Generated Narrative: StructureDefinition epa-medication-pzn-ingredient Name Flags Card. Type Description & Constraints Medication C 0..* Medication Definition of a Medication Constraints: epa-med-1 #xD; meta S 0..1 Meta Metadata about the resource #xD; versionId S 0..1 id Version specific identifier #xD; lastUpdated S 0..1 instant When the resource version last changed #xD; contained 0..0 Contained, inline Resources #xD; Slices for extension S 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:rxPrescriptionProcessIdentifier S 0..1 RxPrescriptionProcessIdentifier Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension #xD; extension:isVaccine S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 boolean Vaccine Indicator #xD; extension:drugCategory S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 Coding Value of extension #xD; system S 1..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 1..1 code Category #xD; display S 0..1 string Representation defined by the system #xD; extension:normSizeCode S 0..1 (Complex) Package size according to N-designation URL: http://fhir.de/StructureDefinition/normgroesse #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 0..1 code Value of extension #xD; extension:packaging S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-formulation-packaging-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Packaging of a formulation. #xD; extension:manufacturingInstructions S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-manufacturing-instructions-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Manufacturing instructions for a formulation. #xD; extension:type S 0..1 (Complex) Medication Type URL: https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] 1..1 Coding Value of extension Binding: TI Medication Type ValueSet for PZN-Medication (required) #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; Slices for identifier S 0..* Identifier Business identifier for this medication Slice: Unordered, Open by value:$this #xD; identifier:EPAMedicationUniqueIdentifier S 0..1 EPAMedicationUniqueIdentifier Business identifier for this medication Required Pattern: At least the following #xD; system 1..1 uri The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; identifier:RxOriginatorProcessIdentifier S 0..1 RxOriginatorProcessIdentifier Business identifier for this medication Required Pattern: At least the following #xD; system 1..1 uri The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier #xD; type S 0..1 CodeableConcept Description of identifier #xD; coding S 0..* Coding Code defined by a terminology system #xD; system S 0..1 uri Identity of the terminology system #xD; version S 0..1 string Version of the system - if relevant #xD; code S 0..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; code S 0..1 CodeableConcept Medication in coded form or as free text if necessary #xD; Slices for coding S 1..* Coding Code defined by a terminology system Slice: Unordered, Open by value:$this #xD; coding:pzn S 1..1 Coding Code defined by a terminology system Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn #xD; version S 0..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; coding:atc-de S 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc #xD; version S 1..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; coding:ask S 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask #xD; version S 0..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; text S 0..1 string Plain text representation of the concept #xD; status S 0..1 code Status of Medication Information #xD; manufacturer S 0..1 Reference(Organization) Manufacturer of the Medication #xD; display S 1..1 string Text alternative for the resource #xD; form S 0..1 CodeableConcept Form of Dispensing #xD; Slices for coding S 0..* Coding Code defined by a terminology system Slice: Unordered, Open by value:$this #xD; coding:kbvDarreichungsform S 0..* Coding Code defined by a terminology system Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_DARREICHUNGSFORM (required) Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM #xD; version S 0..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; amount S 0..1 Ratio Amount of drug in package #xD; numerator S 0..1 Quantity Numerator value Binding: UCUMCodes (preferred) #xD; extension S 0..* Extension Extension #xD; Slices for extension Content/Rules for all slices #xD; extension:packagingSize S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-packaging-size-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Package size according to divided quantity #xD; extension:totalQuantity S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Total quantity of the formulation. #xD; value S 0..1 decimal Numerical value (with implicit precision) #xD; unit S 0..1 string Unit representation #xD; system S 0..1 uri System that defines coded unit form #xD; code S 0..1 code Coded form of the unit #xD; denominator S 0..1 Quantity Denominator value Binding: UCUMCodes (preferred) #xD; value S 0..1 decimal Numerical value (with implicit precision) #xD; unit S 0..1 string Unit representation #xD; system S 0..1 uri System that defines coded unit form #xD; code S 0..1 code Coded form of the unit #xD; ingredient S 0..* BackboneElement Active or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs. #xD; Slices for extension S 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:darreichungsform S 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-darreichungsform-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Dosage form of an ingredient in a formulation. #xD; Slices for item[x] S 1..1 CodeableConcept The actual ingredient or content Slice: Unordered, Open by type:$this #xD; item[x]:itemCodeableConcept S 0..1 CodeableConcept Encoded description of the substance or component. #xD; Slices for coding S 0..* Coding Code defined by a terminology system Slice: Unordered, Open by value:$this #xD; Slices for coding Content/Rules for all slices #xD; coding:ask S 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask #xD; version S 0..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; coding:atc-de S 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc #xD; version S 1..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; coding:pzn S 0..* Coding Code defined by a terminology system Required Pattern: At least the following #xD; system S 1..1 uri Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn #xD; version S 0..1 string Version of the system - if relevant #xD; code S 1..1 code Symbol in syntax defined by the system #xD; display S 0..1 string Representation defined by the system #xD; text S 0..1 string Plain text representation of the concept #xD; item[x]:itemReference S 0..0 Medication Ingredients can't have child Medications #xD; isActive S 0..1 boolean Is it an active ingredient? #xD; strength S 0..1 Ratio Strength #xD; Slices for extension Content/Rules for all slices #xD; extension:amountText 0..1 (Complex) Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-amount-extension #xD; url S 1..1 uri identifies the meaning of the extension #xD; value[x] S 1..1 string Free-text amount of an ingredient in a formulation. #xD; numerator S 0..1 Quantity Numerator value Binding: UCUMCodes (preferred) #xD; value S 1..1 decimal Numerical value (with implicit precision) #xD; unit S 0..1 string Unit representation #xD; system S 0..1 uri System that defines coded unit form #xD; code S 0..1 code Coded form of the unit #xD; denominator S 0..1 Quantity Denominator value Binding: UCUMCodes (preferred) #xD; value S 1..1 decimal Numerical value (with implicit precision) #xD; unit S 0..1 string Unit representation #xD; system S 0..1 uri System that defines coded unit form #xD; code S 0..1 code Coded form of the unit #xD; batch S 0..1 BackboneElement Batch Information #xD; lotNumber S 0..1 string Batch Number #xD; Documentation for this format
Defines the medication resource for a PZN ingredient of a compounding medication for the Medication Service in the ePA system. These profiles are intended to inherit from EPAMedication, but due to tooling issues, this inheritance cannot currently be implemented.
gematik GmbH / Dieses Artefakt ist lizenziert unter [Apache License](./license.html), Version 2.0.
This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
Medication code, name, or ingredients must be specified
NewRx/MedicationPrescribed -or- RxFill/MedicationDispensed -or- RxHistoryResponse/MedicationDispensed -or- RxHistoryResponse/MedicationPrescribed
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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.
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.
When the resource last changed - e.g. when the version changed.
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](http://hl7.org/fhir/R4/http.html#read) interaction.
Identifies where the resource comes from
A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) 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.
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.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
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.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
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.
Security Labels from the Healthcare Privacy and Security Classification System.
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.
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.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
This extension is used to track medication prescription transactions between the E-Rezept-Fachdienst and the ePA. The RxPrescriptionProcessIdentifier is generated by the ePA Medication Service and consists of the PrescriptionId and the authoredOn date of the operation parameters request. It ensures consistent referencing and management of medication-related resources across different systems.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Source of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Indicator of whether this is a vaccine.. false - no vaccine (default value) true - vaccine
Extension for indicating the medication category.
Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Description of the therapy-appropriate package size (e.g., N1)
Information on the packaging of a formulation.
Information on transport containers or packaging for a formulation.
Manufacturing instructions regarding the preparation of a formulation (Subscriptio).
Manufacturing instructions for a formulation.
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
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).
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Business identifier for this medication.
The serial number could be included as an identifier.
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
A reference to a code defined by a terminology system.
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.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
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.
Very often the text is the same as a displayName of one of the codings.
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.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Medication in coded form or as free text if necessary
A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.
Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).
A coded concept that defines the type of a medication.
coding.code = //element(*,MedicationType)/DrugCoded/ProductCode coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier coding.display = //element(*,MedicationType)/DrugDescription
RXO-1.1-Requested Give Code.code / RXE-2.1-Give Code.code / RXD-2.1-Dispense/Give Code.code / RXG-4.1-Give Code.code /RXA-5.1-Administered Code.code / RXC-2.1 Component Code
A code to indicate if the medication is in active use.
This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.
This element changes the interpretation of all descriptive attributes.
A coded concept defining if the medication is in active use.
Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.
Here, the actual manufacturer of the medication can be named, primarily in the case of active ingredient mixtures (compounding prescriptions), such as the hospital pharmacy. It is important to note that the licensing organization, as mentioned in the PZN (Pharmaceutical Central Number) data, is not considered the manufacturer.
RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name
Literal reference, Relative, internal or absolute URL
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.
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.
Type the reference refers to (e.g. "Patient")
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).
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.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
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.
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).
Plain text narrative that identifies the resource in addition to the resource reference.
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.
Describes the form of the item. Powder; tablets; capsule.
When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.
A coded concept defining the form of a medication.
coding.code = //element(*,DrugCodedType)/FormCode coding.system = //element(*,DrugCodedType)/FormSourceCode
RXO-5-Requested Dosage Form / RXE-6-Give Dosage Form / RXD-6-Actual Dosage Form / RXG-8-Give Dosage Form / RXA-8-Administered Dosage Form
KBV updates its "Schüsseltabellen" package more often than ePA versions get released. However, the eRezept clients and eRezept service take over new KBV package versions quickly after release and thus hands them over to the ePA Medication Service. Since the Medication Service is potentially fixed onto an older version of the KBV package, it would reject the forwarded eRezept data. In the future, the Medication Service will be enabled to update to the latest KBV package versions without the need for a new ePA release. Since the eRezept *does* check the codes against the latest KBV package version, the Medication Service will not receive any "invalid" codes and clients can rely on the Medication Service data conforming to the latest KBV package.
Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).
Specification of the package size according to divided quantity (e.g., 100, 2x25), only appears in conjunction with "unit" (e.g., 100 Stück).
Package size according to divided quantity
Total quantity of the formulation (without the unit).
Numerical value (with implicit precision)
The value of the measured amount. The value includes an implicit precision in the presentation of the value.
The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Precision is handled implicitly in almost all cases of measurement.
PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
< | <= | >= | > - how to understand the value
How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
If there is no comparator, then there is no modification of the value
This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
How the Quantity should be understood and represented.
There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
The identification of the system that provides the coded form of the unit.
Need to know the system that defines the coded form of the unit.
CO.codeSystem, PQ.translation.codeSystem
A computer processable form of the unit in some unit representation system.
The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
PQ.code, MO.currency, PQ.translation.code
Active or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
Identifies a particular constituent of interest in the product.
The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.
Dosage form of an ingredient in a formulation.
The dosage form as free text can be used if the ingredient in the formulation is not a finished medicinal product.
Extensions that cannot be ignored even if unrecognized
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).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
The actual ingredient - either a substance (simple ingredient) or another medication of a medication.
The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).
RXC-2-Component Code if medication: RXO-1-Requested Give Code / RXE-2-Give Code / RXD-2-Dispense/Give Code / RXG-4-Give Code / RXA-5-Administered Code
Encoded description of the substance or component.
Medication Ingredients can't have child Medications
Indication of whether this ingredient affects the therapeutic action of the drug.
True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).
Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.
RXC-3-Component Amount & RXC-4-Component Units if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units
Free-text amount of the ingredient for classical Latin notations such as "ad 100.0" or "quantum satis," including the unit.
Free-text amount of an ingredient in a formulation.
Information that only applies to packages (not products).
The assigned lot number of a batch of the specified product.
RXA-15 Substance Lot Number / RXG-19 Substance Lot Number
When this specific batch of product will expire.
RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date