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11.5 Resource Medication - Content

Pharmacy Work Group Maturity Level : 3   Trial Use Security Category : Business Compartments : Not linked to any defined compartments

This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

Representing medications in the majority of healthcare settings is a matter of identifying an item from a list and then conveying a reference for the item selected either into a patient-related resource or to other applications. Additional information about the medication is frequently provided for human verification, but a full representation of the details of composition and efficacy of the medicine is conveyed by referring to drug dictionaries by means of the codes they define. There are some occasions where it is necessary to identify slightly more detail, such as when dispensing a package containing a particular medication requires identification both of the medicine and the package at once. There are also some occasions (e.g. custom formulations) where the composition of a medicine must be represented. In these cases cases, the ingredients of the medicine have to be specified together with the amount contained, though the Medication resource does not provide full details.

The Medication resource allows for medications to be characterized by the form of the drug and the ingredient (or ingredients), as well as how it is packaged. The medication will include the ingredient(s) and their strength(s) and the package can include the amount (for example, number of tablets, volume, etc.) that is contained in a particular container (for example, 100 capsules of Amoxicillin 500mg per bottle).

The Medication resource can be used to describe a compounded (aka extemporaneous or magistral) product that is manufactured by the pharmacy at the time of dispensing. In this case there will be multiple ingredients which are typically base chemicals (for example, hydrocortisone powder) and there may be other ingredients that are manufactured products (for example, Glaxal Base).

When a medication includes a package, further details about the composition can be provided. A package has a container (vacuum packed box, jar, etc.) and a list of the products or other packages that are in the package.

This resource is referenced by ActivityDefinition , AdverseEvent , CarePlan , EntryDefinition ChargeItem , ChargeItemDefinition , ClinicalUseIssue , Flag , Group , itself, MedicationAdministration , MedicationDispense , MedicationRequest MedicationKnowledge , MedicationStatement MedicationRequest , MedicinalProductClinicals MedicationUsage , Procedure , SupplyDelivery and SupplyRequest .

This resource does not implement any patterns.

Structure

serialNumber 0..1 string Identifier assigned to a drug at the time of manufacture
Name Flags Card. Type Description & Constraints doco
. . Medication TU DomainResource Definition of a Medication
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Business identifier for this medication
... code Σ 0..1 CodeableConcept Codes that identify this medication
SNOMED CT Medication Codes ( Example )
. . . status ?! Σ 0..1 code active | inactive | entered-in-error
MedicationStatus Medication status codes ( Required )
. . . manufacturer Σ 0..1 Reference ( Organization ) Manufacturer of the item
. . . form doseForm 0..1 CodeableConcept powder | tablets | capsule +
SNOMED CT Form Codes ( Example )
. . . amount ?! Σ 0..1 SimpleQuantity Ratio Amount of drug in package
. . . ingredient 0..* BackboneElement Active or inactive ingredient
. . . . item[x] 1..1 The product contained actual ingredient or content
. . . . . itemCodeableConcept CodeableConcept
. . . . . itemReference Reference ( Substance | Medication )
. . . . isActive 0..1 boolean Active ingredient indicator
. . . amount . strength[x] 0..1 Ratio Quantity of ingredient present
Medication ingredient strength codes ( Example )
..... strengthRatio Ratio
..... strengthCodeableConcept CodeableConcept
. . . batch 0..1 BackboneElement Details about packaged medications
. . . . lotNumber 0..1 string Identifier assigned to batch
. . . . expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

UML Diagram ( Legend )

Medication ( DomainResource ) Business identifier for this medication identifier : Identifier [0..*] A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems code : CodeableConcept [0..1] « A coded concept that defines the type of a medication medication. (Strength=Example) SNOMED CT Medication SNOMEDCTMedicationCodes ?? » A code to indicate if the medication is in active use (this element modifies the meaning of other elements) status : code [0..1] « A coded concept defining if the medication is in active use use. (Strength=Required) MedicationStatus Medication Status ! » Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product manufacturer : Reference [0..1] « Organization » Describes the form of the item. Powder; tablets; capsule form doseForm : CodeableConcept [0..1] « A coded concept defining the form of a medication medication. (Strength=Example) SNOMED CT Form SNOMEDCTFormCodes ?? » Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.) (this element modifies the meaning of other elements) amount : Quantity ( SimpleQuantity Ratio ) [0..1] Ingredient The actual ingredient - either a substance (simple ingredient) or another medication of a medication item[x] : Type [1..1] « CodeableConcept | Reference ( Substance | Medication ) » Indication of whether this ingredient affects the this ingredient affects the therapeutic action of the drug isActive : boolean [0..1] Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet amount strength[x] : Ratio Type [0..1] « Ratio | CodeableConcept ; A coded concpet defining the strength of an ingredient. (Strength=Example) Medication Ingredient Strengt... ?? » Batch The assigned lot number of a batch of the specified product lotNumber : string [0..1] When this specific batch of product will expire expirationDate : dateTime [0..1] An identifier assigned to a drug at the point of manufacturing and repackaging (at the package or pallet level), sufficient to facilitate the identification, validation, authentication, and tracking and tracking of drugs serialNumber : string [0..1] Identifies a particular constituent of interest in the product ingredient [0..*] Information that only applies to packages (not products) batch [0..1]

XML Template

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>

 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <

 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->

 <manufacturer><!-- 0..1 Reference(Organization) Manufacturer of the item --></manufacturer>
 <</form>
 <</amount>

 <doseForm><!-- 0..1 CodeableConcept powder | tablets | capsule + --></doseForm>
 <amount><!-- 0..1 Ratio Amount of drug in package --></amount>

 <ingredient>  <!-- 0..* Active or inactive ingredient -->
  <</item[x]>
  <
  <</amount>

  <item[x]><!-- 1..1 CodeableConcept|Reference(Medication|Substance) The actual ingredient or content --></item[x]>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <strength[x]><!-- 0..1 Ratio|CodeableConcept Quantity of ingredient present --></strength[x]>

 </ingredient>
 <batch>  <!-- 0..1 Details about packaged medications -->
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
  <

 </batch>
</Medication>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.identifier [ Identifier ], ... ; # 0..* Business identifier for this medication

  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:

  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error

  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Manufacturer of the item
  fhir:
  fhir:

  fhir:Medication.doseForm [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.amount [ Ratio ]; # 0..1 Amount of drug in package

  fhir:Medication.ingredient [ # 0..* Active or inactive ingredient
    # . One of these 2
      fhir: ]
      fhir:) ]
    fhir:
    fhir:

    # Medication.ingredient.item[x] : 1..1 The actual ingredient or content. One of these 2
      fhir:Medication.ingredient.itemCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.itemReference [ Reference(Medication|Substance) ]
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    # Medication.ingredient.strength[x] : 0..1 Quantity of ingredient present. One of these 2
      fhir:Medication.ingredient.strengthRatio [ Ratio ]
      fhir:Medication.ingredient.strengthCodeableConcept [ CodeableConcept ]

  ], ...;
  fhir:Medication.batch [ # 0..1 Details about packaged medications
    fhir:Medication.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
    fhir:Medication.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
    fhir:

  ];
]

Changes since R3

Medication.amount Added Element
Medication
Medication.ingredient.item[x] Remove Reference(Substance|Medication), Add Reference(Substance|Medication) Medication.batch Added Element Medication.batch.lotNumber Medication.status
  • Added Element Change value set from http://hl7.org/fhir/ValueSet/medication-status|4.0.0 to http://hl7.org/fhir/ValueSet/medication-status|4.1.0
Medication.batch.expirationDate Medication.doseForm
  • Added Element
Medication.batch.serialNumber Medication.ingredient.strength[x]
  • Added Element
Medication.isBrand deleted Medication.isOverTheCounter deleted Medication.package Medication.form
  • deleted
Medication.image Medication.ingredient.strength
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 16 22 fail round-trip testing and 1 22 r3 resources are invalid (1 (0 errors). ). Note: these have note yet been updated to be R3 to R4 )

Structure

serialNumber 0..1 string Identifier assigned to a drug at the time of manufacture
Name Flags Card. Type Description & Constraints doco
. . Medication TU DomainResource Definition of a Medication
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Business identifier for this medication
... code Σ 0..1 CodeableConcept Codes that identify this medication
SNOMED CT Medication Codes ( Example )
. . . status ?! Σ 0..1 code active | inactive | entered-in-error
MedicationStatus Medication status codes ( Required )
. . . manufacturer Σ 0..1 Reference ( Organization ) Manufacturer of the item
. . . form doseForm 0..1 CodeableConcept powder | tablets | capsule +
SNOMED CT Form Codes ( Example )
. . . amount ?! Σ 0..1 SimpleQuantity Ratio Amount of drug in package
. . . ingredient 0..* BackboneElement Active or inactive ingredient
. . . . item[x] 1..1 The product contained actual ingredient or content
. . . . . itemCodeableConcept CodeableConcept
. . . . . itemReference Reference ( Substance | Medication )
. . . . isActive 0..1 boolean Active ingredient indicator
. . . amount . strength[x] 0..1 Ratio Quantity of ingredient present
Medication ingredient strength codes ( Example )
..... strengthRatio Ratio
..... strengthCodeableConcept CodeableConcept
. . . batch 0..1 BackboneElement Details about packaged medications
. . . . lotNumber 0..1 string Identifier assigned to batch
. . . . expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

UML Diagram ( Legend )

Medication ( DomainResource ) Business identifier for this medication identifier : Identifier [0..*] A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems code : CodeableConcept [0..1] « A coded concept that defines the type of a medication medication. (Strength=Example) SNOMED CT Medication SNOMEDCTMedicationCodes ?? » A code to indicate if the medication is in active use (this element modifies the meaning of other elements) status : code [0..1] « A coded concept defining if the medication is in active use use. (Strength=Required) MedicationStatus Medication Status ! » Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product manufacturer : Reference [0..1] « Organization » Describes the form of the item. Powder; tablets; capsule form doseForm : CodeableConcept [0..1] « A coded concept defining the form of a medication medication. (Strength=Example) SNOMED CT Form SNOMEDCTFormCodes ?? » Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.) (this element modifies the meaning of other elements) amount : Quantity ( SimpleQuantity Ratio ) [0..1] Ingredient The actual ingredient - either a substance (simple ingredient) or another medication of a medication item[x] : Type [1..1] « CodeableConcept | Reference ( Substance | Medication ) » Indication of whether this ingredient affects the this ingredient affects the therapeutic action of the drug isActive : boolean [0..1] Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet amount strength[x] : Ratio Type [0..1] « Ratio | CodeableConcept ; A coded concpet defining the strength of an ingredient. (Strength=Example) Medication Ingredient Strengt... ?? » Batch The assigned lot number of a batch of the specified product lotNumber : string [0..1] When this specific batch of product will expire expirationDate : dateTime [0..1] An identifier assigned to a drug at the point of manufacturing and repackaging (at the package or pallet level), sufficient to facilitate the identification, validation, authentication, and tracking and tracking of drugs serialNumber : string [0..1] Identifies a particular constituent of interest in the product ingredient [0..*] Information that only applies to packages (not products) batch [0..1]

XML Template

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>

 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <

 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->

 <manufacturer><!-- 0..1 Reference(Organization) Manufacturer of the item --></manufacturer>
 <</form>
 <</amount>

 <doseForm><!-- 0..1 CodeableConcept powder | tablets | capsule + --></doseForm>
 <amount><!-- 0..1 Ratio Amount of drug in package --></amount>

 <ingredient>  <!-- 0..* Active or inactive ingredient -->
  <</item[x]>
  <
  <</amount>

  <item[x]><!-- 1..1 CodeableConcept|Reference(Medication|Substance) The actual ingredient or content --></item[x]>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <strength[x]><!-- 0..1 Ratio|CodeableConcept Quantity of ingredient present --></strength[x]>

 </ingredient>
 <batch>  <!-- 0..1 Details about packaged medications -->
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
  <

 </batch>
</Medication>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.identifier [ Identifier ], ... ; # 0..* Business identifier for this medication

  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:

  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error

  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Manufacturer of the item
  fhir:
  fhir:

  fhir:Medication.doseForm [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.amount [ Ratio ]; # 0..1 Amount of drug in package

  fhir:Medication.ingredient [ # 0..* Active or inactive ingredient
    # . One of these 2
      fhir: ]
      fhir:) ]
    fhir:
    fhir:

    # Medication.ingredient.item[x] : 1..1 The actual ingredient or content. One of these 2
      fhir:Medication.ingredient.itemCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.itemReference [ Reference(Medication|Substance) ]
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    # Medication.ingredient.strength[x] : 0..1 Quantity of ingredient present. One of these 2
      fhir:Medication.ingredient.strengthRatio [ Ratio ]
      fhir:Medication.ingredient.strengthCodeableConcept [ CodeableConcept ]

  ], ...;
  fhir:Medication.batch [ # 0..1 Details about packaged medications
    fhir:Medication.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
    fhir:Medication.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
    fhir:

  ];
]

Changes since DSTU2 Release 3

Medication.amount Added Element
Medication
Medication.ingredient.item[x] Remove Reference(Substance|Medication), Add Reference(Substance|Medication) Medication.batch Added Element Medication.batch.lotNumber Medication.status
  • Added Element Change value set from http://hl7.org/fhir/ValueSet/medication-status|4.0.0 to http://hl7.org/fhir/ValueSet/medication-status|4.1.0
Medication.batch.expirationDate Medication.doseForm
  • Added Element
Medication.batch.serialNumber Medication.ingredient.strength[x]
  • Added Element
Medication.isBrand deleted Medication.isOverTheCounter deleted Medication.package Medication.form
  • deleted
Medication.image Medication.ingredient.strength
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 16 22 fail round-trip testing and 1 22 r3 resources are invalid (1 (0 errors). ). Note: these have note yet been updated to be R3 to R4 )

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

Path Definition Type Reference
Medication.code A coded concept that defines the type of a medication medication. Example SNOMED CT Medication Codes SNOMEDCTMedicationCodes
Medication.status A coded concept defining if the medication is in active use use. Required MedicationStatus Medication Status Codes
Medication.form Medication.doseForm A coded concept defining the form of a medication medication. Example SNOMED CT Form SNOMEDCTFormCodes
Medication.ingredient.strength[x] A coded concpet defining the strength of an ingredient. Example Medication Ingredient Strength Codes

Medication does not have a status. If Medication was used to support a formulary use case, then an extension can be used to convey formulary statuses, such as active (e.g. the medication can be ordered) or inactive (e.g. the medication can be documented, but not ordered). Pharmacy is evaluating formulary use cases. Feedback is encouraged to the Pharmacy working group.

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
code token Codes that identify this medication Returns medications for a specific code Medication.code 4 13 Resources
expiration-date date When Returns medications in a batch will expire with this expiration date Medication.batch.expirationDate
form token powder | tablets | capsule + Returns medications for a specific dose form Medication.form
identifier token Returns medications with this external identifier Medication.identifier
ingredient reference The product contained Returns medications for this ingredient reference Medication.ingredient.item.as(Reference) (Medication.ingredient.item as Reference)
( Medication , Substance )
ingredient-code token The product contained Returns medications for this ingredient code Medication.ingredient.item.as(CodeableConcept) (Medication.ingredient.item as CodeableConcept)
lot-number token Identifier assigned to Returns medications in a batch with this lot number Medication.batch.lotNumber
manufacturer reference Manufacturer of the item Returns medications made or sold for this manufacturer Medication.manufacturer
( Organization )
serial-number token Identifier assigned to a drug at the time of manufacture Medication.batch.serialNumber status token active | inactive | entered-in-error Returns medications for this status Medication.status