AMTS ISiK Implementierungsleitfaden
Version 6.0.0-rc1 - ballot

Resource Profile: ISiKMedikationsInformation - Detailed Descriptions

Active as of 2026-06-10

Definitions for the ISiKMedikationsInformation resource profile.

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

0. MedicationStatement
Definition

A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

ShortRecord of medication being taken by a patient
Comments

When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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. MedicationStatement.id
Definition

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

Shortserverseitige, interne ID des DatensatzesLogical id of this artifact
Comments

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.


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

Control0..1
Typeidstring
Is Modifierfalse
Must Supporttrue
Summarytrue
4. MedicationStatement.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.

ShortVerweis auf die Regeln, nach denen die Ressource erstellt wurdeA set of rules under which this content was created
Comments

Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.


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.

Control0..01
Typeuri
Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. MedicationStatement.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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())
SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. MedicationStatement.extension:acceptedRisk
    Slice NameacceptedRisk
    Definition

    An Extension

    Shortakzeptiertes (in Kauf genommenes) Risiko
    Comments

    Begründung des Must-Support: Folgeinformation der AMTS-Bewertung, sollte auch an nachfolgende Behandelnde übermittelbar sein

    Hinweis: Hier kann ein im Rahmen der Medikation festgestelltes, aber in Kauf genommenes Risiko dokumentiert werden, speziell auch die Begründung und ggf. erforderliche Begleitmaßnahmen.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(ISiK Accepted Risk) (Extension Type: string)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. MedicationStatement.extension:acceptedRisk.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional 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.

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 12. MedicationStatement.extension:acceptedRisk.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      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.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKAcceptedRisk
      14. MedicationStatement.extension:acceptedRisk.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. MedicationStatement.extension:medikationsart
      Slice Namemedikationsart
      Definition

      An Extension

      ShortTherapieart der Medikation
      Comments

      Begründung des Must-Support: von der Fachseite gewünschte Angabe

      Hinweis: Angabe Akut- oder Dauermedikation.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(ISiK Medikationsart) (Extension Type: Coding)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. MedicationStatement.extension:medikationsart.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional 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.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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())
      SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 20. MedicationStatement.extension:medikationsart.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        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.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedikationsart
        22. MedicationStatement.extension:medikationsart.value[x]
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control10..1
        BindingThe codes SHALL be taken from For codes, see ISiKMedikationsartVS
        (required to https://gematik.de/fhir/isik/ValueSet/ISiKMedikationsartVS)
        TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. MedicationStatement.extension:medikationsart.value[x].system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        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.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MedicationStatement.extension:medikationsart.value[x].code
        Definition

        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).

        ShortSymbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. MedicationStatement.extension:medikationsart.value[x].display
        Definition

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortRepresentation defined by the system
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. MedicationStatement.extension:selbstmedikation
        Slice Nameselbstmedikation
        Definition

        An Extension

        ShortSelbstmedikation
        Comments

        Begründung des Must-Support: von der Fachseite gewünschte Angabe

        Hinweis: Flag zur Selbstmedikation.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ISiK Selbstmedikation) (Extension Type: boolean)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. MedicationStatement.extension:selbstmedikation.extension
        Definition

        An Extension


        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.

        ShortExtensionAdditional 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.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-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())
        SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 34. MedicationStatement.extension:selbstmedikation.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          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.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKSelbstmedikation
          36. MedicationStatement.extension:selbstmedikation.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. MedicationStatement.extension:behandlungsziel
          Slice Namebehandlungsziel
          Definition

          An Extension

          ShortBehandlungsziel (textuell)
          Comments

          Begründung des Must-Support: von der Fachseite gewünschte Angabe

          Hinweis: Freitext-Beschreibung des Behandlungsziels.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(ISiK Behandlungsziel) (Extension Type: string)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          40. MedicationStatement.extension:behandlungsziel.extension
          Definition

          An Extension


          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.

          ShortExtensionAdditional 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.

          Control0..0*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-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())
          SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 42. MedicationStatement.extension:behandlungsziel.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            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.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKBehandlungsziel
            44. MedicationStatement.extension:behandlungsziel.value[x]
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control10..1
            Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. MedicationStatement.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).

            ShortExtensions 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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            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 Namesextensions, user content
            Invariantsele-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. MedicationStatement.partOf
            Definition

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

            ShortReferenz auf andere Objekte, deren Bestandteil diese MedikationsInformation istPart of referenced event
            Comments

            Begründung des Must-Support: Abbildung der Zusammenhänge

            Control0..*
            TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
            Is Modifierfalse
            Summarytrue
            Requirements

            This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. MedicationStatement.status
            Definition

            A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

            ShortStatus der Medikationsinformationactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
            Comments

            Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard


            MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).

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

            Control1..1
            BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1
            (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

            A coded concept indicating the current status of a MedicationStatement.

            Typecode
            Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. MedicationStatement.medication[x]
            Definition

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

            ShortAngabe des MedikamentsWhat medication was taken
            Comments

            Begründung des Must-Support: Basisinformation. Siehe Slicing-Definition zur Wahlmöglichkeit zwischen codierter Angabe und Referenz auf Medication-Ressource.


            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.

            Control1..1
            BindingFor 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)

            A coded concept identifying the substance or product being taken.

            TypeChoice of: CodeableConcept, Reference(Medication)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 54. MedicationStatement.medication[x]:medicationCodeableConcept
              Slice NamemedicationCodeableConcept
              Definition

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

              ShortMedikament in codierter Form oder ggf. als FreitextWhat medication was taken
              Comments

              Begründung des Must-Support: Basisinformation

              Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.


              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.

              Control01..1
              BindingFor 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)

              A coded concept identifying the substance or product being taken.

              TypeCodeableConcept, Reference(Medication)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. MedicationStatement.medication[x]:medicationCodeableConcept.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode 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.

              Control0..*
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on MedicationStatement.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ $this
              • 58. MedicationStatement.medication[x]:medicationCodeableConcept.coding:PZN
                Slice NamePZN
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Mehrfachcodierung ist zulässig, da für ein abstraktes Medikament auch mehrere PZN-Codes existieren können, z.B. existieren für Aspirin 3 verschiedene Packungsgrößen.


                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.

                Control0..*
                TypeCoding(ISiKPZNCoding)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. MedicationStatement.medication[x]:medicationCodeableConcept.coding:ATC-DE
                Slice NameATC-DE
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Mehrfachcodierung ist zulässig, da für ein abstraktes Medikament auch mehrere ATC-Codes existieren können, z.B. existieren für Aspirin 4 verschiedene Codes, je nachdem wofür das Medikament angewendet wird.


                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.

                Control0..*
                TypeCoding(ISiKATCCoding)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. MedicationStatement.medication[x]:medicationCodeableConcept.coding:SCT
                Slice NameSCT
                Definition

                A reference to a code defined by a terminology system.

                ShortCode 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.

                Control0..1*
                TypeCoding(ISiKSnomedCTCoding)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "http://snomed.info/sct"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. MedicationStatement.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.

                ShortPlain text representation of the concept
                Comments

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

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. MedicationStatement.medication[x]:medicationReference
                Slice NamemedicationReference
                Definition

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

                ShortReferenz auf das Medikament (Medication-Ressource)What medication was taken
                Comments

                Begründung des Must-Support: Basisinformation

                Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen


                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.

                Control01..1
                TypeReference(Medication, Medication), CodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. MedicationStatement.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.

                ShortLiteral 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.

                Control10..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. MedicationStatement.subject
                Definition

                The person, animal or group who is/was taking the medication.

                ShortReferenz auf den PatientenWho is/was taking the medication
                Comments

                Begründung des Must-Support: Basisinformation

                Control1..1
                TypeReference(Patient, Patient, Group)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. MedicationStatement.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.

                ShortPatienten-LinkLiteral reference, Relative, internal or absolute URL
                Comments

                Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.


                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.

                Control10..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. MedicationStatement.context
                Definition

                The encounter or episode of care that establishes the context for this MedicationStatement.

                ShortReferenz auf den AbteilungskontaktEncounter / Episode associated with MedicationStatement
                Comments

                Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext

                Control0..1
                TypeReference(Encounter, EpisodeOfCare)
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. MedicationStatement.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.

                ShortLiteral reference, Relative, internal or absolute URL
                Comments

                Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.


                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.

                Control10..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. MedicationStatement.effective[x]
                Definition

                The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

                ShortZeitpunkt oder Zeitraum, für den die MedikationsInformation giltThe date/time or interval when the medication is/was/will be taken
                Comments

                Begründung des Must-Support: Basisinformation


                This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

                Control10..1
                TypeChoice of: dateTime, Period
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 80. MedicationStatement.effective[x]:effectiveDateTime
                  Slice NameeffectiveDateTime
                  Definition

                  The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

                  ShortZeitpunkt (Datum oder Datum + Uhrzeit)The date/time or interval when the medication is/was/will be taken
                  Comments

                  Begründung des Must-Support: Basisinformation

                  Festlegung zur Nutzung: An dieser Stelle KANN eine lediglich Datums-genaue Angabe (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe seitens eines bestätigungsrelevanten Systems unterstützt werden. Es KANN auch eine Uhrzeit angegeben werden. Für sekunden-genaue Angaben zur Verabreichung eines Medikaments an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden.


                  This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

                  Control0..1
                  TypedateTime, Period
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  82. MedicationStatement.effective[x]:effectivePeriod
                  Slice NameeffectivePeriod
                  Definition

                  The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

                  ShortZeitraumThe date/time or interval when the medication is/was/will be taken
                  Comments

                  Begründung des Must-Support: Basisinformation

                  Festlegung zur Nutzung: An dieser Stelle KANN eine lediglich Datums-genaue Angabe (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe seitens eines bestätigungsrelevanten Systems unterstützt werden. Es KANN auch eine Uhrzeit angegeben werden. Für sekunden-genaue Angaben zur Verabreichung eines Medikaments an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden.


                  This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.

                  Control0..1
                  TypePeriod, dateTime
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  84. MedicationStatement.effective[x]:effectivePeriod.start
                  Definition

                  The start of the period. The boundary is inclusive.

                  ShortStarting time with inclusive boundary
                  Comments

                  If the low element is missing, the meaning is that the low boundary is not known.

                  Control0..1
                  This element is affected by the following invariants: per-1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. MedicationStatement.effective[x]:effectivePeriod.end
                  Definition

                  The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                  ShortEnd time with inclusive boundary, if not ongoing
                  Comments

                  The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                  Control0..1
                  This element is affected by the following invariants: per-1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. MedicationStatement.dateAsserted
                  Definition

                  The date when the medication statement was asserted by the information source.

                  ShortDatum der Feststellung/des Bekanntwerdens der MedikationsInformationWhen the statement was asserted?
                  Comments

                  Begründung des Must-Support: Nachvollziehbarkeit

                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. MedicationStatement.reasonCode
                  Definition

                  A reason for why the medication is being/was taken.

                  ShortGrund der Medikation (codiert)Reason for why the medication is being/was taken
                  Comments

                  Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.

                  Begründung zu Must-Support: Konsolidierung mit MII.


                  This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.

                  Control0..*
                  BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
                  (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                  A coded concept identifying why the medication is being taken.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. MedicationStatement.reasonCode.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode 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.

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. MedicationStatement.reasonCode.coding.system
                  Definition

                  The identification of the code system that defines the meaning of the symbol in the code.

                  ShortIdentity of the terminology system
                  Comments

                  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.

                  Control10..1
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to be unambiguous about the source of the definition of the symbol.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. MedicationStatement.reasonCode.coding.code
                  Definition

                  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).

                  ShortSymbol in syntax defined by the system
                  Control10..1
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to refer to a particular code in the system.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. MedicationStatement.reasonCode.coding.display
                  Definition

                  A representation of the meaning of the code in the system, following the rules of the system.

                  ShortRepresentation defined by the system
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. MedicationStatement.reasonCode.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.

                  ShortPlain text representation of the concept
                  Comments

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

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. MedicationStatement.reasonReference
                  Definition

                  Condition or observation that supports why the medication is being/was taken.

                  ShortGrund der Medikation (Referenz)Condition or observation that supports why the medication is being/was taken
                  Comments

                  Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.

                  Begründung zu Must-Support: Konsolidierung mit MII.


                  This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.

                  Control0..*
                  TypeReference(Condition, Observation, DiagnosticReport)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. MedicationStatement.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.

                  ShortLiteral 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.

                  Control10..1
                  This element is affected by the following invariants: ref-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. MedicationStatement.note
                  Definition

                  Provides extra information about the medication statement that is not conveyed by the other attributes.

                  ShortZusätzliche Anmerkungen zur MedikationFurther information about the statement
                  Comments

                  Begründung des Must-Support: Fachlich relevante Zusatzinformationen

                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  108. MedicationStatement.note.text
                  Definition

                  The text of the annotation in markdown format.

                  ShortFreitext-NotizThe annotation - text content (as markdown)
                  Comments

                  Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein

                  Control1..1
                  Typemarkdown
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. MedicationStatement.dosage
                  Definition

                  Indicates how the medication is/was or should be taken by the patient.

                  ShortDosierungsangabenDetails of how medication is/was taken or should be taken
                  Comments

                  Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation.

                  Hinweis: Zahlreiche Beispiele zur Dosierungsanweisung sind im Implementierungsleitfaden Medikament von HL7 Deutschland dokumentiert.


                  The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.

                  Control0..*
                  TypeDosage(Dosage DE)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  isik-dosage-as-needed-for: Wenn Indikationen für eine Bedarfsmedikation angegeben sind, MUSS asNeededBoolean vorhanden und true sein. (extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').empty() or asNeededBoolean = true)
                  112. MedicationStatement.dosage.extension
                  Definition

                  An Extension


                  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.

                  ShortIndikation für die BedarfsmedikationAdditional content defined by implementations
                  Comments

                  Begründung des Must-Support: Ermöglicht die Angabe mehrerer Indikationen für die Bedarfsmedikation, z.B. 'Schmerzen', 'Fieber', 'Hustenreiz' etc. Diese Bedingungen sind ODER verknüpft, d.h. die Bedarfsmedikation soll bei Vorliegen einer ODER mehrerer dieser Bedingungen angewendet werden.


                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-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())
                  SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 114. MedicationStatement.dosage.extension.extension
                    Definition

                    An Extension


                    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.

                    ShortExtensionAdditional 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.

                    Control0..0*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-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())
                    SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 116. MedicationStatement.dosage.extension.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      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.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      118. MedicationStatement.dosage.extension.value[x]
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control0..1
                      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 120. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept
                        Slice NamevalueCodeableConcept
                        Definition

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        ShortValue of extension
                        Control0..1
                        TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        122. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept.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.

                        ShortIndikation für die Bedarfsmedikation (Freitext)Plain text representation of the concept
                        Comments

                        Begründung des Must-Support: Ermöglicht die Angabe einer Indikation für die Bedarfsmedikation in Freitextform, eine Kodierung ist nicht verpflichtend. Es wird jedoch empfohlen, die Indikation zusätzlich in kodierter Form anzugeben, um die Interoperabilität zu erhöhen.


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

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        124. MedicationStatement.dosage.extension:asNeededFor
                        Slice NameasNeededFor
                        Definition

                        Optional Extension Element - found in all resources.

                        ShortOptional Extensions Element
                        Control0..*
                        TypeExtension(Dosage AsNeededFor) (Extension Type: CodeableConcept)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-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())
                        126. MedicationStatement.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).

                        ShortExtensions 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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        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 Namesextensions, user content, modifiers
                        Invariantsele-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())
                        128. MedicationStatement.dosage.text
                        Definition

                        Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker


                        Free text dosage instructions e.g. SIG.

                        ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'Free text dosage instructions e.g. SIG
                        Comments

                        Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.

                        Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.
                        
                        Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://gemspec.gematik.de/ig/fhir/isik/basis/6.0.0-rc1/Index_Festlegungen.html/UebergreifendeFestlegungen_Must-Support-Flags): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.'
                        
                        Zum Beispiel könnte ein empfangendes System die Freitext-Dosierungsinformation in strukturierte Dosierungsinformation umwandeln, um sie in einer Medikationsverwaltung anzuzeigen oder später zu exponieren. Geht es zum Beispiel um eine Angabe zu Tageszeiten der Einnahme in der freitextlichen Dosierungsinformation als 'Morgens, Mittags, Abends', so könnte das empfangende System diese Angabe in strukturierte Dosierungsinformationen umwandeln, die die Einnahmezeiten in kodierter Form mit 'MORN', 'NOON', 'EVE' deklariert.
                        
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        130. MedicationStatement.dosage.patientInstruction
                        Definition

                        Instructions in terms that are understood by the patient or consumer.

                        Shortbesondere Anweisungen für den PatientenPatient or consumer oriented instructions
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        132. MedicationStatement.dosage.timing
                        Definition

                        Wann das Medikament verabreicht werden soll.


                        When medication should be administered.

                        ShortWann das Medikament verabreicht werden sollWhen medication should be administered
                        Comments

                        Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.


                        This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                        Control0..1
                        TypeTiming(Timing DE)
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        134. MedicationStatement.dosage.timing.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).

                        ShortExtensions 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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        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 Namesextensions, user content, modifiers
                        Invariantsele-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())
                        136. MedicationStatement.dosage.timing.event
                        Definition

                        Identifies specific times when the event occurs.

                        Shortfester ZeitpunktWhen the event occurs
                        Control0..*
                        TypedateTime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        138. MedicationStatement.dosage.timing.repeat
                        Definition

                        Eine Menge von Regeln, die beschreiben, wann das Ereignis geplant ist.


                        A set of rules that describe when the event is scheduled.

                        ShortWiederholungs-AngabenWhen the event is to occur
                        Control0..1
                        TypeElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Many timing schedules are determined by regular repetitions.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                        TimingSingleDosageForTimeOfDay: Wenn nur timeOfDay verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
                        TimingSingleDosageForWhen: Wenn nur when verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
                        TimingBoundsUnitMatchesCode: boundsDuration.unit muss zur UCUM boundsDuration.code passen (z. B. 'Woche(n)' nur mit code='wk'). (bounds.ofType(Duration).exists().not() or ( ( bounds.ofType(Duration).code = 'd' implies ( bounds.ofType(Duration).unit = 'Tag(e)' or bounds.ofType(Duration).unit = 'Tag' or bounds.ofType(Duration).unit = 'Tage' ) ) and ( bounds.ofType(Duration).code = 'wk' implies ( bounds.ofType(Duration).unit = 'Woche(n)' or bounds.ofType(Duration).unit = 'Woche' or bounds.ofType(Duration).unit = 'Wochen' ) ) and ( bounds.ofType(Duration).code = 'mo' implies ( bounds.ofType(Duration).unit = 'Monat(e)' or bounds.ofType(Duration).unit = 'Monat' or bounds.ofType(Duration).unit = 'Monate' ) ) and ( bounds.ofType(Duration).code = 'a' implies ( bounds.ofType(Duration).unit = 'Jahr(e)' or bounds.ofType(Duration).unit = 'Jahr' or bounds.ofType(Duration).unit = 'Jahre' ) ) ))
                        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                        140. MedicationStatement.dosage.timing.repeat.bounds[x]
                        Definition

                        Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.


                        Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                        ShortLänge/Bereich der Längen oder (Start- und/oder End-)GrenzenLength/Range of lengths, or (Start and/or end) limits
                        Comments

                        tbd

                        Control0..1
                        TypeChoice of: Duration, Range, Period
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 142. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration
                          Slice NameboundsDuration
                          Definition

                          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                          ShortBegrenzung der DauerLength/Range of lengths, or (Start and/or end) limits
                          Control0..1
                          TypeDuration, Period, Range
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Pattern Value{
                            "system" : "http://unitsofmeasure.org"
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          144. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.value
                          Definition

                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                          ShortNumerical value (with implicit precision)
                          Comments

                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                          Control10..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Precision is handled implicitly in almost all cases of measurement.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          146. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.comparator
                          Definition

                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                          Short< | <= | >= | > - how to understand the value
                          Control0..1
                          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                          How the Quantity should be understood and represented.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          148. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.unit
                          Definition

                          A human-readable form of the unit.

                          ShortUnit representation
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          150. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.system
                          Definition

                          The identification of the system that provides the coded form of the unit.

                          ShortUCUM-Einheit für die DauerSystem that defines coded unit form
                          Comments

                          Die UCUM-Einheit für die Dauer, z. B. d für Tag, h für Stunde, min für Minute.

                          Control10..1
                          This element is affected by the following invariants: qty-3
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need to know the system that defines the coded form of the unit.

                          Fixed Valuehttp://unitsofmeasure.org
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          152. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.code
                          Definition

                          A computer processable form of the unit in some unit representation system.

                          ShortCoded form of the unit
                          Comments

                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                          Control10..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          154. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange
                          Slice NameboundsRange
                          Definition

                          Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.


                          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                          ShortBereich für die BegrenzungLength/Range of lengths, or (Start and/or end) limits
                          Comments

                          tbd

                          Control0..1
                          TypeRange, Period, Duration
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          156. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low
                          Definition

                          The low limit. The boundary is inclusive.

                          ShortLow limit
                          Comments

                          If the low element is missing, the low boundary is not known.

                          Control0..1
                          TypeQuantity(SimpleQuantity)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Pattern Value{
                            "system" : "http://unitsofmeasure.org"
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          158. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.value
                          Definition

                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                          ShortNumerical value (with implicit precision)
                          Comments

                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                          Control10..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Precision is handled implicitly in almost all cases of measurement.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          160. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.comparator
                          Definition

                          Not allowed to be used in this context


                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                          Short< | <= | >= | > - how to understand the value
                          Control0..01
                          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                          How the Quantity should be understood and represented.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          162. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.unit
                          Definition

                          A human-readable form of the unit.

                          ShortUnit representation
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          164. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.system
                          Definition

                          The identification of the system that provides the coded form of the unit.

                          ShortSystem that defines coded unit form
                          Control10..1
                          This element is affected by the following invariants: qty-3
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need to know the system that defines the coded form of the unit.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          166. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.code
                          Definition

                          A computer processable form of the unit in some unit representation system.

                          ShortCoded form of the unit
                          Comments

                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                          Control10..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          168. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high
                          Definition

                          The high limit. The boundary is inclusive.

                          ShortHigh limit
                          Comments

                          If the high element is missing, the high boundary is not known.

                          Control0..1
                          TypeQuantity(SimpleQuantity)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Pattern Value{
                            "system" : "http://unitsofmeasure.org"
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          170. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.value
                          Definition

                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                          ShortNumerical value (with implicit precision)
                          Comments

                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                          Control10..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Precision is handled implicitly in almost all cases of measurement.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          172. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.comparator
                          Definition

                          Not allowed to be used in this context


                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                          Short< | <= | >= | > - how to understand the value
                          Control0..01
                          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                          How the Quantity should be understood and represented.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          174. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.unit
                          Definition

                          A human-readable form of the unit.

                          ShortUnit representation
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          176. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.system
                          Definition

                          The identification of the system that provides the coded form of the unit.

                          ShortSystem that defines coded unit form
                          Control10..1
                          This element is affected by the following invariants: qty-3
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need to know the system that defines the coded form of the unit.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          178. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.code
                          Definition

                          A computer processable form of the unit in some unit representation system.

                          ShortCoded form of the unit
                          Comments

                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                          Control10..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          180. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod
                          Slice NameboundsPeriod
                          Definition

                          Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.


                          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                          Shortbegrenzender ZeitraumLength/Range of lengths, or (Start and/or end) limits
                          Comments

                          tbd

                          Control0..1
                          TypePeriod, Duration, Range
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          182. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.start
                          Definition

                          The start of the period. The boundary is inclusive.

                          ShortStarting time with inclusive boundary
                          Comments

                          If the low element is missing, the meaning is that the low boundary is not known.

                          Control0..1
                          This element is affected by the following invariants: per-1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          184. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.end
                          Definition

                          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                          ShortEnd time with inclusive boundary, if not ongoing
                          Comments

                          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                          Control0..1
                          This element is affected by the following invariants: per-1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          186. MedicationStatement.dosage.timing.repeat.count
                          Definition

                          A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

                          ShortAnzahl WiederholungenNumber of times to repeat
                          Comments

                          If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                          Control0..1
                          TypepositiveInt
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Repetitions may be limited by end time or total occurrences.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          188. MedicationStatement.dosage.timing.repeat.countMax
                          Definition

                          If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                          Shortmaximale Anzahl WiederholungenMaximum number of times to repeat
                          Control0..1
                          TypepositiveInt
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          190. MedicationStatement.dosage.timing.repeat.duration
                          Definition

                          How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                          ShortDauer der VerabreichungHow long when it happens
                          Comments

                          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                          Control0..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Some activities are not instantaneous and need to be maintained for a period of time.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          192. MedicationStatement.dosage.timing.repeat.durationMax
                          Definition

                          If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                          Shortmaximale Dauer der VerabreichungHow long when it happens (Max)
                          Comments

                          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                          Control0..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Some activities are not instantaneous and need to be maintained for a period of time.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          194. MedicationStatement.dosage.timing.repeat.durationUnit
                          Definition

                          The units of time for the duration, in UCUM units.

                          ShortEinheit der Dauers | min | h | d | wk | mo | a - unit of time (UCUM)
                          Control0..1
                          BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                          A unit of time (units from UCUM).

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          196. MedicationStatement.dosage.timing.repeat.frequency
                          Definition

                          Die Anzahl der Wiederholungen innerhalb des angegebenen Zeitraums. Falls frequencyMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Häufigkeit an.


                          The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

                          ShortFrequenz (Anzahl der Gaben pro Periode)Event occurs frequency times per period
                          Control0..1
                          TypepositiveInt
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          198. MedicationStatement.dosage.timing.repeat.frequencyMax
                          Definition

                          If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                          Shortmaximale FrequenzEvent occurs up to frequencyMax times per period
                          Control0..1
                          TypepositiveInt
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          200. MedicationStatement.dosage.timing.repeat.period
                          Definition

                          Gibt die Zeitspanne an, über die die Wiederholungen stattfinden sollen; z. B. um „3-mal täglich“ auszudrücken, wäre 3 die Häufigkeit und „1 Tag“ der Zeitraum. Falls periodMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Zeitspanne an.


                          Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

                          ShortZeitperiode zur FrequenzEvent occurs frequency times per period
                          Control0..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          202. MedicationStatement.dosage.timing.repeat.periodMax
                          Definition

                          If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                          Shortmaximale Zeitperiode zur FrequenzUpper limit of period (3-4 hours)
                          Control0..1
                          Typedecimal
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          204. MedicationStatement.dosage.timing.repeat.periodUnit
                          Definition

                          Die Zeiteinheit für den Zeitraum, in UCUM-Einheiten.


                          The units of time for the period in UCUM units.

                          ShortEinheit der Zeitperiodes | min | h | d | wk | mo | a - unit of time (UCUM)
                          Control0..1
                          BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                          A unit of time (units from UCUM).

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          206. MedicationStatement.dosage.timing.repeat.dayOfWeek
                          Definition

                          Wenn ein oder mehrere Wochentage angegeben sind, findet die Aktion nur an den angegebenen Tagen statt.


                          If one or more days of week is provided, then the action happens only on the specified day(s).

                          ShortWochentagmon | tue | wed | thu | fri | sat | sun
                          Comments

                          Wenn keine Tage angegeben sind, wird angenommen, dass die Aktion an jedem Tag wie sonst angegeben stattfindet.


                          If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

                          Control0..*
                          BindingThe codes SHALL be taken from DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          208. MedicationStatement.dosage.timing.repeat.timeOfDay
                          Definition

                          Angegebene Tageszeit, zu der die Aktion stattfinden soll.


                          Specified time of day for action to take place.

                          ShortTageszeitTime of day for action
                          Comments

                          Wenn eine Tageszeit angegeben ist, wird angenommen, dass die Aktion jeden Tag (ggf. gefiltert durch dayOfWeek) zu den angegebenen Zeiten stattfindet.


                          When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

                          Control0..*
                          Typetime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          210. MedicationStatement.dosage.timing.repeat.when
                          Definition

                          Ein ungefährer Zeitraum während des Tages, der möglicherweise mit einem Ereignis des täglichen Lebens verknüpft ist und angibt, wann die Aktion stattfinden soll.


                          An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

                          ShortTageszeitpunkt codiertCode for time period of occurrence
                          Comments

                          Wenn mehr als ein Ereignis angegeben ist, bezieht sich das Ereignis auf die Vereinigung der angegebenen Ereignisse.


                          When more than one event is listed, the event is tied to the union of the specified events.

                          Control0..*
                          BindingThe codes SHALL be taken from EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                          Real world event relating to the schedule.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Timings are frequently determined by occurrences such as waking, eating and sleep.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          212. MedicationStatement.dosage.timing.repeat.offset
                          Definition

                          The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

                          Shortzeitlicher Abstand der Gabe zum beschriebenen ZeitpunktMinutes from event (before or after)
                          Control0..1
                          TypeunsignedInt
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          214. MedicationStatement.dosage.asNeeded[x]
                          Definition

                          Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                          ShortBedarfsmedikation (ja/nein)Take "as needed" (for x)
                          Comments

                          Begründung des Must-Support: Abbildung einer Bedarfsmedikation.


                          Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                          Control0..1
                          Typeboolean, CodeableConcept
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          216. MedicationStatement.dosage.site
                          Definition

                          Body site to administer to.

                          ShortKörperstelle der VerabreichungBody site to administer 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.

                          Control0..1
                          BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

                          A coded concept describing the site location the medicine enters into or onto the body.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          A coded specification of the anatomic site where the medication first enters the body.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          218. MedicationStatement.dosage.site.coding
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode 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.

                          Control0..*
                          TypeCoding
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on MedicationStatement.dosage.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • pattern @ $this
                          • 220. MedicationStatement.dosage.site.coding:SNOMED-CT
                            Slice NameSNOMED-CT
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode 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.

                            Control0..1*
                            TypeCoding(ISiKSnomedCTCoding)
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

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

                            Pattern Value{
                              "system" : "http://snomed.info/sct"
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            222. MedicationStatement.dosage.site.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.

                            ShortPlain text representation of the concept
                            Comments

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

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            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.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            224. MedicationStatement.dosage.route
                            Definition

                            How drug should enter body.

                            ShortRouteHow drug should enter body
                            Control0..1
                            BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
                            (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                            A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            226. MedicationStatement.dosage.route.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode 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.

                            Control0..*
                            TypeCoding
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on MedicationStatement.dosage.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • pattern @ $this
                            • 228. MedicationStatement.dosage.route.coding:EDQM
                              Slice NameEDQM
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode 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.

                              Control0..1*
                              BindingThe codes SHALL be taken from For codes, see Medicine EDQM Route of Administration - IPS
                              (required to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)
                              TypeCoding(ISiKCoding)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

                              Pattern Value{
                                "system" : "http://standardterms.edqm.eu"
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              230. MedicationStatement.dosage.route.coding:SNOMED-CT
                              Slice NameSNOMED-CT
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode 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.

                              Control0..1*
                              BindingThe codes SHALL be taken from For codes, see SctRouteOfAdministration
                              (required to https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration)
                              TypeCoding(ISiKSnomedCTCoding)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

                              Pattern Value{
                                "system" : "http://snomed.info/sct"
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              232. MedicationStatement.dosage.route.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.

                              ShortPlain text representation of the concept
                              Comments

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

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              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.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              234. MedicationStatement.dosage.doseAndRate
                              Definition

                              Die verabreichte Menge des Medikaments.


                              The amount of medication administered.

                              ShortMenge des verabreichten MedikamentsAmount of medication administered
                              Control0..*
                              TypeElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              236. MedicationStatement.dosage.doseAndRate.dose[x]
                              Definition

                              Amount of medication per dose.

                              ShortAmount of medication per dose
                              Comments

                              Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                              Control0..1
                              TypeChoice of: Range, Quantity(SimpleQuantity)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              The amount of therapeutic or other substance given at one administration event.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 238. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity
                                Slice NamedoseQuantity
                                Definition

                                Menge des Medikaments pro Dosis.


                                Amount of medication per dose.

                                ShortDosisAmount of medication per dose
                                Comments

                                Das Must-Support-Flag auf doseQuantity bedeutet, dass produzierende Systeme zur Kodierung der Dosisangaben nach eigenem Ermessen entweder den Datentyp Quantity oder Ratio verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.


                                Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                Control0..1
                                BindingThe codes SHALL be taken from For codes, see Dosage DoseQuantity ValueSet
                                (required to http://ig.fhir.de/igs/medication/ValueSet/DosageDoseQuantityDE)
                                TypeQuantity(SimpleQuantity, SimpleQuantity), Range
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                The amount of therapeutic or other substance given at one administration event.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                240. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value
                                Definition

                                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                ShortDosiswertNumerical value (with implicit precision)
                                Comments

                                Begründung MS: Der Dosiswert ist notwendig, um die Dosisangabe korrekt interpretieren zu können.


                                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).

                                Control0..1
                                Typedecimal
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Precision is handled implicitly in almost all cases of measurement.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                242. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator
                                Definition

                                Not allowed to be used in this context


                                How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                Short< | <= | >= | > - how to understand the value
                                Control0..01
                                BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                How the Quantity should be understood and represented.

                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                244. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit
                                Definition

                                A human-readable form of the unit.

                                ShortMenschenlesbare Dosis-EinheitUnit representation
                                Comments

                                Begründung MS: Die menschenlesbare Dosis-Einheit ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                246. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system
                                Definition

                                The identification of the system that provides the coded form of the unit.

                                ShortCodeSystem der DosisangabeSystem that defines coded unit form
                                Comments

                                Begründung MS: Das CodeSystem der Dosisangabe ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                Control0..1
                                This element is affected by the following invariants: qty-3
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Need to know the system that defines the coded form of the unit.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                248. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code
                                Definition

                                A computer processable form of the unit in some unit representation system.

                                ShortCode der DosisangabeCoded form of the unit
                                Comments

                                Begründung MS: Der Code der Dosisangabe ist notwendig, um die Dosisangabe korrekt interpretieren zu können.


                                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.

                                Control0..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                250. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange
                                Slice NamedoseRange
                                Definition

                                Amount of medication per dose.

                                ShortDosisbereichAmount of medication per dose
                                Comments

                                Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                Control0..1
                                TypeRange, Quantity(SimpleQuantity)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                The amount of therapeutic or other substance given at one administration event.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                252. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.low
                                Definition

                                The low limit. The boundary is inclusive.

                                ShortLow limit
                                Comments

                                If the low element is missing, the low boundary is not known.

                                Control0..1
                                TypeQuantity(Medication Quantity Dose Form, SimpleQuantity)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                254. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.high
                                Definition

                                The high limit. The boundary is inclusive.

                                ShortHigh limit
                                Comments

                                If the high element is missing, the high boundary is not known.

                                Control0..1
                                TypeQuantity(Medication Quantity Dose Form, SimpleQuantity)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                256. MedicationStatement.dosage.doseAndRate.rate[x]
                                Definition

                                Amount of medication per unit of time.

                                ShortAmount of medication per unit of time
                                Comments

                                It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                Control0..1
                                TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.rate[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 258. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio
                                  Slice NamerateRatio
                                  Definition

                                  Amount of medication per unit of time.

                                  ShortRaten-VerhältnisAmount of medication per unit of time
                                  Comments

                                  Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.


                                  It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                  It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                  Control0..1
                                  TypeRatio, Quantity(SimpleQuantity), Range
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  260. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.numerator
                                  Definition

                                  The value of the numerator.

                                  ShortNumerator value
                                  Control10..1
                                  TypeQuantity(Medication Quantity Dose Form)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  262. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.denominator
                                  Definition

                                  The value of the denominator.

                                  ShortDenominator value
                                  Control10..1
                                  TypeQuantity(Medication Quantity)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  264. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange
                                  Slice NamerateRange
                                  Definition

                                  Amount of medication per unit of time.

                                  ShortRaten-BereichAmount of medication per unit of time
                                  Comments

                                  It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                  It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                  Control0..1
                                  TypeRange, Quantity(SimpleQuantity), Ratio
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  266. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.low
                                  Definition

                                  The low limit. The boundary is inclusive.

                                  ShortLow limit
                                  Comments

                                  If the low element is missing, the low boundary is not known.

                                  Control0..1
                                  TypeQuantity(Medication Quantity Dose Form, SimpleQuantity)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  268. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.high
                                  Definition

                                  The high limit. The boundary is inclusive.

                                  ShortHigh limit
                                  Comments

                                  If the high element is missing, the high boundary is not known.

                                  Control0..1
                                  TypeQuantity(Medication Quantity Dose Form, SimpleQuantity)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  270. MedicationStatement.dosage.doseAndRate.rate[x]:rateQuantity
                                  Slice NamerateQuantity
                                  Definition

                                  Amount of medication per unit of time.

                                  ShortRateAmount of medication per unit of time
                                  Comments

                                  Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.


                                  It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                  It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                  Control0..1
                                  TypeQuantity(Medication Quantity, SimpleQuantity), Ratio, Range
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  272. MedicationStatement.dosage.maxDosePerPeriod
                                  Definition

                                  Upper limit on medication per unit of time.

                                  ShortMaximaldosis (Zähler) pro Zeitraum (Nenner)Upper limit on medication per unit of time
                                  Comments

                                  This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                  Control0..1
                                  TypeRatio
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  274. MedicationStatement.dosage.maxDosePerPeriod.numerator
                                  Definition

                                  The value of the numerator.

                                  ShortNumerator value
                                  Control10..1
                                  TypeQuantity(Medication Quantity Dose Form)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  276. MedicationStatement.dosage.maxDosePerPeriod.denominator
                                  Definition

                                  The value of the denominator.

                                  ShortDenominator value
                                  Control10..1
                                  TypeQuantity(Medication Quantity)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  278. MedicationStatement.dosage.maxDosePerAdministration
                                  Definition

                                  Upper limit on medication per administration.

                                  ShortMaximaldosis pro VerabreichungUpper limit on medication per administration
                                  Comments

                                  This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                  Control0..1
                                  TypeQuantity(Medication Quantity Dose Form, SimpleQuantity)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                  Invariantsele-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. MedicationStatement
                                  2. MedicationStatement.id
                                  Shortserverseitige, interne ID des Datensatzes
                                  Comments

                                  bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

                                  Must Supporttrue
                                  4. MedicationStatement.meta
                                  6. MedicationStatement.meta.versionId
                                  ShortEindeutiger Name der serverseitigen Version des Datensatzes
                                  Comments

                                  Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

                                  8. MedicationStatement.meta.lastUpdated
                                  ShortZeitpunkt der letzten Änderung
                                  Comments

                                  Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

                                  10. MedicationStatement.implicitRules
                                  ShortVerweis auf die Regeln, nach denen die Ressource erstellt wurde
                                  Comments

                                  Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.

                                  Control0..0
                                  12. MedicationStatement.extension
                                  Must Supporttrue
                                  SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 14. MedicationStatement.extension:acceptedRisk
                                    Slice NameacceptedRisk
                                    Shortakzeptiertes (in Kauf genommenes) Risiko
                                    Comments

                                    Begründung des Must-Support: Folgeinformation der AMTS-Bewertung, sollte auch an nachfolgende Behandelnde übermittelbar sein

                                    Hinweis: Hier kann ein im Rahmen der Medikation festgestelltes, aber in Kauf genommenes Risiko dokumentiert werden, speziell auch die Begründung und ggf. erforderliche Begleitmaßnahmen.

                                    Control0..1
                                    TypeExtension(ISiK Accepted Risk) (Extension Type: string)
                                    Must Supporttrue
                                    16. MedicationStatement.extension:acceptedRisk.value[x]
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Must Supporttrue
                                    18. MedicationStatement.extension:medikationsart
                                    Slice Namemedikationsart
                                    ShortTherapieart der Medikation
                                    Comments

                                    Begründung des Must-Support: von der Fachseite gewünschte Angabe

                                    Hinweis: Angabe Akut- oder Dauermedikation.

                                    Control0..1
                                    TypeExtension(ISiK Medikationsart) (Extension Type: Coding)
                                    Must Supporttrue
                                    20. MedicationStatement.extension:medikationsart.value[x]
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    22. MedicationStatement.extension:medikationsart.value[x].system
                                    Must Supporttrue
                                    24. MedicationStatement.extension:medikationsart.value[x].code
                                    Must Supporttrue
                                    26. MedicationStatement.extension:medikationsart.value[x].display
                                    Must Supporttrue
                                    28. MedicationStatement.extension:selbstmedikation
                                    Slice Nameselbstmedikation
                                    ShortSelbstmedikation
                                    Comments

                                    Begründung des Must-Support: von der Fachseite gewünschte Angabe

                                    Hinweis: Flag zur Selbstmedikation.

                                    Control0..1
                                    TypeExtension(ISiK Selbstmedikation) (Extension Type: boolean)
                                    Must Supporttrue
                                    30. MedicationStatement.extension:selbstmedikation.value[x]
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Must Supporttrue
                                    32. MedicationStatement.extension:behandlungsziel
                                    Slice Namebehandlungsziel
                                    ShortBehandlungsziel (textuell)
                                    Comments

                                    Begründung des Must-Support: von der Fachseite gewünschte Angabe

                                    Hinweis: Freitext-Beschreibung des Behandlungsziels.

                                    Control0..1
                                    TypeExtension(ISiK Behandlungsziel) (Extension Type: string)
                                    Must Supporttrue
                                    34. MedicationStatement.extension:behandlungsziel.value[x]
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Must Supporttrue
                                    36. MedicationStatement.partOf
                                    ShortReferenz auf andere Objekte, deren Bestandteil diese MedikationsInformation ist
                                    Comments

                                    Begründung des Must-Support: Abbildung der Zusammenhänge

                                    38. MedicationStatement.status
                                    ShortStatus der Medikationsinformation
                                    Comments

                                    Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard

                                    Must Supporttrue
                                    40. MedicationStatement.medication[x]
                                    ShortAngabe des Medikaments
                                    Comments

                                    Begründung des Must-Support: Basisinformation. Siehe Slicing-Definition zur Wahlmöglichkeit zwischen codierter Angabe und Referenz auf Medication-Ressource.

                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Must Supporttrue
                                    SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 42. MedicationStatement.medication[x]:medicationCodeableConcept
                                      Slice NamemedicationCodeableConcept
                                      ShortMedikament in codierter Form oder ggf. als Freitext
                                      Comments

                                      Begründung des Must-Support: Basisinformation

                                      Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.

                                      Control0..1
                                      TypeCodeableConcept
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Must Supporttrue
                                      44. MedicationStatement.medication[x]:medicationCodeableConcept.coding
                                      Must Supporttrue
                                      SlicingThis element introduces a set of slices on MedicationStatement.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • pattern @ $this
                                      • 46. MedicationStatement.medication[x]:medicationCodeableConcept.coding:PZN
                                        Slice NamePZN
                                        Comments

                                        Mehrfachcodierung ist zulässig, da für ein abstraktes Medikament auch mehrere PZN-Codes existieren können, z.B. existieren für Aspirin 3 verschiedene Packungsgrößen.

                                        Control0..*
                                        TypeCoding(ISiKPZNCoding)
                                        Must Supporttrue
                                        Pattern Value{
                                          "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                                        }
                                        48. MedicationStatement.medication[x]:medicationCodeableConcept.coding:ATC-DE
                                        Slice NameATC-DE
                                        Comments

                                        Mehrfachcodierung ist zulässig, da für ein abstraktes Medikament auch mehrere ATC-Codes existieren können, z.B. existieren für Aspirin 4 verschiedene Codes, je nachdem wofür das Medikament angewendet wird.

                                        Control0..*
                                        TypeCoding(ISiKATCCoding)
                                        Must Supporttrue
                                        Pattern Value{
                                          "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                                        }
                                        50. MedicationStatement.medication[x]:medicationCodeableConcept.coding:SCT
                                        Slice NameSCT
                                        Control0..1
                                        TypeCoding(ISiKSnomedCTCoding)
                                        Must Supporttrue
                                        Pattern Value{
                                          "system" : "http://snomed.info/sct"
                                        }
                                        52. MedicationStatement.medication[x]:medicationCodeableConcept.text
                                        Must Supporttrue
                                        54. MedicationStatement.medication[x]:medicationReference
                                        Slice NamemedicationReference
                                        ShortReferenz auf das Medikament (Medication-Ressource)
                                        Comments

                                        Begründung des Must-Support: Basisinformation

                                        Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen

                                        Control0..1
                                        TypeReference(Medication)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        56. MedicationStatement.medication[x]:medicationReference.reference
                                        Control1..?
                                        Must Supporttrue
                                        58. MedicationStatement.subject
                                        ShortReferenz auf den Patienten
                                        Comments

                                        Begründung des Must-Support: Basisinformation

                                        TypeReference(Patient)
                                        Must Supporttrue
                                        60. MedicationStatement.subject.reference
                                        ShortPatienten-Link
                                        Comments

                                        Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

                                        Control1..?
                                        Must Supporttrue
                                        62. MedicationStatement.context
                                        ShortReferenz auf den Abteilungskontakt
                                        Comments

                                        Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext

                                        Must Supporttrue
                                        64. MedicationStatement.context.reference
                                        Comments

                                        Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

                                        Control1..?
                                        Must Supporttrue
                                        66. MedicationStatement.effective[x]
                                        ShortZeitpunkt oder Zeitraum, für den die MedikationsInformation gilt
                                        Comments

                                        Begründung des Must-Support: Basisinformation

                                        Control1..?
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 68. MedicationStatement.effective[x]:effectiveDateTime
                                          Slice NameeffectiveDateTime
                                          ShortZeitpunkt (Datum oder Datum + Uhrzeit)
                                          Comments

                                          Begründung des Must-Support: Basisinformation

                                          Festlegung zur Nutzung: An dieser Stelle KANN eine lediglich Datums-genaue Angabe (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe seitens eines bestätigungsrelevanten Systems unterstützt werden. Es KANN auch eine Uhrzeit angegeben werden. Für sekunden-genaue Angaben zur Verabreichung eines Medikaments an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden.

                                          Control0..1
                                          TypedateTime
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          70. MedicationStatement.effective[x]:effectivePeriod
                                          Slice NameeffectivePeriod
                                          ShortZeitraum
                                          Comments

                                          Begründung des Must-Support: Basisinformation

                                          Festlegung zur Nutzung: An dieser Stelle KANN eine lediglich Datums-genaue Angabe (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe seitens eines bestätigungsrelevanten Systems unterstützt werden. Es KANN auch eine Uhrzeit angegeben werden. Für sekunden-genaue Angaben zur Verabreichung eines Medikaments an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden.

                                          Control0..1
                                          TypePeriod
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Must Supporttrue
                                          72. MedicationStatement.effective[x]:effectivePeriod.start
                                          Must Supporttrue
                                          74. MedicationStatement.effective[x]:effectivePeriod.end
                                          Must Supporttrue
                                          76. MedicationStatement.dateAsserted
                                          ShortDatum der Feststellung/des Bekanntwerdens der MedikationsInformation
                                          Comments

                                          Begründung des Must-Support: Nachvollziehbarkeit

                                          Must Supporttrue
                                          78. MedicationStatement.reasonCode
                                          ShortGrund der Medikation (codiert)
                                          Comments

                                          Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.

                                          Begründung zu Must-Support: Konsolidierung mit MII.

                                          Must Supporttrue
                                          80. MedicationStatement.reasonCode.coding
                                          Must Supporttrue
                                          82. MedicationStatement.reasonCode.coding.system
                                          Control1..?
                                          Must Supporttrue
                                          84. MedicationStatement.reasonCode.coding.code
                                          Control1..?
                                          Must Supporttrue
                                          86. MedicationStatement.reasonCode.coding.display
                                          Must Supporttrue
                                          88. MedicationStatement.reasonCode.text
                                          Must Supporttrue
                                          90. MedicationStatement.reasonReference
                                          ShortGrund der Medikation (Referenz)
                                          Comments

                                          Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.

                                          Begründung zu Must-Support: Konsolidierung mit MII.

                                          Must Supporttrue
                                          92. MedicationStatement.reasonReference.reference
                                          Control1..?
                                          Must Supporttrue
                                          94. MedicationStatement.note
                                          ShortZusätzliche Anmerkungen zur Medikation
                                          Comments

                                          Begründung des Must-Support: Fachlich relevante Zusatzinformationen

                                          Must Supporttrue
                                          96. MedicationStatement.note.text
                                          ShortFreitext-Notiz
                                          Comments

                                          Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein

                                          Must Supporttrue
                                          98. MedicationStatement.dosage
                                          ShortDosierungsangaben
                                          Comments

                                          Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation.

                                          Hinweis: Zahlreiche Beispiele zur Dosierungsanweisung sind im Implementierungsleitfaden Medikament von HL7 Deutschland dokumentiert.

                                          TypeDosage(Dosage DE)
                                          Must Supporttrue
                                          Invariantsisik-dosage-as-needed-for: Wenn Indikationen für eine Bedarfsmedikation angegeben sind, MUSS asNeededBoolean vorhanden und true sein. (extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').empty() or asNeededBoolean = true)
                                          100. MedicationStatement.dosage.extension
                                          ShortIndikation für die Bedarfsmedikation
                                          Comments

                                          Begründung des Must-Support: Ermöglicht die Angabe mehrerer Indikationen für die Bedarfsmedikation, z.B. 'Schmerzen', 'Fieber', 'Hustenreiz' etc. Diese Bedingungen sind ODER verknüpft, d.h. die Bedarfsmedikation soll bei Vorliegen einer ODER mehrerer dieser Bedingungen angewendet werden.

                                          102. MedicationStatement.dosage.extension.extension
                                          Control0..0
                                          104. MedicationStatement.dosage.extension.value[x]
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 106. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept
                                            Slice NamevalueCodeableConcept
                                            Control0..1
                                            TypeCodeableConcept
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            108. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept.text
                                            ShortIndikation für die Bedarfsmedikation (Freitext)
                                            Comments

                                            Begründung des Must-Support: Ermöglicht die Angabe einer Indikation für die Bedarfsmedikation in Freitextform, eine Kodierung ist nicht verpflichtend. Es wird jedoch empfohlen, die Indikation zusätzlich in kodierter Form anzugeben, um die Interoperabilität zu erhöhen.

                                            Must Supporttrue
                                            110. MedicationStatement.dosage.extension:asNeededFor
                                            Slice NameasNeededFor
                                            Control0..*
                                            TypeExtension(Dosage AsNeededFor) (Extension Type: CodeableConcept)
                                            Must Supporttrue
                                            112. MedicationStatement.dosage.text
                                            Comments

                                            Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.

                                            Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.
                                            
                                            Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://gemspec.gematik.de/ig/fhir/isik/basis/6.0.0-rc1/Index_Festlegungen.html/UebergreifendeFestlegungen_Must-Support-Flags): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.'
                                            
                                            Zum Beispiel könnte ein empfangendes System die Freitext-Dosierungsinformation in strukturierte Dosierungsinformation umwandeln, um sie in einer Medikationsverwaltung anzuzeigen oder später zu exponieren. Geht es zum Beispiel um eine Angabe zu Tageszeiten der Einnahme in der freitextlichen Dosierungsinformation als 'Morgens, Mittags, Abends', so könnte das empfangende System diese Angabe in strukturierte Dosierungsinformationen umwandeln, die die Einnahmezeiten in kodierter Form mit 'MORN', 'NOON', 'EVE' deklariert.
                                            
                                            114. MedicationStatement.dosage.patientInstruction
                                            Shortbesondere Anweisungen für den Patienten
                                            Must Supporttrue
                                            116. MedicationStatement.dosage.timing
                                            118. MedicationStatement.dosage.timing.event
                                            Shortfester Zeitpunkt
                                            Must Supporttrue
                                            120. MedicationStatement.dosage.timing.repeat
                                            ShortWiederholungs-Angaben
                                            122. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration
                                            Slice NameboundsDuration
                                            ShortBegrenzung der Dauer
                                            TypeDuration
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Pattern Value{
                                              "system" : "http://unitsofmeasure.org"
                                            }
                                            124. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.value
                                            Control1..?
                                            126. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.system
                                            Control1..?
                                            128. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.code
                                            Control1..?
                                            130. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange
                                            Slice NameboundsRange
                                            ShortBereich für die Begrenzung
                                            Control0..1
                                            TypeRange
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Must Supporttrue
                                            132. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low
                                            Must Supporttrue
                                            Pattern Value{
                                              "system" : "http://unitsofmeasure.org"
                                            }
                                            134. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.value
                                            Control1..?
                                            Must Supporttrue
                                            136. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.unit
                                            Must Supporttrue
                                            138. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.system
                                            Control1..?
                                            Must Supporttrue
                                            140. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.code
                                            Control1..?
                                            Must Supporttrue
                                            142. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high
                                            Must Supporttrue
                                            Pattern Value{
                                              "system" : "http://unitsofmeasure.org"
                                            }
                                            144. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.value
                                            Control1..?
                                            Must Supporttrue
                                            146. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.unit
                                            Must Supporttrue
                                            148. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.system
                                            Control1..?
                                            Must Supporttrue
                                            150. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.code
                                            Control1..?
                                            Must Supporttrue
                                            152. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod
                                            Slice NameboundsPeriod
                                            Shortbegrenzender Zeitraum
                                            Control0..1
                                            TypePeriod
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Must Supporttrue
                                            154. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.start
                                            Must Supporttrue
                                            156. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.end
                                            Must Supporttrue
                                            158. MedicationStatement.dosage.timing.repeat.count
                                            ShortAnzahl Wiederholungen
                                            Must Supporttrue
                                            160. MedicationStatement.dosage.timing.repeat.countMax
                                            Shortmaximale Anzahl Wiederholungen
                                            Must Supporttrue
                                            162. MedicationStatement.dosage.timing.repeat.duration
                                            ShortDauer der Verabreichung
                                            Must Supporttrue
                                            164. MedicationStatement.dosage.timing.repeat.durationMax
                                            Shortmaximale Dauer der Verabreichung
                                            Must Supporttrue
                                            166. MedicationStatement.dosage.timing.repeat.durationUnit
                                            ShortEinheit der Dauer
                                            Must Supporttrue
                                            168. MedicationStatement.dosage.timing.repeat.frequency
                                            ShortFrequenz (Anzahl der Gaben pro Periode)
                                            170. MedicationStatement.dosage.timing.repeat.frequencyMax
                                            Shortmaximale Frequenz
                                            Must Supporttrue
                                            172. MedicationStatement.dosage.timing.repeat.period
                                            ShortZeitperiode zur Frequenz
                                            174. MedicationStatement.dosage.timing.repeat.periodMax
                                            Shortmaximale Zeitperiode zur Frequenz
                                            Must Supporttrue
                                            176. MedicationStatement.dosage.timing.repeat.periodUnit
                                            ShortEinheit der Zeitperiode
                                            178. MedicationStatement.dosage.timing.repeat.dayOfWeek
                                            ShortWochentag
                                            180. MedicationStatement.dosage.timing.repeat.timeOfDay
                                            ShortTageszeit
                                            182. MedicationStatement.dosage.timing.repeat.when
                                            ShortTageszeitpunkt codiert
                                            184. MedicationStatement.dosage.timing.repeat.offset
                                            Shortzeitlicher Abstand der Gabe zum beschriebenen Zeitpunkt
                                            Must Supporttrue
                                            186. MedicationStatement.dosage.asNeeded[x]
                                            ShortBedarfsmedikation (ja/nein)
                                            Comments

                                            Begründung des Must-Support: Abbildung einer Bedarfsmedikation.

                                            Typeboolean
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            188. MedicationStatement.dosage.site
                                            ShortKörperstelle der Verabreichung
                                            Must Supporttrue
                                            190. MedicationStatement.dosage.site.coding
                                            Must Supporttrue
                                            SlicingThis element introduces a set of slices on MedicationStatement.dosage.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • pattern @ $this
                                            • 192. MedicationStatement.dosage.site.coding:SNOMED-CT
                                              Slice NameSNOMED-CT
                                              Control0..1
                                              TypeCoding(ISiKSnomedCTCoding)
                                              Must Supporttrue
                                              Pattern Value{
                                                "system" : "http://snomed.info/sct"
                                              }
                                              194. MedicationStatement.dosage.site.text
                                              Must Supporttrue
                                              196. MedicationStatement.dosage.route
                                              ShortRoute
                                              Must Supporttrue
                                              198. MedicationStatement.dosage.route.coding
                                              Must Supporttrue
                                              SlicingThis element introduces a set of slices on MedicationStatement.dosage.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • pattern @ $this
                                              • 200. MedicationStatement.dosage.route.coding:EDQM
                                                Slice NameEDQM
                                                Control0..1
                                                BindingThe codes SHALL be taken from Medicine EDQM Route of Administration - IPS
                                                (required to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)
                                                TypeCoding(ISiKCoding)
                                                Must Supporttrue
                                                Pattern Value{
                                                  "system" : "http://standardterms.edqm.eu"
                                                }
                                                202. MedicationStatement.dosage.route.coding:SNOMED-CT
                                                Slice NameSNOMED-CT
                                                Control0..1
                                                BindingThe codes SHALL be taken from SctRouteOfAdministration
                                                (required to https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration)
                                                TypeCoding(ISiKSnomedCTCoding)
                                                Must Supporttrue
                                                Pattern Value{
                                                  "system" : "http://snomed.info/sct"
                                                }
                                                204. MedicationStatement.dosage.route.text
                                                Must Supporttrue
                                                206. MedicationStatement.dosage.doseAndRate
                                                208. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity
                                                Slice NamedoseQuantity
                                                ShortDosis
                                                Comments

                                                Das Must-Support-Flag auf doseQuantity bedeutet, dass produzierende Systeme zur Kodierung der Dosisangaben nach eigenem Ermessen entweder den Datentyp Quantity oder Ratio verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

                                                TypeQuantity(SimpleQuantity)
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                210. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value
                                                ShortDosiswert
                                                Comments

                                                Begründung MS: Der Dosiswert ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                Must Supporttrue
                                                212. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit
                                                ShortMenschenlesbare Dosis-Einheit
                                                Comments

                                                Begründung MS: Die menschenlesbare Dosis-Einheit ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                Must Supporttrue
                                                214. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system
                                                ShortCodeSystem der Dosisangabe
                                                Comments

                                                Begründung MS: Das CodeSystem der Dosisangabe ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                Must Supporttrue
                                                216. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code
                                                ShortCode der Dosisangabe
                                                Comments

                                                Begründung MS: Der Code der Dosisangabe ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                Must Supporttrue
                                                218. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange
                                                Slice NamedoseRange
                                                ShortDosisbereich
                                                Control0..1
                                                TypeRange
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Must Supporttrue
                                                220. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.low
                                                TypeQuantity(Medication Quantity Dose Form)
                                                Must Supporttrue
                                                222. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.high
                                                TypeQuantity(Medication Quantity Dose Form)
                                                Must Supporttrue
                                                224. MedicationStatement.dosage.doseAndRate.rate[x]
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.rate[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 226. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio
                                                  Slice NamerateRatio
                                                  ShortRaten-Verhältnis
                                                  Comments

                                                  Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

                                                  Control0..1
                                                  TypeRatio
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  228. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.numerator
                                                  Control1..?
                                                  TypeQuantity(Medication Quantity Dose Form)
                                                  Must Supporttrue
                                                  230. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.denominator
                                                  Control1..?
                                                  TypeQuantity(Medication Quantity)
                                                  Must Supporttrue
                                                  232. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange
                                                  Slice NamerateRange
                                                  ShortRaten-Bereich
                                                  Control0..1
                                                  TypeRange
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  234. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.low
                                                  TypeQuantity(Medication Quantity Dose Form)
                                                  Must Supporttrue
                                                  236. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.high
                                                  TypeQuantity(Medication Quantity Dose Form)
                                                  Must Supporttrue
                                                  238. MedicationStatement.dosage.doseAndRate.rate[x]:rateQuantity
                                                  Slice NamerateQuantity
                                                  ShortRate
                                                  Comments

                                                  Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

                                                  Control0..1
                                                  TypeQuantity(Medication Quantity)
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  240. MedicationStatement.dosage.maxDosePerPeriod
                                                  ShortMaximaldosis (Zähler) pro Zeitraum (Nenner)
                                                  Must Supporttrue
                                                  242. MedicationStatement.dosage.maxDosePerPeriod.numerator
                                                  Control1..?
                                                  TypeQuantity(Medication Quantity Dose Form)
                                                  Must Supporttrue
                                                  244. MedicationStatement.dosage.maxDosePerPeriod.denominator
                                                  Control1..?
                                                  TypeQuantity(Medication Quantity)
                                                  Must Supporttrue
                                                  246. MedicationStatement.dosage.maxDosePerAdministration
                                                  ShortMaximaldosis pro Verabreichung
                                                  TypeQuantity(Medication Quantity Dose Form)
                                                  Must Supporttrue

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

                                                  0. MedicationStatement
                                                  Definition

                                                  A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains.

                                                  The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.

                                                  ShortRecord of medication being taken by a patient
                                                  Comments

                                                  When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.

                                                  Control0..*
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsdom-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. MedicationStatement.id
                                                  Definition

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

                                                  Shortserverseitige, interne ID des Datensatzes
                                                  Comments

                                                  bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

                                                  Control0..1
                                                  Typeid
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  4. MedicationStatement.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.

                                                  ShortMetadata about the resource
                                                  Control0..1
                                                  TypeMeta
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  6. MedicationStatement.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.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  8. MedicationStatement.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.

                                                  ShortAdditional 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.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-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())
                                                  SlicingThis element introduces a set of slices on MedicationStatement.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 10. MedicationStatement.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.

                                                    ShortEindeutiger Name der serverseitigen Version des Datensatzes
                                                    Comments

                                                    Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

                                                    Control0..1
                                                    Typeid
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    12. MedicationStatement.meta.lastUpdated
                                                    Definition

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

                                                    ShortZeitpunkt der letzten Änderung
                                                    Comments

                                                    Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

                                                    Control0..1
                                                    Typeinstant
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    14. MedicationStatement.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.

                                                    ShortIdentifies 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.

                                                    Control0..1
                                                    Typeuri
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    16. MedicationStatement.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.

                                                    ShortProfiles 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.

                                                    Control0..*
                                                    Typecanonical(StructureDefinition)
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    18. MedicationStatement.meta.security
                                                    Definition

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

                                                    ShortSecurity 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.

                                                    Control0..*
                                                    BindingUnless 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.

                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    20. MedicationStatement.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.

                                                    ShortTags 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.

                                                    Control0..*
                                                    BindingFor 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".

                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    22. MedicationStatement.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.

                                                    ShortVerweis auf die Regeln, nach denen die Ressource erstellt wurde
                                                    Comments

                                                    Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.

                                                    Control0..0
                                                    Typeuri
                                                    Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    24. MedicationStatement.language
                                                    Definition

                                                    The base language in which the resource is written.

                                                    ShortLanguage 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).

                                                    Control0..1
                                                    BindingThe codes SHOULD be taken from CommonLanguages
                                                    (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                    A human language.

                                                    Additional BindingsPurpose
                                                    AllLanguagesMax Binding
                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    26. MedicationStatement.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.

                                                    ShortText 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.

                                                    Control0..1
                                                    TypeNarrative
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesnarrative, html, xhtml, display
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    28. MedicationStatement.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.

                                                    ShortContained, 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.

                                                    Control0..*
                                                    TypeResource
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesinline resources, anonymous resources, contained resources
                                                    30. MedicationStatement.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Invariantsele-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())
                                                    SlicingThis element introduces a set of slices on MedicationStatement.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 32. MedicationStatement.extension:acceptedRisk
                                                      Slice NameacceptedRisk
                                                      Definition

                                                      An Extension

                                                      Shortakzeptiertes (in Kauf genommenes) Risiko
                                                      Comments

                                                      Begründung des Must-Support: Folgeinformation der AMTS-Bewertung, sollte auch an nachfolgende Behandelnde übermittelbar sein

                                                      Hinweis: Hier kann ein im Rahmen der Medikation festgestelltes, aber in Kauf genommenes Risiko dokumentiert werden, speziell auch die Begründung und ggf. erforderliche Begleitmaßnahmen.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(ISiK Accepted Risk) (Extension Type: string)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-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. MedicationStatement.extension:acceptedRisk.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      36. MedicationStatement.extension:acceptedRisk.extension
                                                      Definition

                                                      An Extension

                                                      ShortExtension
                                                      Control0..0
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-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())
                                                      SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 38. MedicationStatement.extension:acceptedRisk.url
                                                        Definition

                                                        Source of the definition for the extension code - a logical name or a URL.

                                                        Shortidentifies the meaning of the extension
                                                        Comments

                                                        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.

                                                        Control1..1
                                                        Typeuri
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKAcceptedRisk
                                                        40. MedicationStatement.extension:acceptedRisk.value[x]
                                                        Definition

                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                        ShortValue of extension
                                                        Control1..1
                                                        Typestring
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        42. MedicationStatement.extension:medikationsart
                                                        Slice Namemedikationsart
                                                        Definition

                                                        An Extension

                                                        ShortTherapieart der Medikation
                                                        Comments

                                                        Begründung des Must-Support: von der Fachseite gewünschte Angabe

                                                        Hinweis: Angabe Akut- oder Dauermedikation.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(ISiK Medikationsart) (Extension Type: Coding)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-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())
                                                        44. MedicationStatement.extension:medikationsart.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        46. MedicationStatement.extension:medikationsart.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..0
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-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())
                                                        SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 48. MedicationStatement.extension:medikationsart.url
                                                          Definition

                                                          Source of the definition for the extension code - a logical name or a URL.

                                                          Shortidentifies the meaning of the extension
                                                          Comments

                                                          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.

                                                          Control1..1
                                                          Typeuri
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKMedikationsart
                                                          50. MedicationStatement.extension:medikationsart.value[x]
                                                          Definition

                                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                          ShortValue of extension
                                                          Control1..1
                                                          BindingThe codes SHALL be taken from ISiKMedikationsartVS
                                                          (required to https://gematik.de/fhir/isik/ValueSet/ISiKMedikationsartVS)
                                                          TypeCoding
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          52. MedicationStatement.extension:medikationsart.value[x].id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          54. MedicationStatement.extension:medikationsart.value[x].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.

                                                          ShortAdditional 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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-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())
                                                          SlicingThis element introduces a set of slices on MedicationStatement.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 56. MedicationStatement.extension:medikationsart.value[x].system
                                                            Definition

                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                            ShortIdentity of the terminology system
                                                            Comments

                                                            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.

                                                            Control1..1
                                                            Typeuri
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            58. MedicationStatement.extension:medikationsart.value[x].version
                                                            Definition

                                                            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.

                                                            ShortVersion of the system - if relevant
                                                            Comments

                                                            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.

                                                            NoteThis is a business version Id, not a resource version Id (see discussion)
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            60. MedicationStatement.extension:medikationsart.value[x].code
                                                            Definition

                                                            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).

                                                            ShortSymbol in syntax defined by the system
                                                            Control1..1
                                                            Typecode
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            Need to refer to a particular code in the system.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            62. MedicationStatement.extension:medikationsart.value[x].display
                                                            Definition

                                                            A representation of the meaning of the code in the system, following the rules of the system.

                                                            ShortRepresentation defined by the system
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            64. MedicationStatement.extension:medikationsart.value[x].userSelected
                                                            Definition

                                                            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                            ShortIf this coding was chosen directly by the user
                                                            Comments

                                                            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.

                                                            Control0..1
                                                            Typeboolean
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            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.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            66. MedicationStatement.extension:selbstmedikation
                                                            Slice Nameselbstmedikation
                                                            Definition

                                                            An Extension

                                                            ShortSelbstmedikation
                                                            Comments

                                                            Begründung des Must-Support: von der Fachseite gewünschte Angabe

                                                            Hinweis: Flag zur Selbstmedikation.

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(ISiK Selbstmedikation) (Extension Type: boolean)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Invariantsele-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())
                                                            68. MedicationStatement.extension:selbstmedikation.id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            70. MedicationStatement.extension:selbstmedikation.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..0
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-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())
                                                            SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 72. MedicationStatement.extension:selbstmedikation.url
                                                              Definition

                                                              Source of the definition for the extension code - a logical name or a URL.

                                                              Shortidentifies the meaning of the extension
                                                              Comments

                                                              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.

                                                              Control1..1
                                                              Typeuri
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKSelbstmedikation
                                                              74. MedicationStatement.extension:selbstmedikation.value[x]
                                                              Definition

                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                              ShortValue of extension
                                                              Control1..1
                                                              Typeboolean
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              76. MedicationStatement.extension:behandlungsziel
                                                              Slice Namebehandlungsziel
                                                              Definition

                                                              An Extension

                                                              ShortBehandlungsziel (textuell)
                                                              Comments

                                                              Begründung des Must-Support: von der Fachseite gewünschte Angabe

                                                              Hinweis: Freitext-Beschreibung des Behandlungsziels.

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension(ISiK Behandlungsziel) (Extension Type: string)
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-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())
                                                              78. MedicationStatement.extension:behandlungsziel.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              80. MedicationStatement.extension:behandlungsziel.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..0
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-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())
                                                              SlicingThis element introduces a set of slices on MedicationStatement.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 82. MedicationStatement.extension:behandlungsziel.url
                                                                Definition

                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                Shortidentifies the meaning of the extension
                                                                Comments

                                                                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.

                                                                Control1..1
                                                                Typeuri
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                Fixed Valuehttps://gematik.de/fhir/isik/StructureDefinition/ExtensionISiKBehandlungsziel
                                                                84. MedicationStatement.extension:behandlungsziel.value[x]
                                                                Definition

                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                ShortValue of extension
                                                                Control1..1
                                                                Typestring
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                86. MedicationStatement.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).

                                                                ShortExtensions 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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                Summaryfalse
                                                                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 Namesextensions, user content
                                                                Invariantsele-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())
                                                                88. MedicationStatement.identifier
                                                                Definition

                                                                Identifiers associated with this Medication Statement 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.

                                                                ShortExternal identifier
                                                                Comments

                                                                This is a business identifier, not a resource identifier.

                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control0..*
                                                                TypeIdentifier
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                90. MedicationStatement.basedOn
                                                                Definition

                                                                A plan, proposal or order that is fulfilled in whole or in part by this event.

                                                                ShortFulfils plan, proposal or order
                                                                Control0..*
                                                                TypeReference(MedicationRequest, CarePlan, ServiceRequest)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                92. MedicationStatement.partOf
                                                                Definition

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

                                                                ShortReferenz auf andere Objekte, deren Bestandteil diese MedikationsInformation ist
                                                                Comments

                                                                Begründung des Must-Support: Abbildung der Zusammenhänge

                                                                Control0..*
                                                                TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Observation)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                94. MedicationStatement.status
                                                                Definition

                                                                A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.

                                                                ShortStatus der Medikationsinformation
                                                                Comments

                                                                Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard

                                                                Control1..1
                                                                BindingThe codes SHALL be taken from Medication Status Codes
                                                                (required to http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1)

                                                                A coded concept indicating the current status of a MedicationStatement.

                                                                Typecode
                                                                Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                96. MedicationStatement.statusReason
                                                                Definition

                                                                Captures the reason for the current state of the MedicationStatement.

                                                                ShortReason for current status
                                                                Comments

                                                                This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.

                                                                Control0..*
                                                                BindingFor example codes, see SNOMEDCTDrugTherapyStatusCodes
                                                                (example to http://hl7.org/fhir/ValueSet/reason-medication-status-codes|4.0.1)

                                                                A coded concept indicating the reason for the status of the statement.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                98. MedicationStatement.category
                                                                Definition

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

                                                                ShortType of medication usage
                                                                Control0..1
                                                                BindingThe codes SHOULD be taken from Medication usage category codes
                                                                (preferred to http://hl7.org/fhir/ValueSet/medication-statement-category|4.0.1)

                                                                A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                100. MedicationStatement.medication[x]
                                                                Definition

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

                                                                ShortAngabe des Medikaments
                                                                Comments

                                                                Begründung des Must-Support: Basisinformation. Siehe Slicing-Definition zur Wahlmöglichkeit zwischen codierter Angabe und Referenz auf Medication-Ressource.

                                                                Control1..1
                                                                BindingFor example codes, see SNOMEDCTMedicationCodes
                                                                (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                                                                A coded concept identifying the substance or product being taken.

                                                                TypeChoice of: CodeableConcept, Reference(Medication)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on MedicationStatement.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                • type @ $this
                                                                • 102. MedicationStatement.medication[x]:medicationCodeableConcept
                                                                  Slice NamemedicationCodeableConcept
                                                                  Definition

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

                                                                  ShortMedikament in codierter Form oder ggf. als Freitext
                                                                  Comments

                                                                  Begründung des Must-Support: Basisinformation

                                                                  Hinweis: kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren.

                                                                  Control0..1
                                                                  BindingFor example codes, see SNOMEDCTMedicationCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                                                                  A coded concept identifying the substance or product being taken.

                                                                  TypeCodeableConcept
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  104. MedicationStatement.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.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  106. MedicationStatement.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.

                                                                  ShortAdditional 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.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-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())
                                                                  SlicingThis element introduces a set of slices on MedicationStatement.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 108. MedicationStatement.medication[x]:medicationCodeableConcept.coding
                                                                    Definition

                                                                    A reference to a code defined by a terminology system.

                                                                    ShortCode 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.

                                                                    Control0..*
                                                                    TypeCoding
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on MedicationStatement.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • pattern @ $this
                                                                    • 110. MedicationStatement.medication[x]:medicationCodeableConcept.coding:PZN
                                                                      Slice NamePZN
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

                                                                      Mehrfachcodierung ist zulässig, da für ein abstraktes Medikament auch mehrere PZN-Codes existieren können, z.B. existieren für Aspirin 3 verschiedene Packungsgrößen.

                                                                      Control0..*
                                                                      TypeCoding(ISiKPZNCoding)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Pattern Value{
                                                                        "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      112. MedicationStatement.medication[x]:medicationCodeableConcept.coding:ATC-DE
                                                                      Slice NameATC-DE
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

                                                                      Mehrfachcodierung ist zulässig, da für ein abstraktes Medikament auch mehrere ATC-Codes existieren können, z.B. existieren für Aspirin 4 verschiedene Codes, je nachdem wofür das Medikament angewendet wird.

                                                                      Control0..*
                                                                      TypeCoding(ISiKATCCoding)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Pattern Value{
                                                                        "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      114. MedicationStatement.medication[x]:medicationCodeableConcept.coding:SCT
                                                                      Slice NameSCT
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode 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.

                                                                      Control0..1
                                                                      TypeCoding(ISiKSnomedCTCoding)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Pattern Value{
                                                                        "system" : "http://snomed.info/sct"
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      116. MedicationStatement.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.

                                                                      ShortPlain text representation of the concept
                                                                      Comments

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

                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      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.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      118. MedicationStatement.medication[x]:medicationReference
                                                                      Slice NamemedicationReference
                                                                      Definition

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

                                                                      ShortReferenz auf das Medikament (Medication-Ressource)
                                                                      Comments

                                                                      Begründung des Must-Support: Basisinformation

                                                                      Hinweis: wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen

                                                                      Control0..1
                                                                      TypeReference(Medication)
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      120. MedicationStatement.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.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      122. MedicationStatement.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.

                                                                      ShortAdditional 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.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-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())
                                                                      SlicingThis element introduces a set of slices on MedicationStatement.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 124. MedicationStatement.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.

                                                                        ShortLiteral 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.

                                                                        Control1..1
                                                                        This element is affected by the following invariants: ref-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        126. MedicationStatement.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).

                                                                        ShortType 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.

                                                                        Control0..1
                                                                        BindingUnless 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).

                                                                        Typeuri
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        128. MedicationStatement.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.

                                                                        ShortLogical 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).

                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                        Control0..1
                                                                        TypeIdentifier
                                                                        Is Modifierfalse
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        130. MedicationStatement.medication[x]:medicationReference.display
                                                                        Definition

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

                                                                        ShortText 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.

                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        132. MedicationStatement.subject
                                                                        Definition

                                                                        The person, animal or group who is/was taking the medication.

                                                                        ShortReferenz auf den Patienten
                                                                        Comments

                                                                        Begründung des Must-Support: Basisinformation

                                                                        Control1..1
                                                                        TypeReference(Patient)
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        134. MedicationStatement.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.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        136. MedicationStatement.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.

                                                                        ShortAdditional 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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-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())
                                                                        SlicingThis element introduces a set of slices on MedicationStatement.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 138. MedicationStatement.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.

                                                                          ShortPatienten-Link
                                                                          Comments

                                                                          Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

                                                                          Control1..1
                                                                          This element is affected by the following invariants: ref-1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          140. MedicationStatement.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).

                                                                          ShortType 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.

                                                                          Control0..1
                                                                          BindingUnless 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).

                                                                          Typeuri
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          142. MedicationStatement.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.

                                                                          ShortLogical 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).

                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                          Control0..1
                                                                          TypeIdentifier
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          144. MedicationStatement.subject.display
                                                                          Definition

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

                                                                          ShortText 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.

                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          146. MedicationStatement.context
                                                                          Definition

                                                                          The encounter or episode of care that establishes the context for this MedicationStatement.

                                                                          ShortReferenz auf den Abteilungskontakt
                                                                          Comments

                                                                          Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext

                                                                          Control0..1
                                                                          TypeReference(Encounter, EpisodeOfCare)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          148. MedicationStatement.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.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          150. MedicationStatement.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.

                                                                          ShortAdditional 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.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-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())
                                                                          SlicingThis element introduces a set of slices on MedicationStatement.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 152. MedicationStatement.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.

                                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                                            Comments

                                                                            Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ref-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            154. MedicationStatement.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).

                                                                            ShortType 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.

                                                                            Control0..1
                                                                            BindingUnless 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).

                                                                            Typeuri
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            156. MedicationStatement.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.

                                                                            ShortLogical 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).

                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                            Control0..1
                                                                            TypeIdentifier
                                                                            Is Modifierfalse
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            158. MedicationStatement.context.display
                                                                            Definition

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

                                                                            ShortText 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.

                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            160. MedicationStatement.effective[x]
                                                                            Definition

                                                                            The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

                                                                            ShortZeitpunkt oder Zeitraum, für den die MedikationsInformation gilt
                                                                            Comments

                                                                            Begründung des Must-Support: Basisinformation

                                                                            Control1..1
                                                                            TypeChoice of: dateTime, Period
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            SlicingThis element introduces a set of slices on MedicationStatement.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                            • type @ $this
                                                                            • 162. MedicationStatement.effective[x]:effectiveDateTime
                                                                              Slice NameeffectiveDateTime
                                                                              Definition

                                                                              The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

                                                                              ShortZeitpunkt (Datum oder Datum + Uhrzeit)
                                                                              Comments

                                                                              Begründung des Must-Support: Basisinformation

                                                                              Festlegung zur Nutzung: An dieser Stelle KANN eine lediglich Datums-genaue Angabe (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe seitens eines bestätigungsrelevanten Systems unterstützt werden. Es KANN auch eine Uhrzeit angegeben werden. Für sekunden-genaue Angaben zur Verabreichung eines Medikaments an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden.

                                                                              Control0..1
                                                                              TypedateTime
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              164. MedicationStatement.effective[x]:effectivePeriod
                                                                              Slice NameeffectivePeriod
                                                                              Definition

                                                                              The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).

                                                                              ShortZeitraum
                                                                              Comments

                                                                              Begründung des Must-Support: Basisinformation

                                                                              Festlegung zur Nutzung: An dieser Stelle KANN eine lediglich Datums-genaue Angabe (einschließlich Granularität Jahr, Monat oder Tag für .effectiveDateTime oder .effectivePeriod auf Datums-Ebene gemäß der FHIR-Core Vorgabe seitens eines bestätigungsrelevanten Systems unterstützt werden. Es KANN auch eine Uhrzeit angegeben werden. Für sekunden-genaue Angaben zur Verabreichung eines Medikaments an einen Patienten SOLL das Profil ISiKMedikationsVerabreichung (MedicationAdministration) verwendet werden.

                                                                              Control0..1
                                                                              TypePeriod
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              166. MedicationStatement.effective[x]:effectivePeriod.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              168. MedicationStatement.effective[x]:effectivePeriod.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.

                                                                              ShortAdditional 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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-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())
                                                                              SlicingThis element introduces a set of slices on MedicationStatement.effective[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 170. MedicationStatement.effective[x]:effectivePeriod.start
                                                                                Definition

                                                                                The start of the period. The boundary is inclusive.

                                                                                ShortStarting time with inclusive boundary
                                                                                Comments

                                                                                If the low element is missing, the meaning is that the low boundary is not known.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: per-1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                172. MedicationStatement.effective[x]:effectivePeriod.end
                                                                                Definition

                                                                                The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                                                ShortEnd time with inclusive boundary, if not ongoing
                                                                                Comments

                                                                                The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: per-1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                174. MedicationStatement.dateAsserted
                                                                                Definition

                                                                                The date when the medication statement was asserted by the information source.

                                                                                ShortDatum der Feststellung/des Bekanntwerdens der MedikationsInformation
                                                                                Comments

                                                                                Begründung des Must-Support: Nachvollziehbarkeit

                                                                                Control0..1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                176. MedicationStatement.informationSource
                                                                                Definition

                                                                                The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.

                                                                                ShortPerson or organization that provided the information about the taking of this medication
                                                                                Control0..1
                                                                                TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                178. MedicationStatement.derivedFrom
                                                                                Definition

                                                                                Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.

                                                                                ShortAdditional supporting information
                                                                                Comments

                                                                                Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.

                                                                                Control0..*
                                                                                TypeReference(Resource)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                180. MedicationStatement.reasonCode
                                                                                Definition

                                                                                A reason for why the medication is being/was taken.

                                                                                ShortGrund der Medikation (codiert)
                                                                                Comments

                                                                                Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.

                                                                                Begründung zu Must-Support: Konsolidierung mit MII.

                                                                                Control0..*
                                                                                BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                                                                A coded concept identifying why the medication is being taken.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                182. MedicationStatement.reasonCode.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                184. MedicationStatement.reasonCode.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.

                                                                                ShortAdditional 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.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-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())
                                                                                SlicingThis element introduces a set of slices on MedicationStatement.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 186. MedicationStatement.reasonCode.coding
                                                                                  Definition

                                                                                  A reference to a code defined by a terminology system.

                                                                                  ShortCode 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.

                                                                                  Control0..*
                                                                                  TypeCoding
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

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

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  188. MedicationStatement.reasonCode.coding.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  190. MedicationStatement.reasonCode.coding.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.

                                                                                  ShortAdditional 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.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-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())
                                                                                  SlicingThis element introduces a set of slices on MedicationStatement.reasonCode.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 192. MedicationStatement.reasonCode.coding.system
                                                                                    Definition

                                                                                    The identification of the code system that defines the meaning of the symbol in the code.

                                                                                    ShortIdentity of the terminology system
                                                                                    Comments

                                                                                    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.

                                                                                    Control1..1
                                                                                    Typeuri
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to be unambiguous about the source of the definition of the symbol.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    194. MedicationStatement.reasonCode.coding.version
                                                                                    Definition

                                                                                    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.

                                                                                    ShortVersion of the system - if relevant
                                                                                    Comments

                                                                                    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.

                                                                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    196. MedicationStatement.reasonCode.coding.code
                                                                                    Definition

                                                                                    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).

                                                                                    ShortSymbol in syntax defined by the system
                                                                                    Control1..1
                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to refer to a particular code in the system.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    198. MedicationStatement.reasonCode.coding.display
                                                                                    Definition

                                                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                                                    ShortRepresentation defined by the system
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    200. MedicationStatement.reasonCode.coding.userSelected
                                                                                    Definition

                                                                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                                    ShortIf this coding was chosen directly by the user
                                                                                    Comments

                                                                                    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.

                                                                                    Control0..1
                                                                                    Typeboolean
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    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.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    202. MedicationStatement.reasonCode.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.

                                                                                    ShortPlain text representation of the concept
                                                                                    Comments

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

                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    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.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    204. MedicationStatement.reasonReference
                                                                                    Definition

                                                                                    Condition or observation that supports why the medication is being/was taken.

                                                                                    ShortGrund der Medikation (Referenz)
                                                                                    Comments

                                                                                    Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Weiterhin MÜSSEN beide Elemente interpretiert werden können.

                                                                                    Begründung zu Must-Support: Konsolidierung mit MII.

                                                                                    Control0..*
                                                                                    TypeReference(Condition, Observation, DiagnosticReport)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    206. MedicationStatement.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.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    208. MedicationStatement.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.

                                                                                    ShortAdditional 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.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-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())
                                                                                    SlicingThis element introduces a set of slices on MedicationStatement.reasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 210. MedicationStatement.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.

                                                                                      ShortLiteral 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.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: ref-1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Must Supporttrue
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      212. MedicationStatement.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).

                                                                                      ShortType 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.

                                                                                      Control0..1
                                                                                      BindingUnless 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).

                                                                                      Typeuri
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      214. MedicationStatement.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.

                                                                                      ShortLogical 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).

                                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                      Control0..1
                                                                                      TypeIdentifier
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      216. MedicationStatement.reasonReference.display
                                                                                      Definition

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

                                                                                      ShortText 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.

                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      218. MedicationStatement.note
                                                                                      Definition

                                                                                      Provides extra information about the medication statement that is not conveyed by the other attributes.

                                                                                      ShortZusätzliche Anmerkungen zur Medikation
                                                                                      Comments

                                                                                      Begründung des Must-Support: Fachlich relevante Zusatzinformationen

                                                                                      Control0..*
                                                                                      TypeAnnotation
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      220. MedicationStatement.note.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      222. MedicationStatement.note.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.

                                                                                      ShortAdditional 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.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-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())
                                                                                      SlicingThis element introduces a set of slices on MedicationStatement.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 224. MedicationStatement.note.author[x]
                                                                                        Definition

                                                                                        The individual responsible for making the annotation.

                                                                                        ShortIndividual responsible for the annotation
                                                                                        Comments

                                                                                        Organization is used when there's no need for specific attribution as to who made the comment.

                                                                                        Control0..1
                                                                                        TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        226. MedicationStatement.note.time
                                                                                        Definition

                                                                                        Indicates when this particular annotation was made.

                                                                                        ShortWhen the annotation was made
                                                                                        Control0..1
                                                                                        TypedateTime
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        228. MedicationStatement.note.text
                                                                                        Definition

                                                                                        The text of the annotation in markdown format.

                                                                                        ShortFreitext-Notiz
                                                                                        Comments

                                                                                        Begründung des Must-Support: Angabe zusätzlicher Informationen kann fachlich relevant sein

                                                                                        Control1..1
                                                                                        Typemarkdown
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Must Supporttrue
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        230. MedicationStatement.dosage
                                                                                        Definition

                                                                                        Indicates how the medication is/was or should be taken by the patient.

                                                                                        ShortDosierungsangaben
                                                                                        Comments

                                                                                        Begründung des Must-Support: Basisinformation. Zur vollständig strukturierten Abbildung der zahlreichen Möglichkeiten sind die hier mit Must-Support gekennzeichneten Unterelemente erforderlich gemäß Konsens der ISiK AG Medikation.

                                                                                        Hinweis: Zahlreiche Beispiele zur Dosierungsanweisung sind im Implementierungsleitfaden Medikament von HL7 Deutschland dokumentiert.

                                                                                        Control0..*
                                                                                        TypeDosage(Dosage DE)
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        isik-dosage-as-needed-for: Wenn Indikationen für eine Bedarfsmedikation angegeben sind, MUSS asNeededBoolean vorhanden und true sein. (extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').empty() or asNeededBoolean = true)
                                                                                        232. MedicationStatement.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.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Summaryfalse
                                                                                        234. MedicationStatement.dosage.extension
                                                                                        Definition

                                                                                        An Extension

                                                                                        ShortIndikation für die Bedarfsmedikation
                                                                                        Comments

                                                                                        Begründung des Must-Support: Ermöglicht die Angabe mehrerer Indikationen für die Bedarfsmedikation, z.B. 'Schmerzen', 'Fieber', 'Hustenreiz' etc. Diese Bedingungen sind ODER verknüpft, d.h. die Bedarfsmedikation soll bei Vorliegen einer ODER mehrerer dieser Bedingungen angewendet werden.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-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())
                                                                                        SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 236. MedicationStatement.dosage.extension.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Summaryfalse
                                                                                          238. MedicationStatement.dosage.extension.extension
                                                                                          Definition

                                                                                          An Extension

                                                                                          ShortExtension
                                                                                          Control0..0
                                                                                          TypeExtension
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-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())
                                                                                          SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 240. MedicationStatement.dosage.extension.url
                                                                                            Definition

                                                                                            Source of the definition for the extension code - a logical name or a URL.

                                                                                            Shortidentifies the meaning of the extension
                                                                                            Comments

                                                                                            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.

                                                                                            Control1..1
                                                                                            Typeuri
                                                                                            Is Modifierfalse
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            Summaryfalse
                                                                                            242. MedicationStatement.dosage.extension.value[x]
                                                                                            Definition

                                                                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                            ShortValue of extension
                                                                                            Control0..1
                                                                                            TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • type @ $this
                                                                                            • 244. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept
                                                                                              Slice NamevalueCodeableConcept
                                                                                              Definition

                                                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                              ShortValue of extension
                                                                                              Control0..1
                                                                                              TypeCodeableConcept
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              246. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept.id
                                                                                              Definition

                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              ShortUnique id for inter-element referencing
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              Summaryfalse
                                                                                              248. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept.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.

                                                                                              ShortAdditional 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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-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())
                                                                                              SlicingThis element introduces a set of slices on MedicationStatement.dosage.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 250. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept.coding
                                                                                                Definition

                                                                                                A reference to a code defined by a terminology system.

                                                                                                ShortCode 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.

                                                                                                Control0..*
                                                                                                TypeCoding
                                                                                                Is Modifierfalse
                                                                                                Summarytrue
                                                                                                Requirements

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

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                252. MedicationStatement.dosage.extension.value[x]:valueCodeableConcept.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.

                                                                                                ShortIndikation für die Bedarfsmedikation (Freitext)
                                                                                                Comments

                                                                                                Begründung des Must-Support: Ermöglicht die Angabe einer Indikation für die Bedarfsmedikation in Freitextform, eine Kodierung ist nicht verpflichtend. Es wird jedoch empfohlen, die Indikation zusätzlich in kodierter Form anzugeben, um die Interoperabilität zu erhöhen.

                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                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.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                254. MedicationStatement.dosage.extension:asNeededFor
                                                                                                Slice NameasNeededFor
                                                                                                Definition

                                                                                                Optional Extension Element - found in all resources.

                                                                                                ShortOptional Extensions Element
                                                                                                Control0..*
                                                                                                TypeExtension(Dosage AsNeededFor) (Extension Type: CodeableConcept)
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                Invariantsele-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())
                                                                                                256. MedicationStatement.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).

                                                                                                ShortExtensions 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.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                Summarytrue
                                                                                                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 Namesextensions, user content, modifiers
                                                                                                Invariantsele-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())
                                                                                                258. MedicationStatement.dosage.sequence
                                                                                                Definition

                                                                                                Indicates the order in which the dosage instructions should be applied or interpreted.

                                                                                                ShortThe order of the dosage instructions
                                                                                                Control0..1
                                                                                                Typeinteger
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                260. MedicationStatement.dosage.text
                                                                                                Definition

                                                                                                Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker

                                                                                                ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'
                                                                                                Comments

                                                                                                Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.

                                                                                                Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.
                                                                                                
                                                                                                Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://gemspec.gematik.de/ig/fhir/isik/basis/6.0.0-rc1/Index_Festlegungen.html/UebergreifendeFestlegungen_Must-Support-Flags): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.'
                                                                                                
                                                                                                Zum Beispiel könnte ein empfangendes System die Freitext-Dosierungsinformation in strukturierte Dosierungsinformation umwandeln, um sie in einer Medikationsverwaltung anzuzeigen oder später zu exponieren. Geht es zum Beispiel um eine Angabe zu Tageszeiten der Einnahme in der freitextlichen Dosierungsinformation als 'Morgens, Mittags, Abends', so könnte das empfangende System diese Angabe in strukturierte Dosierungsinformationen umwandeln, die die Einnahmezeiten in kodierter Form mit 'MORN', 'NOON', 'EVE' deklariert.
                                                                                                
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                262. MedicationStatement.dosage.additionalInstruction
                                                                                                Definition

                                                                                                Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                                                                                                ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                                                                                Comments

                                                                                                Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                                                                                                Control0..*
                                                                                                BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                                                                                (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

                                                                                                A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                264. MedicationStatement.dosage.patientInstruction
                                                                                                Definition

                                                                                                Instructions in terms that are understood by the patient or consumer.

                                                                                                Shortbesondere Anweisungen für den Patienten
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                266. MedicationStatement.dosage.timing
                                                                                                Definition

                                                                                                Wann das Medikament verabreicht werden soll.

                                                                                                ShortWann das Medikament verabreicht werden soll
                                                                                                Comments

                                                                                                Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.

                                                                                                Control0..1
                                                                                                TypeTiming(Timing DE)
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                268. MedicationStatement.dosage.timing.id
                                                                                                Definition

                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                Summaryfalse
                                                                                                270. MedicationStatement.dosage.timing.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.

                                                                                                ShortAdditional 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.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Alternate Namesextensions, user content
                                                                                                Invariantsele-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())
                                                                                                SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ url
                                                                                                • 272. MedicationStatement.dosage.timing.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).

                                                                                                  ShortExtensions 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.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                  Summarytrue
                                                                                                  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 Namesextensions, user content, modifiers
                                                                                                  Invariantsele-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())
                                                                                                  274. MedicationStatement.dosage.timing.event
                                                                                                  Definition

                                                                                                  Identifies specific times when the event occurs.

                                                                                                  Shortfester Zeitpunkt
                                                                                                  Control0..*
                                                                                                  TypedateTime
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  276. MedicationStatement.dosage.timing.repeat
                                                                                                  Definition

                                                                                                  Eine Menge von Regeln, die beschreiben, wann das Ereignis geplant ist.

                                                                                                  ShortWiederholungs-Angaben
                                                                                                  Control0..1
                                                                                                  TypeElement
                                                                                                  Is Modifierfalse
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Many timing schedules are determined by regular repetitions.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                                                                                                  tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                                                                                                  tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                                                                                                  tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                                                                                                  tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                                                                                                  tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                                                                                                  tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                                                                                                  tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                                                                                                  tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                                                                                                  TimingSingleDosageForTimeOfDay: Wenn nur timeOfDay verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
                                                                                                  TimingSingleDosageForWhen: Wenn nur when verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
                                                                                                  TimingBoundsUnitMatchesCode: boundsDuration.unit muss zur UCUM boundsDuration.code passen (z. B. 'Woche(n)' nur mit code='wk'). (bounds.ofType(Duration).exists().not() or ( ( bounds.ofType(Duration).code = 'd' implies ( bounds.ofType(Duration).unit = 'Tag(e)' or bounds.ofType(Duration).unit = 'Tag' or bounds.ofType(Duration).unit = 'Tage' ) ) and ( bounds.ofType(Duration).code = 'wk' implies ( bounds.ofType(Duration).unit = 'Woche(n)' or bounds.ofType(Duration).unit = 'Woche' or bounds.ofType(Duration).unit = 'Wochen' ) ) and ( bounds.ofType(Duration).code = 'mo' implies ( bounds.ofType(Duration).unit = 'Monat(e)' or bounds.ofType(Duration).unit = 'Monat' or bounds.ofType(Duration).unit = 'Monate' ) ) and ( bounds.ofType(Duration).code = 'a' implies ( bounds.ofType(Duration).unit = 'Jahr(e)' or bounds.ofType(Duration).unit = 'Jahr' or bounds.ofType(Duration).unit = 'Jahre' ) ) ))
                                                                                                  278. MedicationStatement.dosage.timing.repeat.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  Summaryfalse
                                                                                                  280. MedicationStatement.dosage.timing.repeat.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.

                                                                                                  ShortAdditional 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.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-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())
                                                                                                  SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 282. MedicationStatement.dosage.timing.repeat.bounds[x]
                                                                                                    Definition

                                                                                                    Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.

                                                                                                    ShortLänge/Bereich der Längen oder (Start- und/oder End-)Grenzen
                                                                                                    Comments

                                                                                                    tbd

                                                                                                    Control0..1
                                                                                                    TypeChoice of: Duration, Range, Period
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Is Modifierfalse
                                                                                                    Must Supporttrue
                                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                    Summarytrue
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                    • type @ $this
                                                                                                    • 284. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration
                                                                                                      Slice NameboundsDuration
                                                                                                      Definition

                                                                                                      Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                                                                                      ShortBegrenzung der Dauer
                                                                                                      Control0..1
                                                                                                      TypeDuration
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Is Modifierfalse
                                                                                                      Must Supporttrue
                                                                                                      Summarytrue
                                                                                                      Pattern Value{
                                                                                                        "system" : "http://unitsofmeasure.org"
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      286. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.id
                                                                                                      Definition

                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      Summaryfalse
                                                                                                      288. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.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.

                                                                                                      ShortAdditional 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.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-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())
                                                                                                      SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 290. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.value
                                                                                                        Definition

                                                                                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                        ShortNumerical value (with implicit precision)
                                                                                                        Comments

                                                                                                        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                        Control1..1
                                                                                                        Typedecimal
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Precision is handled implicitly in almost all cases of measurement.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        292. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.comparator
                                                                                                        Definition

                                                                                                        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                                                                        Short< | <= | >= | > - how to understand the value
                                                                                                        Control0..1
                                                                                                        BindingThe codes SHALL be taken from QuantityComparator
                                                                                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                        How the Quantity should be understood and represented.

                                                                                                        Typecode
                                                                                                        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        294. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.unit
                                                                                                        Definition

                                                                                                        A human-readable form of the unit.

                                                                                                        ShortUnit representation
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        296. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.system
                                                                                                        Definition

                                                                                                        The identification of the system that provides the coded form of the unit.

                                                                                                        ShortUCUM-Einheit für die Dauer
                                                                                                        Comments

                                                                                                        Die UCUM-Einheit für die Dauer, z. B. d für Tag, h für Stunde, min für Minute.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: qty-3
                                                                                                        Typeuri
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need to know the system that defines the coded form of the unit.

                                                                                                        Fixed Valuehttp://unitsofmeasure.org
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        298. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsDuration.code
                                                                                                        Definition

                                                                                                        A computer processable form of the unit in some unit representation system.

                                                                                                        ShortCoded form of the unit
                                                                                                        Comments

                                                                                                        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                        Control1..1
                                                                                                        Typecode
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        300. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange
                                                                                                        Slice NameboundsRange
                                                                                                        Definition

                                                                                                        Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.

                                                                                                        ShortBereich für die Begrenzung
                                                                                                        Comments

                                                                                                        tbd

                                                                                                        Control0..1
                                                                                                        TypeRange
                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        302. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Summaryfalse
                                                                                                        304. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.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.

                                                                                                        ShortAdditional 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.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-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())
                                                                                                        SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 306. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low
                                                                                                          Definition

                                                                                                          The low limit. The boundary is inclusive.

                                                                                                          ShortLow limit
                                                                                                          Comments

                                                                                                          If the low element is missing, the low boundary is not known.

                                                                                                          Control0..1
                                                                                                          TypeQuantity(SimpleQuantity)
                                                                                                          Is Modifierfalse
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Pattern Value{
                                                                                                            "system" : "http://unitsofmeasure.org"
                                                                                                          }
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          308. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.id
                                                                                                          Definition

                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Summaryfalse
                                                                                                          310. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.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.

                                                                                                          ShortAdditional 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.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-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())
                                                                                                          SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x].low.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 312. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.value
                                                                                                            Definition

                                                                                                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                            ShortNumerical value (with implicit precision)
                                                                                                            Comments

                                                                                                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                            Control1..1
                                                                                                            Typedecimal
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Precision is handled implicitly in almost all cases of measurement.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            314. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.comparator
                                                                                                            Definition

                                                                                                            Not allowed to be used in this context

                                                                                                            Short< | <= | >= | > - how to understand the value
                                                                                                            Control0..0
                                                                                                            BindingThe codes SHALL be taken from QuantityComparator
                                                                                                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                            How the Quantity should be understood and represented.

                                                                                                            Typecode
                                                                                                            Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            316. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.unit
                                                                                                            Definition

                                                                                                            A human-readable form of the unit.

                                                                                                            ShortUnit representation
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            318. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.system
                                                                                                            Definition

                                                                                                            The identification of the system that provides the coded form of the unit.

                                                                                                            ShortSystem that defines coded unit form
                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: qty-3
                                                                                                            Typeuri
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need to know the system that defines the coded form of the unit.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            320. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.low.code
                                                                                                            Definition

                                                                                                            A computer processable form of the unit in some unit representation system.

                                                                                                            ShortCoded form of the unit
                                                                                                            Comments

                                                                                                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                            Control1..1
                                                                                                            Typecode
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            322. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high
                                                                                                            Definition

                                                                                                            The high limit. The boundary is inclusive.

                                                                                                            ShortHigh limit
                                                                                                            Comments

                                                                                                            If the high element is missing, the high boundary is not known.

                                                                                                            Control0..1
                                                                                                            TypeQuantity(SimpleQuantity)
                                                                                                            Is Modifierfalse
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Pattern Value{
                                                                                                              "system" : "http://unitsofmeasure.org"
                                                                                                            }
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            324. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            Summaryfalse
                                                                                                            326. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.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.

                                                                                                            ShortAdditional 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.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-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())
                                                                                                            SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x].high.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 328. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.value
                                                                                                              Definition

                                                                                                              The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                              ShortNumerical value (with implicit precision)
                                                                                                              Comments

                                                                                                              The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                              Control1..1
                                                                                                              Typedecimal
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Precision is handled implicitly in almost all cases of measurement.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              330. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.comparator
                                                                                                              Definition

                                                                                                              Not allowed to be used in this context

                                                                                                              Short< | <= | >= | > - how to understand the value
                                                                                                              Control0..0
                                                                                                              BindingThe codes SHALL be taken from QuantityComparator
                                                                                                              (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                              How the Quantity should be understood and represented.

                                                                                                              Typecode
                                                                                                              Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                              Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              332. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.unit
                                                                                                              Definition

                                                                                                              A human-readable form of the unit.

                                                                                                              ShortUnit representation
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              334. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.system
                                                                                                              Definition

                                                                                                              The identification of the system that provides the coded form of the unit.

                                                                                                              ShortSystem that defines coded unit form
                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: qty-3
                                                                                                              Typeuri
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Need to know the system that defines the coded form of the unit.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              336. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsRange.high.code
                                                                                                              Definition

                                                                                                              A computer processable form of the unit in some unit representation system.

                                                                                                              ShortCoded form of the unit
                                                                                                              Comments

                                                                                                              The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                              Control1..1
                                                                                                              Typecode
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              338. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod
                                                                                                              Slice NameboundsPeriod
                                                                                                              Definition

                                                                                                              Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.

                                                                                                              Shortbegrenzender Zeitraum
                                                                                                              Comments

                                                                                                              tbd

                                                                                                              Control0..1
                                                                                                              TypePeriod
                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              340. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              342. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.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.

                                                                                                              ShortAdditional 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.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-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())
                                                                                                              SlicingThis element introduces a set of slices on MedicationStatement.dosage.timing.repeat.bounds[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 344. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.start
                                                                                                                Definition

                                                                                                                The start of the period. The boundary is inclusive.

                                                                                                                ShortStarting time with inclusive boundary
                                                                                                                Comments

                                                                                                                If the low element is missing, the meaning is that the low boundary is not known.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: per-1
                                                                                                                TypedateTime
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                346. MedicationStatement.dosage.timing.repeat.bounds[x]:boundsPeriod.end
                                                                                                                Definition

                                                                                                                The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                                                                                ShortEnd time with inclusive boundary, if not ongoing
                                                                                                                Comments

                                                                                                                The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: per-1
                                                                                                                TypedateTime
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                348. MedicationStatement.dosage.timing.repeat.count
                                                                                                                Definition

                                                                                                                A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

                                                                                                                ShortAnzahl Wiederholungen
                                                                                                                Comments

                                                                                                                If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                                                                                                                Control0..1
                                                                                                                TypepositiveInt
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Repetitions may be limited by end time or total occurrences.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                350. MedicationStatement.dosage.timing.repeat.countMax
                                                                                                                Definition

                                                                                                                If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                                                                                                                Shortmaximale Anzahl Wiederholungen
                                                                                                                Control0..1
                                                                                                                TypepositiveInt
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                352. MedicationStatement.dosage.timing.repeat.duration
                                                                                                                Definition

                                                                                                                How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                                                                                                                ShortDauer der Verabreichung
                                                                                                                Comments

                                                                                                                For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                                                                                                Control0..1
                                                                                                                Typedecimal
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Some activities are not instantaneous and need to be maintained for a period of time.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                354. MedicationStatement.dosage.timing.repeat.durationMax
                                                                                                                Definition

                                                                                                                If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                                                                                                                Shortmaximale Dauer der Verabreichung
                                                                                                                Comments

                                                                                                                For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                                                                                                Control0..1
                                                                                                                Typedecimal
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Some activities are not instantaneous and need to be maintained for a period of time.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                356. MedicationStatement.dosage.timing.repeat.durationUnit
                                                                                                                Definition

                                                                                                                The units of time for the duration, in UCUM units.

                                                                                                                ShortEinheit der Dauer
                                                                                                                Control0..1
                                                                                                                BindingThe codes SHALL be taken from UnitsOfTime
                                                                                                                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                                                                                                A unit of time (units from UCUM).

                                                                                                                Typecode
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                358. MedicationStatement.dosage.timing.repeat.frequency
                                                                                                                Definition

                                                                                                                Die Anzahl der Wiederholungen innerhalb des angegebenen Zeitraums. Falls frequencyMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Häufigkeit an.

                                                                                                                ShortFrequenz (Anzahl der Gaben pro Periode)
                                                                                                                Control0..1
                                                                                                                TypepositiveInt
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                360. MedicationStatement.dosage.timing.repeat.frequencyMax
                                                                                                                Definition

                                                                                                                If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                                                                                                                Shortmaximale Frequenz
                                                                                                                Control0..1
                                                                                                                TypepositiveInt
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                362. MedicationStatement.dosage.timing.repeat.period
                                                                                                                Definition

                                                                                                                Gibt die Zeitspanne an, über die die Wiederholungen stattfinden sollen; z. B. um „3-mal täglich“ auszudrücken, wäre 3 die Häufigkeit und „1 Tag“ der Zeitraum. Falls periodMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Zeitspanne an.

                                                                                                                ShortZeitperiode zur Frequenz
                                                                                                                Control0..1
                                                                                                                Typedecimal
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                364. MedicationStatement.dosage.timing.repeat.periodMax
                                                                                                                Definition

                                                                                                                If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                                                                                                                Shortmaximale Zeitperiode zur Frequenz
                                                                                                                Control0..1
                                                                                                                Typedecimal
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                366. MedicationStatement.dosage.timing.repeat.periodUnit
                                                                                                                Definition

                                                                                                                Die Zeiteinheit für den Zeitraum, in UCUM-Einheiten.

                                                                                                                ShortEinheit der Zeitperiode
                                                                                                                Control0..1
                                                                                                                BindingThe codes SHALL be taken from UnitsOfTime
                                                                                                                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                                                                                                A unit of time (units from UCUM).

                                                                                                                Typecode
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                368. MedicationStatement.dosage.timing.repeat.dayOfWeek
                                                                                                                Definition

                                                                                                                Wenn ein oder mehrere Wochentage angegeben sind, findet die Aktion nur an den angegebenen Tagen statt.

                                                                                                                ShortWochentag
                                                                                                                Comments

                                                                                                                Wenn keine Tage angegeben sind, wird angenommen, dass die Aktion an jedem Tag wie sonst angegeben stattfindet.

                                                                                                                Control0..*
                                                                                                                BindingThe codes SHALL be taken from DaysOfWeek
                                                                                                                (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                                                                                                                Typecode
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                370. MedicationStatement.dosage.timing.repeat.timeOfDay
                                                                                                                Definition

                                                                                                                Angegebene Tageszeit, zu der die Aktion stattfinden soll.

                                                                                                                ShortTageszeit
                                                                                                                Comments

                                                                                                                Wenn eine Tageszeit angegeben ist, wird angenommen, dass die Aktion jeden Tag (ggf. gefiltert durch dayOfWeek) zu den angegebenen Zeiten stattfindet.

                                                                                                                Control0..*
                                                                                                                Typetime
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                372. MedicationStatement.dosage.timing.repeat.when
                                                                                                                Definition

                                                                                                                Ein ungefährer Zeitraum während des Tages, der möglicherweise mit einem Ereignis des täglichen Lebens verknüpft ist und angibt, wann die Aktion stattfinden soll.

                                                                                                                ShortTageszeitpunkt codiert
                                                                                                                Comments

                                                                                                                Wenn mehr als ein Ereignis angegeben ist, bezieht sich das Ereignis auf die Vereinigung der angegebenen Ereignisse.

                                                                                                                Control0..*
                                                                                                                BindingThe codes SHALL be taken from EventTiming
                                                                                                                (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                                                                                                                Real world event relating to the schedule.

                                                                                                                Typecode
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Timings are frequently determined by occurrences such as waking, eating and sleep.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                374. MedicationStatement.dosage.timing.repeat.offset
                                                                                                                Definition

                                                                                                                The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

                                                                                                                Shortzeitlicher Abstand der Gabe zum beschriebenen Zeitpunkt
                                                                                                                Control0..1
                                                                                                                TypeunsignedInt
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                376. MedicationStatement.dosage.timing.code
                                                                                                                Definition

                                                                                                                A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                                                                                                                ShortBID | TID | QID | AM | PM | QD | QOD | +
                                                                                                                Comments

                                                                                                                BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                                                                                                                Control0..1
                                                                                                                BindingThe codes SHOULD be taken from TimingAbbreviation
                                                                                                                (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1)

                                                                                                                Code for a known / defined timing pattern.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                378. MedicationStatement.dosage.asNeeded[x]
                                                                                                                Definition

                                                                                                                Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                                                                                                ShortBedarfsmedikation (ja/nein)
                                                                                                                Comments

                                                                                                                Begründung des Must-Support: Abbildung einer Bedarfsmedikation.

                                                                                                                Control0..1
                                                                                                                Typeboolean
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                380. MedicationStatement.dosage.site
                                                                                                                Definition

                                                                                                                Body site to administer to.

                                                                                                                ShortKörperstelle der Verabreichung
                                                                                                                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.

                                                                                                                Control0..1
                                                                                                                BindingFor 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.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                A coded specification of the anatomic site where the medication first enters the body.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                382. MedicationStatement.dosage.site.id
                                                                                                                Definition

                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                Control0..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                Summaryfalse
                                                                                                                384. MedicationStatement.dosage.site.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.

                                                                                                                ShortAdditional 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.

                                                                                                                Control0..*
                                                                                                                TypeExtension
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Alternate Namesextensions, user content
                                                                                                                Invariantsele-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())
                                                                                                                SlicingThis element introduces a set of slices on MedicationStatement.dosage.site.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 386. MedicationStatement.dosage.site.coding
                                                                                                                  Definition

                                                                                                                  A reference to a code defined by a terminology system.

                                                                                                                  ShortCode 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.

                                                                                                                  Control0..*
                                                                                                                  TypeCoding
                                                                                                                  Is Modifierfalse
                                                                                                                  Must Supporttrue
                                                                                                                  Summarytrue
                                                                                                                  Requirements

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

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  SlicingThis element introduces a set of slices on MedicationStatement.dosage.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • pattern @ $this
                                                                                                                  • 388. MedicationStatement.dosage.site.coding:SNOMED-CT
                                                                                                                    Slice NameSNOMED-CT
                                                                                                                    Definition

                                                                                                                    A reference to a code defined by a terminology system.

                                                                                                                    ShortCode 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.

                                                                                                                    Control0..1
                                                                                                                    TypeCoding(ISiKSnomedCTCoding)
                                                                                                                    Is Modifierfalse
                                                                                                                    Must Supporttrue
                                                                                                                    Summarytrue
                                                                                                                    Requirements

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

                                                                                                                    Pattern Value{
                                                                                                                      "system" : "http://snomed.info/sct"
                                                                                                                    }
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    390. MedicationStatement.dosage.site.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.

                                                                                                                    ShortPlain text representation of the concept
                                                                                                                    Comments

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

                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Must Supporttrue
                                                                                                                    Summarytrue
                                                                                                                    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.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    392. MedicationStatement.dosage.route
                                                                                                                    Definition

                                                                                                                    How drug should enter body.

                                                                                                                    ShortRoute
                                                                                                                    Control0..1
                                                                                                                    BindingFor example codes, see SNOMEDCTRouteCodes
                                                                                                                    (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                                                                                                                    A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Must Supporttrue
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    394. MedicationStatement.dosage.route.id
                                                                                                                    Definition

                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                    Summaryfalse
                                                                                                                    396. MedicationStatement.dosage.route.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.

                                                                                                                    ShortAdditional 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.

                                                                                                                    Control0..*
                                                                                                                    TypeExtension
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Alternate Namesextensions, user content
                                                                                                                    Invariantsele-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())
                                                                                                                    SlicingThis element introduces a set of slices on MedicationStatement.dosage.route.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 398. MedicationStatement.dosage.route.coding
                                                                                                                      Definition

                                                                                                                      A reference to a code defined by a terminology system.

                                                                                                                      ShortCode 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.

                                                                                                                      Control0..*
                                                                                                                      TypeCoding
                                                                                                                      Is Modifierfalse
                                                                                                                      Must Supporttrue
                                                                                                                      Summarytrue
                                                                                                                      Requirements

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

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      SlicingThis element introduces a set of slices on MedicationStatement.dosage.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • pattern @ $this
                                                                                                                      • 400. MedicationStatement.dosage.route.coding:EDQM
                                                                                                                        Slice NameEDQM
                                                                                                                        Definition

                                                                                                                        A reference to a code defined by a terminology system.

                                                                                                                        ShortCode 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.

                                                                                                                        Control0..1
                                                                                                                        BindingThe codes SHALL be taken from Medicine EDQM Route of Administration - IPS
                                                                                                                        (required to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)
                                                                                                                        TypeCoding(ISiKCoding)
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        Requirements

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

                                                                                                                        Pattern Value{
                                                                                                                          "system" : "http://standardterms.edqm.eu"
                                                                                                                        }
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        402. MedicationStatement.dosage.route.coding:SNOMED-CT
                                                                                                                        Slice NameSNOMED-CT
                                                                                                                        Definition

                                                                                                                        A reference to a code defined by a terminology system.

                                                                                                                        ShortCode 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.

                                                                                                                        Control0..1
                                                                                                                        BindingThe codes SHALL be taken from SctRouteOfAdministration
                                                                                                                        (required to https://gematik.de/fhir/isik/ValueSet/SctRouteOfAdministration)
                                                                                                                        TypeCoding(ISiKSnomedCTCoding)
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        Requirements

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

                                                                                                                        Pattern Value{
                                                                                                                          "system" : "http://snomed.info/sct"
                                                                                                                        }
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        404. MedicationStatement.dosage.route.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.

                                                                                                                        ShortPlain text representation of the concept
                                                                                                                        Comments

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

                                                                                                                        Control0..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        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.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        406. MedicationStatement.dosage.method
                                                                                                                        Definition

                                                                                                                        Technique for administering medication.

                                                                                                                        ShortTechnique for administering medication
                                                                                                                        Comments

                                                                                                                        Terminologies used often pre-coordinate this term with the route and or form of administration.

                                                                                                                        Control0..1
                                                                                                                        BindingFor 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.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        408. MedicationStatement.dosage.doseAndRate
                                                                                                                        Definition

                                                                                                                        Die verabreichte Menge des Medikaments.

                                                                                                                        ShortMenge des verabreichten Medikaments
                                                                                                                        Control0..*
                                                                                                                        TypeElement
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        410. MedicationStatement.dosage.doseAndRate.id
                                                                                                                        Definition

                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                        Control0..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        412. MedicationStatement.dosage.doseAndRate.extension
                                                                                                                        Definition

                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                        ShortAdditional 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.

                                                                                                                        Control0..*
                                                                                                                        TypeExtension
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Alternate Namesextensions, user content
                                                                                                                        Invariantsele-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())
                                                                                                                        SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • value @ url
                                                                                                                        • 414. MedicationStatement.dosage.doseAndRate.type
                                                                                                                          Definition

                                                                                                                          The kind of dose or rate specified, for example, ordered or calculated.

                                                                                                                          ShortThe kind of dose or rate specified
                                                                                                                          Control0..1
                                                                                                                          BindingFor example codes, see DoseAndRateType
                                                                                                                          (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                                                                                                                          The kind of dose or rate specified.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          If the type is not populated, assume to be "ordered".

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          416. MedicationStatement.dosage.doseAndRate.dose[x]
                                                                                                                          Definition

                                                                                                                          Amount of medication per dose.

                                                                                                                          ShortAmount of medication per dose
                                                                                                                          Comments

                                                                                                                          Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                                                                                                          Control0..1
                                                                                                                          TypeChoice of: Range, Quantity(SimpleQuantity)
                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          The amount of therapeutic or other substance given at one administration event.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                          • type @ $this
                                                                                                                          • 418. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity
                                                                                                                            Slice NamedoseQuantity
                                                                                                                            Definition

                                                                                                                            Menge des Medikaments pro Dosis.

                                                                                                                            ShortDosis
                                                                                                                            Comments

                                                                                                                            Das Must-Support-Flag auf doseQuantity bedeutet, dass produzierende Systeme zur Kodierung der Dosisangaben nach eigenem Ermessen entweder den Datentyp Quantity oder Ratio verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

                                                                                                                            Control0..1
                                                                                                                            BindingThe codes SHALL be taken from Dosage DoseQuantity ValueSet
                                                                                                                            (required to http://ig.fhir.de/igs/medication/ValueSet/DosageDoseQuantityDE)
                                                                                                                            TypeQuantity(SimpleQuantity)
                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                            Is Modifierfalse
                                                                                                                            Must Supporttrue
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            The amount of therapeutic or other substance given at one administration event.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            420. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.id
                                                                                                                            Definition

                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                            Control0..1
                                                                                                                            Typestring
                                                                                                                            Is Modifierfalse
                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                            Summaryfalse
                                                                                                                            422. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.extension
                                                                                                                            Definition

                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                            ShortAdditional 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.

                                                                                                                            Control0..*
                                                                                                                            TypeExtension
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Alternate Namesextensions, user content
                                                                                                                            Invariantsele-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())
                                                                                                                            SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                            • value @ url
                                                                                                                            • 424. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.value
                                                                                                                              Definition

                                                                                                                              The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                                              ShortDosiswert
                                                                                                                              Comments

                                                                                                                              Begründung MS: Der Dosiswert ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                                                                                              Control0..1
                                                                                                                              Typedecimal
                                                                                                                              Is Modifierfalse
                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Precision is handled implicitly in almost all cases of measurement.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              426. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.comparator
                                                                                                                              Definition

                                                                                                                              Not allowed to be used in this context

                                                                                                                              Short< | <= | >= | > - how to understand the value
                                                                                                                              Control0..0
                                                                                                                              BindingThe codes SHALL be taken from QuantityComparator
                                                                                                                              (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                                              How the Quantity should be understood and represented.

                                                                                                                              Typecode
                                                                                                                              Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                                              Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              428. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.unit
                                                                                                                              Definition

                                                                                                                              A human-readable form of the unit.

                                                                                                                              ShortMenschenlesbare Dosis-Einheit
                                                                                                                              Comments

                                                                                                                              Begründung MS: Die menschenlesbare Dosis-Einheit ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                                                                                              Control0..1
                                                                                                                              Typestring
                                                                                                                              Is Modifierfalse
                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              430. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.system
                                                                                                                              Definition

                                                                                                                              The identification of the system that provides the coded form of the unit.

                                                                                                                              ShortCodeSystem der Dosisangabe
                                                                                                                              Comments

                                                                                                                              Begründung MS: Das CodeSystem der Dosisangabe ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                                                                                              Control0..1
                                                                                                                              This element is affected by the following invariants: qty-3
                                                                                                                              Typeuri
                                                                                                                              Is Modifierfalse
                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Need to know the system that defines the coded form of the unit.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              432. MedicationStatement.dosage.doseAndRate.dose[x]:doseQuantity.code
                                                                                                                              Definition

                                                                                                                              A computer processable form of the unit in some unit representation system.

                                                                                                                              ShortCode der Dosisangabe
                                                                                                                              Comments

                                                                                                                              Begründung MS: Der Code der Dosisangabe ist notwendig, um die Dosisangabe korrekt interpretieren zu können.

                                                                                                                              Control0..1
                                                                                                                              Typecode
                                                                                                                              Is Modifierfalse
                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              434. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange
                                                                                                                              Slice NamedoseRange
                                                                                                                              Definition

                                                                                                                              Amount of medication per dose.

                                                                                                                              ShortDosisbereich
                                                                                                                              Comments

                                                                                                                              Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                                                                                                              Control0..1
                                                                                                                              TypeRange
                                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              The amount of therapeutic or other substance given at one administration event.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              436. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.id
                                                                                                                              Definition

                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                              Control0..1
                                                                                                                              Typestring
                                                                                                                              Is Modifierfalse
                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                              Summaryfalse
                                                                                                                              438. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.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.

                                                                                                                              ShortAdditional 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.

                                                                                                                              Control0..*
                                                                                                                              TypeExtension
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Alternate Namesextensions, user content
                                                                                                                              Invariantsele-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())
                                                                                                                              SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • value @ url
                                                                                                                              • 440. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.low
                                                                                                                                Definition

                                                                                                                                The low limit. The boundary is inclusive.

                                                                                                                                ShortLow limit
                                                                                                                                Comments

                                                                                                                                If the low element is missing, the low boundary is not known.

                                                                                                                                Control0..1
                                                                                                                                TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supporttrue
                                                                                                                                Summarytrue
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                442. MedicationStatement.dosage.doseAndRate.dose[x]:doseRange.high
                                                                                                                                Definition

                                                                                                                                The high limit. The boundary is inclusive.

                                                                                                                                ShortHigh limit
                                                                                                                                Comments

                                                                                                                                If the high element is missing, the high boundary is not known.

                                                                                                                                Control0..1
                                                                                                                                TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supporttrue
                                                                                                                                Summarytrue
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                444. MedicationStatement.dosage.doseAndRate.rate[x]
                                                                                                                                Definition

                                                                                                                                Amount of medication per unit of time.

                                                                                                                                ShortAmount of medication per unit of time
                                                                                                                                Comments

                                                                                                                                It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                                                                                                It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                                                                                                Control0..1
                                                                                                                                TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                Is Modifierfalse
                                                                                                                                Summarytrue
                                                                                                                                Requirements

                                                                                                                                Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.rate[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                                • type @ $this
                                                                                                                                • 446. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio
                                                                                                                                  Slice NamerateRatio
                                                                                                                                  Definition

                                                                                                                                  Amount of medication per unit of time.

                                                                                                                                  ShortRaten-Verhältnis
                                                                                                                                  Comments

                                                                                                                                  Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

                                                                                                                                  Control0..1
                                                                                                                                  TypeRatio
                                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Must Supporttrue
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  448. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.id
                                                                                                                                  Definition

                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                  Control0..1
                                                                                                                                  Typestring
                                                                                                                                  Is Modifierfalse
                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                  Summaryfalse
                                                                                                                                  450. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.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.

                                                                                                                                  ShortAdditional 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.

                                                                                                                                  Control0..*
                                                                                                                                  TypeExtension
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Summaryfalse
                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                  Invariantsele-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())
                                                                                                                                  SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.rate[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                  • value @ url
                                                                                                                                  • 452. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.numerator
                                                                                                                                    Definition

                                                                                                                                    The value of the numerator.

                                                                                                                                    ShortNumerator value
                                                                                                                                    Control1..1
                                                                                                                                    TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Must Supporttrue
                                                                                                                                    Summarytrue
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    454. MedicationStatement.dosage.doseAndRate.rate[x]:rateRatio.denominator
                                                                                                                                    Definition

                                                                                                                                    The value of the denominator.

                                                                                                                                    ShortDenominator value
                                                                                                                                    Control1..1
                                                                                                                                    TypeQuantity(Medication Quantity)
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Must Supporttrue
                                                                                                                                    Summarytrue
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    456. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange
                                                                                                                                    Slice NamerateRange
                                                                                                                                    Definition

                                                                                                                                    Amount of medication per unit of time.

                                                                                                                                    ShortRaten-Bereich
                                                                                                                                    Comments

                                                                                                                                    It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                                                                                                    It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                                                                                                    Control0..1
                                                                                                                                    TypeRange
                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Must Supporttrue
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    458. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.id
                                                                                                                                    Definition

                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                    Control0..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    Summaryfalse
                                                                                                                                    460. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.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.

                                                                                                                                    ShortAdditional 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.

                                                                                                                                    Control0..*
                                                                                                                                    TypeExtension
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Summaryfalse
                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                    Invariantsele-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())
                                                                                                                                    SlicingThis element introduces a set of slices on MedicationStatement.dosage.doseAndRate.rate[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                    • value @ url
                                                                                                                                    • 462. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.low
                                                                                                                                      Definition

                                                                                                                                      The low limit. The boundary is inclusive.

                                                                                                                                      ShortLow limit
                                                                                                                                      Comments

                                                                                                                                      If the low element is missing, the low boundary is not known.

                                                                                                                                      Control0..1
                                                                                                                                      TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      464. MedicationStatement.dosage.doseAndRate.rate[x]:rateRange.high
                                                                                                                                      Definition

                                                                                                                                      The high limit. The boundary is inclusive.

                                                                                                                                      ShortHigh limit
                                                                                                                                      Comments

                                                                                                                                      If the high element is missing, the high boundary is not known.

                                                                                                                                      Control0..1
                                                                                                                                      TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Summarytrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      466. MedicationStatement.dosage.doseAndRate.rate[x]:rateQuantity
                                                                                                                                      Slice NamerateQuantity
                                                                                                                                      Definition

                                                                                                                                      Amount of medication per unit of time.

                                                                                                                                      ShortRate
                                                                                                                                      Comments

                                                                                                                                      Das Must-Support-Flag auf rateRatio bzw. rateQuantity bedeutet, dass produzierende Systeme zur Kodierung der Ratenangaben nach eigenem Ermessen entweder den Datentyp Ratio oder Quantity verwenden können. Beim Empfang und Verarbeitung der eingehenden Daten müssen dagegen beide Datentypen interpretiert werden können.

                                                                                                                                      Control0..1
                                                                                                                                      TypeQuantity(Medication Quantity)
                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      468. MedicationStatement.dosage.maxDosePerPeriod
                                                                                                                                      Definition

                                                                                                                                      Upper limit on medication per unit of time.

                                                                                                                                      ShortMaximaldosis (Zähler) pro Zeitraum (Nenner)
                                                                                                                                      Comments

                                                                                                                                      This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                                                                                                                      Control0..1
                                                                                                                                      TypeRatio
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      470. MedicationStatement.dosage.maxDosePerPeriod.id
                                                                                                                                      Definition

                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                      Control0..1
                                                                                                                                      Typestring
                                                                                                                                      Is Modifierfalse
                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                      Summaryfalse
                                                                                                                                      472. MedicationStatement.dosage.maxDosePerPeriod.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.

                                                                                                                                      ShortAdditional 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.

                                                                                                                                      Control0..*
                                                                                                                                      TypeExtension
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summaryfalse
                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                      Invariantsele-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())
                                                                                                                                      SlicingThis element introduces a set of slices on MedicationStatement.dosage.maxDosePerPeriod.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                      • value @ url
                                                                                                                                      • 474. MedicationStatement.dosage.maxDosePerPeriod.numerator
                                                                                                                                        Definition

                                                                                                                                        The value of the numerator.

                                                                                                                                        ShortNumerator value
                                                                                                                                        Control1..1
                                                                                                                                        TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        476. MedicationStatement.dosage.maxDosePerPeriod.denominator
                                                                                                                                        Definition

                                                                                                                                        The value of the denominator.

                                                                                                                                        ShortDenominator value
                                                                                                                                        Control1..1
                                                                                                                                        TypeQuantity(Medication Quantity)
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        478. MedicationStatement.dosage.maxDosePerAdministration
                                                                                                                                        Definition

                                                                                                                                        Upper limit on medication per administration.

                                                                                                                                        ShortMaximaldosis pro Verabreichung
                                                                                                                                        Comments

                                                                                                                                        This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                                                                                                                        Control0..1
                                                                                                                                        TypeQuantity(Medication Quantity Dose Form)
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        480. MedicationStatement.dosage.maxDosePerLifetime
                                                                                                                                        Definition

                                                                                                                                        Upper limit on medication per lifetime of the patient.

                                                                                                                                        ShortUpper limit on medication per lifetime of the patient
                                                                                                                                        Control0..1
                                                                                                                                        TypeQuantity(SimpleQuantity)
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))