHSN-MS) Literal reference, Relative, internal or absolute URLLiteral reference, Relative, internal or absolute URL
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control 10..1
    This element is affected by the following invariants: ref-1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. MedicationAdministration.dosage
    Definition

    Describes the medication dosage information details e.g. dose, rate, site, route, etc.

    Short (NHSN-MS) Details of how medication was takenDetails of how medication was taken
    Control 10..1
    Type BackboneElement
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (dose.exists() or rate.exists())
    mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (dose.exists() or rate.exists())
    46. MedicationAdministration.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..*
    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())
    48. MedicationAdministration.dosage.route
    Definition

    A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

    Short (NHSN-MS)(QI-Core) Path of substance into bodyPath of substance into body
    Control 10..1
    Binding Unless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
    (extensible to http://hl7.org/fhir/ValueSet/route-codes)
    Type CodeableConcept
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. MedicationAdministration.dosage.method
    Definition

    A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.

    Short (NHSN-MS) How drug was administeredHow drug was administered
    Comments

    One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.

    Control 0..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
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. MedicationAdministration.dosage.dose
    Definition

    The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

    Short (NHSN-MS)(QI-Core) Amount of medication per doseAmount of medication per dose
    Comments

    If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

    Control 10..1
    Type Quantity(SimpleQuantity)
    Is Modifier false
    Must Support true
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. MedicationAdministration
    2. MedicationAdministration.id
    Short (NHSN-MS) Logical id of this artifact
    Control 1..?
    Must Support true
    4. MedicationAdministration.meta
    6. MedicationAdministration.meta.extension:link-received-date-extension
    Slice Name link-received-date-extension
    Control 0..1
    Type Extension(Received Date) (Extension Type: dateTime)
    8. MedicationAdministration.status
    Short (NHSN-MS)(QI-Core) in-progress | on-hold | completed | entered-in-error | stopped | unknown
    Must Support true
    10. MedicationAdministration.statusReason
    Short (NHSN-MS) Reason administration not performed
    Binding Unless not suitable, these codes SHALL be taken from SNOMEDCTReasonMedicationNotGivenCodes
    (extensible to http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes)
    Must Support true
    12. MedicationAdministration.category
    Short (NHSN-MS) Type of medication usage
    Binding Unless not suitable, these codes SHALL be taken from MedicationAdministration Category Codes
    (extensible to http://hl7.org/fhir/ValueSet/medication-admin-category)
    Must Support true
    14. MedicationAdministration.medication[x]
    Short (NHSN-MS)(QI-Core) What was administered
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Must Support true
    Invariants not-done-extension-present: qicore-notDoneValueSet extension does not exist (extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not())
    Slicing This element introduces a set of slices on MedicationAdministration.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 16. MedicationAdministration.medication[x]:medicationCodeableConcept
      Slice Name medicationCodeableConcept
      Control 0..1
      Binding Unless not suitable, these codes SHALL be taken from MedicationClinicalDrug (20240606) .
      (extensible to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4|20240606)
      Type CodeableConcept
      [x] Note SeeChoice of Data Typesfor further information about how to use [x]
      18. MedicationAdministration.medication[x]:medicationCodeableConcept.extension:notDoneValueSet
      Slice Name notDoneValueSet
      Short (QI-Core) If not administered, Url of a value set of medications not administered
      Control 0..1
      Type Extension(QICore Not Done ValueSet) (Extension Type: canonical(ValueSet))
      20. MedicationAdministration.medication[x]:medicationReference
      Slice Name medicationReference
      Control 0..1
      Type Reference(ACH Monthly Event Medication)
      [x] Note SeeChoice of Data Typesfor further information about how to use [x]
      22. MedicationAdministration.medication[x]:medicationReference.reference
      Control 1..?
      Must Support true
      24. MedicationAdministration.subject
      Short (NHSN-MS)(QI-Core) Who received medication
      Type Reference(Cross-Measure Patient Profile)
      Must Support true
      26. MedicationAdministration.subject.reference
      Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
      Control 1..?
      Must Support true
      28. MedicationAdministration.context
      Short (NHSN-MS)(QI-Core) Encounter or Episode of Care administered as part of
      Must Support true
      30. MedicationAdministration.context.reference
      Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
      Control 1..?
      Must Support true
      32. MedicationAdministration.effective[x]
      Short (NHSN-MS)(QI-Core) Start and end time of administration
      [x] Note SeeChoice of Data Typesfor further information about how to use [x]
      Must Support true
      34. MedicationAdministration.reasonCode
      Short (NHSN-MS) Reason administration performed
      Must Support true
      36. MedicationAdministration.reasonReference
      Short (NHSN-MS) Condition or observation that supports why the medication was administered
      Type Reference(ACH Monthly Event Condition)
      Must Support true
      38. MedicationAdministration.reasonReference.reference
      Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
      Control 1..?
      Must Support true
      40. MedicationAdministration.request
      Short (NHSN-MS)(QI-Core) Request administration performed against
      Type Reference(ACH Monthly Event MedicationRequest)
      Must Support true
      42. MedicationAdministration.request.reference
      Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
      Control 1..?
      Must Support true
      44. MedicationAdministration.dosage
      Short (NHSN-MS) Details of how medication was taken
      Control 1..?
      Must Support true
      46. MedicationAdministration.dosage.route
      Short (NHSN-MS)(QI-Core) Path of substance into body
      Control 1..?
      Binding Unless not suitable, these codes SHALL be taken from SNOMEDCTRouteCodes
      (extensible to http://hl7.org/fhir/ValueSet/route-codes)
      Must Support true
      48. MedicationAdministration.dosage.method
      Short (NHSN-MS) How drug was administered
      Must Support true
      50. MedicationAdministration.dosage.dose
      Short (NHSN-MS)(QI-Core) Amount of medication per dose
      Control 1..?
      Must Support true

      Guidance on how to interpret the contents of this table can be foundhere

      0. MedicationAdministration
      Definition

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

      Short Administration of medication to a patient
      Control 0..*
      Is Modifier false
      Summary false
      Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationAdministration.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      Short (NHSN-MS) Logical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control 1..1
      Type id
      Is Modifier false
      Must Support true
      Summary true
      4. MedicationAdministration.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      Short Metadata about the resource
      Control 0..1
      Type Meta
      Is Modifier false
      Summary true
      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. MedicationAdministration.meta.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
      Is Modifier false
      XML Format In the XML format, this property is represented as an attribute.
      Summary false
      8. MedicationAdministration.meta.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..*
      Type Extension
      Is Modifier false
      Summary false
      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 MedicationAdministration.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. MedicationAdministration.meta.extension:link-received-date-extension
        Slice Name link-received-date-extension
        Definition

        This extension stores the date and time a Resource was received by the processing system (e.g. NHSNLink).

        Short Received Date
        Control 0..1
        Type Extension(Received Date) (Extension Type: dateTime)
        Is Modifier false
        Summary false
        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())
        12. MedicationAdministration.meta.versionId
        Definition

        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

        Short Version specific identifier
        Comments

        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

        Control 0..1
        Type id
        Is Modifier false
        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()))
        14. MedicationAdministration.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        Short When the resource version last changed
        Comments

        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control 0..1
        Type instant
        Is Modifier false
        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. MedicationAdministration.meta.source
        Definition

        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

        Short Identifies where the resource comes from
        Comments

        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

        Control 0..1
        Type uri
        Is Modifier false
        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()))
        18. MedicationAdministration.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        Short Profiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control 0..*
        Type canonical(StructureDefinition)
        Is Modifier false
        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. MedicationAdministration.meta.security
        Definition

        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

        Short Security Labels applied to this resource
        Comments

        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control 0..*
        Binding Unless not suitable, these codes SHALL be taken from All Security Labels
        (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

        Security Labels from the Healthcare Privacy and Security Classification System.

        Type Coding
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. MedicationAdministration.meta.tag
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        Short Tags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control 0..*
        Binding For example codes, see CommonTags
        (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        Type Coding
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationAdministration.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        Short A set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control 0..1
        Type uri
        Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        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()))
        26. MedicationAdministration.language
        Definition

        The base language in which the resource is written.

        Short Language of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control 0..1
        Binding The codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

        A human language.

        Additional Bindings Purpose
        AllLanguages Max Binding
        Type code
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. MedicationAdministration.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        Short Text summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control 0..1
        Type Narrative
        Is Modifier false
        Summary false
        Alternate Names narrative, html, xhtml, display
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. MedicationAdministration.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        Short Contained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control 0..*
        Type Resource
        Is Modifier false
        Summary false
        Alternate Names inline resources, anonymous resources, contained resources
        32. MedicationAdministration.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource. 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..*
        Type Extension
        Is Modifier false
        Summary false
        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())
        34. MedicationAdministration.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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
        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..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summary false
        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
        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())
        36. MedicationAdministration.identifier
        Definition

        Identifiers associated with this Medication Administration that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

        Short External identifier
        Comments

        This is a business identifier, not a resource identifier.

        Note This is a business identifier, not a resource identifier (see discussion)
        Control 0..*
        Type Identifier
        Is Modifier false
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. MedicationAdministration.instantiates
        Definition

        A protocol, guideline, orderset, or other definition that was adhered to in whole or in part by this event.

        Short Instantiates protocol or definition
        Control 0..*
        Type uri
        Is Modifier false
        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()))
        40. MedicationAdministration.partOf
        Definition

        A larger event of which this particular event is a component or step.

        Short Part of referenced event
        Control 0..*
        Type Reference(MedicationAdministration, Procedure)
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationAdministration.status
        Definition

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

        Short (NHSN-MS)(QI-Core) in-progress | on-hold | completed | entered-in-error | stopped | unknown
        Comments

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control 1..1
        Binding The codes SHALL be taken from MedicationAdministration Status Codes
        (required to http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1)

        A set of codes indicating the current status of a MedicationAdministration.

        Type code
        Is Modifier true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MedicationAdministration.statusReason
        Definition

        A code indicating why the administration was not performed.

        Short (NHSN-MS) Reason administration not performed
        Control 0..*
        Binding Unless not suitable, these codes SHALL be taken from SNOMEDCTReasonMedicationNotGivenCodes
        (extensible to http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes)
        Type CodeableConcept
        Is Modifier false
        Must Support true
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. MedicationAdministration.category
        Definition

        Indicates where the medication is expected to be consumed or administered.

        Short (NHSN-MS) Type of medication usage
        Control 0..1
        Binding Unless not suitable, these codes SHALL be taken from MedicationAdministration Category Codes
        (extensible to http://hl7.org/fhir/ValueSet/medication-admin-category)
        Type CodeableConcept
        Is Modifier false
        Must Support true
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationAdministration.medication[x]
        Definition

        Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

        Short (NHSN-MS)(QI-Core) What was administered
        Comments

        If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

        Control 1..1
        Binding For example codes, see SNOMEDCTMedicationCodes
        (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

        Codes identifying substance or product that can be administered.

        Type Choice of: CodeableConcept, Reference(Medication)
        [x] Note SeeChoice of Data Typesfor further information about how to use [x]
        Is Modifier false
        Must Support true
        Must Support Types No must-support rules about the choice of types/profiles
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        not-done-extension-present: qicore-notDoneValueSet extension does not exist (extension.where(url='http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists().not())
        Slicing This element introduces a set of slices on MedicationAdministration.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 50. MedicationAdministration.medication[x]:medicationCodeableConcept
          Slice Name medicationCodeableConcept
          Definition

          Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

          Short What was administered
          Comments

          If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

          Control 0..1
          Binding Unless not suitable, these codes SHALL be taken from MedicationClinicalDrug (20240606) .
          (extensible to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4|20240606)
          Type CodeableConcept
          [x] Note SeeChoice of Data Typesfor further information about how to use [x]
          Is Modifier false
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationAdministration.medication[x]:medicationCodeableConcept.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
          Is Modifier false
          XML Format In the XML format, this property is represented as an attribute.
          Summary false
          54. MedicationAdministration.medication[x]:medicationCodeableConcept.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..*
          Type Extension
          Is Modifier false
          Summary false
          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 MedicationAdministration.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 56. MedicationAdministration.medication[x]:medicationCodeableConcept.extension:notDoneValueSet
            Slice Name notDoneValueSet
            Definition

            A logical reference (e.g. a reference to ValueSet.url) to a value set/version that identifies a set of possible coded values representing activities that were not requested, ordered, or performed.

            Short (QI-Core) If not administered, Url of a value set of medications not administered
            Control 0..1
            Type Extension(QICore Not Done ValueSet) (Extension Type: canonical(ValueSet))
            Is Modifier false
            Summary false
            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())
            58. MedicationAdministration.medication[x]:medicationCodeableConcept.coding
            Definition

            A reference to a code defined by a terminology system.

            Short Code defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control 0..*
            Type Coding
            Is Modifier false
            Summary true
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. MedicationAdministration.medication[x]:medicationCodeableConcept.text
            Definition

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            Short Plain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control 0..1
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary true
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. MedicationAdministration.medication[x]:medicationReference
            Slice Name medicationReference
            Definition

            Identifies the medication that was administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

            Short What was administered
            Comments

            If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

            Control 0..1
            Type Reference(ACH Monthly Event Medication)
            [x] Note SeeChoice of Data Typesfor further information about how to use [x]
            Is Modifier false
            Summary true
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. MedicationAdministration.medication[x]:medicationReference.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
            Is Modifier false
            XML Format In the XML format, this property is represented as an attribute.
            Summary false
            66. MedicationAdministration.medication[x]:medicationReference.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..*
            Type Extension
            Is Modifier false
            Summary false
            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 MedicationAdministration.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 68. MedicationAdministration.medication[x]:medicationReference.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              Short Literal reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control 1..1
              This element is affected by the following invariants: ref-1
              Type string
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Must Support true
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. MedicationAdministration.medication[x]:medicationReference.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              Short Type the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control 0..1
              Binding Unless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

              Aa resource (or, for logical models, the URI of the logical model).

              Type uri
              Is Modifier false
              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()))
              72. MedicationAdministration.medication[x]:medicationReference.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              Short Logical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              Note This is a business identifier, not a resource identifier (see discussion)
              Control 0..1
              Type Identifier
              Is Modifier false
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. MedicationAdministration.medication[x]:medicationReference.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              Short Text alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control 0..1
              Type string
              Is Modifier false
              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()))
              76. MedicationAdministration.subject
              Definition

              The person or animal or group receiving the medication.

              Short (NHSN-MS)(QI-Core) Who received medication
              Control 1..1
              Type Reference(Cross-Measure Patient Profile)
              Is Modifier false
              Must Support true
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. MedicationAdministration.subject.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
              Is Modifier false
              XML Format In the XML format, this property is represented as an attribute.
              Summary false
              80. MedicationAdministration.subject.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..*
              Type Extension
              Is Modifier false
              Summary false
              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 MedicationAdministration.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 82. MedicationAdministration.subject.reference
                Definition

                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
                Comments

                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                Control 1..1
                This element is affected by the following invariants: ref-1
                Type string
                Is Modifier false
                Primitive Value This primitive element may be present, or absent, or replaced by an extension
                Must Support true
                Summary true
                Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. MedicationAdministration.subject.type
                Definition

                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                Short Type the reference refers to (e.g. "Patient")
                Comments

                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                Control 0..1
                Binding Unless not suitable, these codes SHALL be taken from ResourceType
                (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                Aa resource (or, for logical models, the URI of the logical model).

                Type uri
                Is Modifier false
                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()))
                86. MedicationAdministration.subject.identifier
                Definition

                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                Short Logical reference, when literal reference is not known
                Comments

                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                Note This is a business identifier, not a resource identifier (see discussion)
                Control 0..1
                Type Identifier
                Is Modifier false
                Summary true
                Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. MedicationAdministration.subject.display
                Definition

                Plain text narrative that identifies the resource in addition to the resource reference.

                Short Text alternative for the resource
                Comments

                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                Control 0..1
                Type string
                Is Modifier false
                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()))
                90. MedicationAdministration.context
                Definition

                The visit, admission, or other contact between patient and health care provider during which the medication administration was performed.

                Short (NHSN-MS)(QI-Core) Encounter or Episode of Care administered as part of
                Control 0..1
                Type Reference(Encounter, EpisodeOfCare)
                Is Modifier false
                Must Support true
                Must Support Types No must-support rules about the choice of types/profiles
                Summary false
                Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. MedicationAdministration.context.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
                Is Modifier false
                XML Format In the XML format, this property is represented as an attribute.
                Summary false
                94. MedicationAdministration.context.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..*
                Type Extension
                Is Modifier false
                Summary false
                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 MedicationAdministration.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 96. MedicationAdministration.context.reference
                  Definition

                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                  Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
                  Comments

                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                  Control 1..1
                  This element is affected by the following invariants: ref-1
                  Type string
                  Is Modifier false
                  Primitive Value This primitive element may be present, or absent, or replaced by an extension
                  Must Support true
                  Summary true
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. MedicationAdministration.context.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  Short Type the reference refers to (e.g. "Patient")
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                  Control 0..1
                  Binding Unless not suitable, these codes SHALL be taken from ResourceType
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Type uri
                  Is Modifier false
                  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()))
                  100. MedicationAdministration.context.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                  Short Logical reference, when literal reference is not known
                  Comments

                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  Note This is a business identifier, not a resource identifier (see discussion)
                  Control 0..1
                  Type Identifier
                  Is Modifier false
                  Summary true
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. MedicationAdministration.context.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  Short Text alternative for the resource
                  Comments

                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                  Control 0..1
                  Type string
                  Is Modifier false
                  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()))
                  104. MedicationAdministration.supportingInformation
                  Definition

                  Additional information (for example, patient height and weight) that supports the administration of the medication.

                  Short Additional information to support administration
                  Control 0..*
                  Type Reference(Resource)
                  Is Modifier false
                  Summary false
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. MedicationAdministration.effective[x]
                  Definition

                  A specific date/time or interval of time during which the administration took place (or did not take place, when the 'notGiven' attribute is true). For many administrations, such as swallowing a tablet the use of dateTime is more appropriate.

                  Short (NHSN-MS)(QI-Core) Start and end time of administration
                  Control 1..1
                  Type Choice of: dateTime, Period
                  [x] Note SeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifier false
                  Primitive Value This primitive element may be present, or absent, or replaced by an extension
                  Must Support true
                  Must Support Types No must-support rules about the choice of types/profiles
                  Summary true
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. MedicationAdministration.performer
                  Definition

                  Indicates who or what performed the medication administration and how they were involved.

                  Short Who performed the medication administration and what they did
                  Control 0..*
                  Type BackboneElement
                  Is Modifier false
                  Summary true
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. MedicationAdministration.performer.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
                  Is Modifier false
                  XML Format In the XML format, this property is represented as an attribute.
                  Summary false
                  112. MedicationAdministration.performer.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..*
                  Type Extension
                  Is Modifier false
                  Summary false
                  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())
                  114. MedicationAdministration.performer.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..*
                  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())
                  116. MedicationAdministration.performer.function
                  Definition

                  Distinguishes the type of involvement of the performer in the medication administration.

                  Short Type of performance
                  Control 0..1
                  Binding For example codes, see MedicationAdministration Performer Function Codes
                  (example to http://hl7.org/fhir/ValueSet/med-admin-perform-function|4.0.1)

                  A code describing the role an individual played in administering the medication.

                  Type CodeableConcept
                  Is Modifier false
                  Summary false
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  118. MedicationAdministration.performer.actor
                  Definition

                  Indicates who or what performed the medication administration.

                  Short Who performed the medication administration
                  Control 1..1
                  Type Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Device)
                  Is Modifier false
                  Summary true
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  120. MedicationAdministration.reasonCode
                  Definition

                  A code indicating why the medication was given.

                  Short (NHSN-MS) Reason administration performed
                  Control 0..*
                  Binding For example codes, see ReasonMedicationGivenCodes
                  (example to http://hl7.org/fhir/ValueSet/reason-medication-given-codes|4.0.1)

                  A set of codes indicating the reason why the MedicationAdministration was made.

                  Type CodeableConcept
                  Is Modifier false
                  Must Support true
                  Summary false
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  122. MedicationAdministration.reasonReference
                  Definition

                  Condition or observation that supports why the medication was administered.

                  Short (NHSN-MS) Condition or observation that supports why the medication was administered
                  Comments

                  This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode.

                  Control 0..*
                  Type Reference(ACH Monthly Event Condition)
                  Is Modifier false
                  Must Support true
                  Summary false
                  Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  124. MedicationAdministration.reasonReference.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
                  Is Modifier false
                  XML Format In the XML format, this property is represented as an attribute.
                  Summary false
                  126. MedicationAdministration.reasonReference.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..*
                  Type Extension
                  Is Modifier false
                  Summary false
                  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 MedicationAdministration.reasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 128. MedicationAdministration.reasonReference.reference
                    Definition

                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                    Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
                    Comments

                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                    Control 1..1
                    This element is affected by the following invariants: ref-1
                    Type string
                    Is Modifier false
                    Primitive Value This primitive element may be present, or absent, or replaced by an extension
                    Must Support true
                    Summary true
                    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    130. MedicationAdministration.reasonReference.type
                    Definition

                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                    Short Type the reference refers to (e.g. "Patient")
                    Comments

                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                    Control 0..1
                    Binding Unless not suitable, these codes SHALL be taken from ResourceType
                    (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                    Aa resource (or, for logical models, the URI of the logical model).

                    Type uri
                    Is Modifier false
                    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()))
                    132. MedicationAdministration.reasonReference.identifier
                    Definition

                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                    Short Logical reference, when literal reference is not known
                    Comments

                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                    Note This is a business identifier, not a resource identifier (see discussion)
                    Control 0..1
                    Type Identifier
                    Is Modifier false
                    Summary true
                    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    134. MedicationAdministration.reasonReference.display
                    Definition

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    Short Text alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control 0..1
                    Type string
                    Is Modifier false
                    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()))
                    136. MedicationAdministration.request
                    Definition

                    The original request, instruction or authority to perform the administration.

                    Short (NHSN-MS)(QI-Core) Request administration performed against
                    Comments

                    This is a reference to the MedicationRequest where the intent is either order or instance-order. It should not reference MedicationRequests where the intent is any other value.

                    Control 0..1
                    Type Reference(ACH Monthly Event MedicationRequest)
                    Is Modifier false
                    Must Support true
                    Summary false
                    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    138. MedicationAdministration.request.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
                    Is Modifier false
                    XML Format In the XML format, this property is represented as an attribute.
                    Summary false
                    140. MedicationAdministration.request.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..*
                    Type Extension
                    Is Modifier false
                    Summary false
                    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 MedicationAdministration.request.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 142. MedicationAdministration.request.reference
                      Definition

                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                      Short (NHSN-MS) Literal reference, Relative, internal or absolute URL
                      Comments

                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                      Control 1..1
                      This element is affected by the following invariants: ref-1
                      Type string
                      Is Modifier false
                      Primitive Value This primitive element may be present, or absent, or replaced by an extension
                      Must Support true
                      Summary true
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      144. MedicationAdministration.request.type
                      Definition

                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                      Short Type the reference refers to (e.g. "Patient")
                      Comments

                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                      Control 0..1
                      Binding Unless not suitable, these codes SHALL be taken from ResourceType
                      (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                      Aa resource (or, for logical models, the URI of the logical model).

                      Type uri
                      Is Modifier false
                      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()))
                      146. MedicationAdministration.request.identifier
                      Definition

                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                      Short Logical reference, when literal reference is not known
                      Comments

                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                      Note This is a business identifier, not a resource identifier (see discussion)
                      Control 0..1
                      Type Identifier
                      Is Modifier false
                      Summary true
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      148. MedicationAdministration.request.display
                      Definition

                      Plain text narrative that identifies the resource in addition to the resource reference.

                      Short Text alternative for the resource
                      Comments

                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                      Control 0..1
                      Type string
                      Is Modifier false
                      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()))
                      150. MedicationAdministration.device
                      Definition

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

                      Short Device used to administer
                      Control 0..*
                      Type Reference(Device)
                      Is Modifier false
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      152. MedicationAdministration.note
                      Definition

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

                      Short Information about the administration
                      Control 0..*
                      Type Annotation
                      Is Modifier false
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      154. MedicationAdministration.dosage
                      Definition

                      Describes the medication dosage information details e.g. dose, rate, site, route, etc.

                      Short (NHSN-MS) Details of how medication was taken
                      Control 1..1
                      Type BackboneElement
                      Is Modifier false
                      Must Support true
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (dose.exists() or rate.exists())
                      156. MedicationAdministration.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
                      Is Modifier false
                      XML Format In the XML format, this property is represented as an attribute.
                      Summary false
                      158. MedicationAdministration.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..*
                      Type Extension
                      Is Modifier false
                      Summary false
                      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())
                      160. MedicationAdministration.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..*
                      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())
                      162. MedicationAdministration.dosage.text
                      Definition

                      Free text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans.

                      The dosage instructions should reflect the dosage of the medication that was administered.

                      Short Free text dosage instructions e.g. SIG
                      Control 0..1
                      Type string
                      Is Modifier false
                      Primitive Value This primitive element may be present, or absent, or replaced by an extension
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      164. MedicationAdministration.dosage.site
                      Definition

                      A coded specification of the anatomic site where the medication first entered the body. For example, "left arm".

                      Short Body site administered to
                      Comments

                      If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                      Control 0..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
                      Is Modifier false
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      166. MedicationAdministration.dosage.route
                      Definition

                      A code specifying the route or physiological path of administration of a therapeutic agent into or onto the patient. For example, topical, intravenous, etc.

                      Short (NHSN-MS)(QI-Core) Path of substance into body
                      Control 1..1
                      Binding Unless not suitable, these codes SHALL be taken from SNOMEDCTRouteCodes
                      (extensible to http://hl7.org/fhir/ValueSet/route-codes)
                      Type CodeableConcept
                      Is Modifier false
                      Must Support true
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      168. MedicationAdministration.dosage.method
                      Definition

                      A coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV.

                      Short (NHSN-MS) How drug was administered
                      Comments

                      One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.

                      Control 0..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
                      Is Modifier false
                      Must Support true
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      170. MedicationAdministration.dosage.dose
                      Definition

                      The amount of the medication given at one administration event. Use this value when the administration is essentially an instantaneous event such as a swallowing a tablet or giving an injection.

                      Short (NHSN-MS)(QI-Core) Amount of medication per dose
                      Comments

                      If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration.

                      Control 1..1
                      Type Quantity(SimpleQuantity)
                      Is Modifier false
                      Must Support true
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      172. MedicationAdministration.dosage.rate[x]
                      Definition

                      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.

                      Short Dose quantity per unit of time
                      Comments

                      If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.

                      Control 0..1
                      Type Choice of: Ratio, Quantity(SimpleQuantity)
                      [x] Note SeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifier false
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      174. MedicationAdministration.eventHistory
                      Definition

                      A summary of the events of interest that have occurred, such as when the administration was verified.

                      Short A list of events of interest in the lifecycle
                      Comments

                      This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                      Control 0..*
                      Type Reference(Provenance)
                      Is Modifier false
                      Summary false
                      Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))