FHIR Implementatiegids voor de Nederlandse Kankerregistratie
1.2.2 - release

FHIR Implementatiegids voor de Nederlandse Kankerregistratie - Local Development build (v1.2.2) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: NcrEhrMedicationAdministration - Detailed Descriptions

Draft as of 2025-02-10

Definitions for the ncr-ehr-medication-administration resource profile.

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

0. MedicationAdministration
Definition

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

ShortMedicationAdministrationAdministration of medication to a patient
Control0..*
Is Modifierfalse
Alternate NamesMedicatietoediening
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
2. MedicationAdministration.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
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()))
4. MedicationAdministration.extension:agreedDateTime
Slice NameagreedDateTime
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..1
This element is affected by the following invariants: ele-1
TypeExtension(ext MedicationAdministration2.AgreedDateTime) (Extension Type: dateTime)
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationAdministration.extension:agreedDateTime.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.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime
8. MedicationAdministration.extension:asAgreedIndicator
Slice NameasAgreedIndicator
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..1
This element is affected by the following invariants: ele-1
TypeExtension(ext AsAgreedIndicator) (Extension Type: boolean)
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MedicationAdministration.extension:asAgreedIndicator.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.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-AsAgreedIndicator
12. MedicationAdministration.extension:medicationAdministrationReasonForDeviation
Slice NamemedicationAdministrationReasonForDeviation
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..*
This element is affected by the following invariants: ele-1
TypeExtension(ext MedicationAdministration2.ReasonForDeviation) (Extension Type: CodeableConcept)
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. MedicationAdministration.extension:medicationAdministrationReasonForDeviation.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.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation
16. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier
Slice NamepharmaceuticalTreatmentIdentifier
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..1
This element is affected by the following invariants: ele-1
TypeExtension(ext PharmaceuticalTreatment.Identifier) (Extension Type: Identifier)
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.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.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier
20. MedicationAdministration.extension:injectionPatchSite
Slice NameinjectionPatchSite
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..1
This element is affected by the following invariants: ele-1
TypeExtension(ext MedicationAdministration2.InjectionPatchSite) (Extension Type: CodeableConcept)
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. MedicationAdministration.extension:injectionPatchSite.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.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.InjectionPatchSite
24. MedicationAdministration.extension:registrationDateTime
Slice NameregistrationDateTime
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
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..1
This element is affected by the following invariants: ele-1
TypeExtension(ext RegistrationDateTime) (Extension Type: dateTime)
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. MedicationAdministration.extension:registrationDateTime.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.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RegistrationDateTime
28. MedicationAdministration.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Standard StatusNormative (from Trial Use)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationAdministration.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 30. MedicationAdministration.status
    Definition

    The status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’.

    When documenting this, the following interpretations are used:

    • Active: The product is administered.
    • Interrupted: Use has (temporarily) been interrupted, because of a side effect, for example. Later, the patient and/or doctor can decide whether or not to resume or discontinue use.
    • Discontinued: Administration has stopped.
    • Completed: Administration has been completed.
    • Not started: The product was never administered.

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

    ShortMedicationAdministrationStatusin-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
    Comments

    If no value for MedicationAdministrationStatus is present, and the system is thus unable to infer the status, .status will be set to unknown.


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

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from MedicationAdministration Status Codeshttp://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1)

    Use ConceptMap 'MedicatieToedieningStatusCodelijst-to-MedicationAdministrationStatusCodes' to translate zib terminology to profile terminology in ValueSet 'MedicationAdministration Status Codes'


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

    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
    Summarytrue
    Alternate NamesMedicatietoedieningStatus
    Pattern Valuecompleted
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. MedicationAdministration.category
    Definition

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

    ShortType of medication usage
    Comments

    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

    Control10..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHOULD be taken from MedicationAdministration Category Codeshttp://hl7.org/fhir/ValueSet/medication-admin-category
    (preferred to http://hl7.org/fhir/ValueSet/medication-admin-category)

    A coded concept describing where the medication administered is expected to occur.

    TypeCodeableConcept
    Is Modifierfalse
    Pattern Value{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "18629005"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. MedicationAdministration.category.extension:additionalCategory
    Slice NameadditionalCategory
    Definition

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    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..*
    This element is affected by the following invariants: ele-1
    TypeExtension(ext AdditionalCategory) (Extension Type: CodeableConcept)
    Standard StatusNormative (from Trial Use)
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    36. MedicationAdministration.category.extension:additionalCategory.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.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-AdditionalCategory
    38. MedicationAdministration.medication[x]
    Definition

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

    ShortWhat was administered
    Comments

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

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
    (example to http://hl7.org/fhir/ValueSet/medication-codes)

    Codes identifying substance or product that can be administered.

    TypeChoice of: CodeableConcept, Reference(Medication)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    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 MedicationAdministration.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 40. MedicationAdministration.medication[x]:medicationReference
      Slice NamemedicationReference
      Definition

      The product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well.

      In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet.


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

      ShortAdministrationProductWhat was administered
      Comments

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

      Control01..1
      This element is affected by the following invariants: ele-1
      TypeReference(NcrEhrMedication, Medication), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate NamesToedieningsProduct
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. MedicationAdministration.subject
      Definition

      The person or animal or group receiving the medication.

      ShortWho received medication
      Comments

      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

      Control1..1
      This element is affected by the following invariants: ele-1
      TypeReference(NcrEhrPatient, Patient, Group)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
      44. MedicationAdministration.supportingInformation
      Definition

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

      ShortAdditional information to support administration
      Comments

      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeReference(Resource)
      Is Modifierfalse
      Standard StatusNormative (from Trial Use)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
      SlicingThis element introduces a set of slices on MedicationAdministration.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 46. MedicationAdministration.supportingInformation:administrationAgreement
        Slice NameadministrationAgreement
        Definition

        Administration agreement on which this administration is based.


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

        ShortAdministrationAgreementAdditional information to support administration
        Comments

        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

        Control0..1*
        This element is affected by the following invariants: ele-1
        TypeReference(mp AdministrationAgreement, Resource)
        Is Modifierfalse
        Standard StatusNormative (from Trial Use)
        Alternate NamesToedieningsafspraak
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        48. MedicationAdministration.effective[x]
        Definition

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

        ShortStart and end time of administration
        Control1..1
        This element is affected by the following invariants: ele-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
        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 MedicationAdministration.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 50. MedicationAdministration.effective[x]:effectiveDateTime
          Slice NameeffectiveDateTime
          Definition

          The date and time at which the medication was administered.


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

          ShortAdministrationDateTimeStart and end time of administration
          Control1..1
          This element is affected by the following invariants: ele-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
          Alternate NamesToedieningsDatumTijd
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. MedicationAdministration.performer
          Definition

          The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the informal carer, for example.


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

          ShortAdministratorWho performed the medication administration and what they did
          Control0..1*
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Alternate NamesToediener
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. MedicationAdministration.performer.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          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..*
          This element is affected by the following invariants: ele-1
          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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          56. MedicationAdministration.performer.actor
          Definition

          A reference from one resource to another.


          Indicates who or what performed the medication administration.

          ShortPatient / HealthProfessional / CaregiverWho performed the medication administration
          Comments

          Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

          In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeReference(Reference)(Practitioner, PractitionerRole, Patient, RelatedPerson, Device, nl core Patient, nl core HealthProfessional PractitionerRole, nl core ContactPerson)
          Is Modifierfalse
          Summarytrue
          Alternate NamesPatiënt, Zorgverlener, Mantelzorger
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          58. MedicationAdministration.request
          Definition

          Medication agreement on which this administration is based.


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

          ShortMedicationAgreementRequest administration performed against
          Comments

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

          Control10..1
          This element is affected by the following invariants: ele-1
          TypeReference(NcrEhrMedicationAgreement, MedicationRequest)
          Is Modifierfalse
          Must Supporttrue
          Alternate NamesMedicatieafspraak
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          60. MedicationAdministration.request.extension:resourceCategory
          Slice NameresourceCategory
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          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..1
          This element is affected by the following invariants: ele-1
          TypeExtension(ext ResourceCategory) (Extension Type: CodeableConcept)
          Standard StatusNormative (from Trial Use)
          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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          62. MedicationAdministration.request.reference
          Definition

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

          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.

          Control0..1
          This element is affected by the following invariants: ele-1, ref-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()))
          64. MedicationAdministration.note
          Definition

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

          ShortInformation about the administration
          Comments

          For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

          Control0..1*
          This element is affected by the following invariants: ele-1
          TypeAnnotation
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationAdministration.note.text
          Definition

          Comments on administering the medication.


          The text of the annotation in markdown format.

          ShortCommentThe annotation - text content (as markdown)
          Comments

          Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

          Control1..1
          This element is affected by the following invariants: ele-1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesToelichting
          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 found here

          0. MedicationAdministration
          2. MedicationAdministration.status
          Pattern Valuecompleted
          4. MedicationAdministration.medication[x]:medicationReference
          Slice NamemedicationReference
          TypeReference(NcrEhrMedication)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          6. MedicationAdministration.subject
          TypeReference(NcrEhrPatient)
          Must Supporttrue
          8. MedicationAdministration.effective[x]:effectiveDateTime
          Slice NameeffectiveDateTime
          Control1..?
          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
          10. MedicationAdministration.request
          Control1..?
          TypeReference(NcrEhrMedicationAgreement)
          Must Supporttrue

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

          0. MedicationAdministration
          Definition

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

          ShortMedicationAdministration
          Control0..*
          Alternate NamesMedicatietoediening
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          2. MedicationAdministration.id
          Definition

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

          ShortLogical id of this artifact
          Comments

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

          Control0..1
          Typeid
          Summarytrue
          4. MedicationAdministration.meta
          Definition

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

          ShortMetadata about the resource
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeMeta
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. MedicationAdministration.implicitRules
          Definition

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

          ShortA set of rules under which this content was created
          Comments

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

          Control0..1
          This element is affected by the following invariants: ele-1
          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()))
          8. MedicationAdministration.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
          This element is affected by the following invariants: ele-1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

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

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

          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
          This element is affected by the following invariants: ele-1
          TypeNarrative
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. MedicationAdministration.contained
          Definition

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

          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
          Alternate Namesinline resources, anonymous resources, contained resources
          14. MedicationAdministration.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          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..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Standard StatusNormative (from Trial Use)
          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 MedicationAdministration.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. MedicationAdministration.extension:agreedDateTime
            Slice NameagreedDateTime
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            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..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ext MedicationAdministration2.AgreedDateTime) (Extension Type: dateTime)
            Standard StatusNormative (from Trial Use)
            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())
            18. MedicationAdministration.extension:agreedDateTime.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
            XML FormatIn the XML format, this property is represented as an attribute.
            20. MedicationAdministration.extension:agreedDateTime.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..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Standard StatusNormative (from Trial Use)
            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 MedicationAdministration.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 22. MedicationAdministration.extension:agreedDateTime.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
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.AgreedDateTime
              24. MedicationAdministration.extension:agreedDateTime.value[x]
              Definition

              Date and time in the medication or administration agreement to which this administration pertains. Since multiple times can be indicated in one medication/administration agreement, this can be used to identify the agreed time in the event of e.g. early administration or a late administration.

              ShortAgreedDateTime
              Control0..1
              This element is affected by the following invariants: ele-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
              Standard StatusNormative (from Trial Use)
              Alternate NamesAfgesprokenDatumTijd
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. MedicationAdministration.extension:asAgreedIndicator
              Slice NameasAgreedIndicator
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              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..1
              This element is affected by the following invariants: ele-1
              TypeExtension(ext AsAgreedIndicator) (Extension Type: boolean)
              Standard StatusNormative (from Trial Use)
              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())
              28. MedicationAdministration.extension:asAgreedIndicator.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
              XML FormatIn the XML format, this property is represented as an attribute.
              30. MedicationAdministration.extension:asAgreedIndicator.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..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Standard StatusNormative (from Trial Use)
              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 MedicationAdministration.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 32. MedicationAdministration.extension:asAgreedIndicator.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
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-AsAgreedIndicator
                34. MedicationAdministration.extension:asAgreedIndicator.value[x]
                Definition

                Is the medicine used or administered as outlined in the medication respectively medication/administration agreement?

                ShortAsAgreedIndicator
                Control0..1
                This element is affected by the following invariants: ele-1
                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
                Standard StatusNormative (from Trial Use)
                Alternate NamesVolgensAfspraakIndicator
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. MedicationAdministration.extension:medicationAdministrationReasonForDeviation
                Slice NamemedicationAdministrationReasonForDeviation
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                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..*
                This element is affected by the following invariants: ele-1
                TypeExtension(ext MedicationAdministration2.ReasonForDeviation) (Extension Type: CodeableConcept)
                Standard StatusNormative (from Trial Use)
                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())
                38. MedicationAdministration.extension:medicationAdministrationReasonForDeviation.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
                XML FormatIn the XML format, this property is represented as an attribute.
                40. MedicationAdministration.extension:medicationAdministrationReasonForDeviation.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..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Standard StatusNormative (from Trial Use)
                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 MedicationAdministration.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 42. MedicationAdministration.extension:medicationAdministrationReasonForDeviation.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
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.ReasonForDeviation
                  44. MedicationAdministration.extension:medicationAdministrationReasonForDeviation.value[x]
                  Definition

                  Reason why the medication was not taken or administered or was taken or administered differently.

                  ShortMedicationAdministrationReasonForDeviation
                  Comments

                  This MedicationAdministrationReasonForDeviation extension has overlap with .statusReason. Both concepts allow the documentation of reasons why an administration did not take place, potentially resulting in duplicated information in both places. This extension, however, has a broader scope because it also covers the reasons why administrations are performed differently than the agreement.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from MedicatieToedieningRedenVanAfwijkenCodelijst
                  (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.47--20240131165054)
                  TypeCodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Standard StatusNormative (from Trial Use)
                  Alternate NamesMedicatietoedieningRedenVanAfwijken
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier
                  Slice NamepharmaceuticalTreatmentIdentifier
                  Definition

                  Optional Extension Element - found in all resources.

                  ShortOptional Extensions Element
                  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..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(ext PharmaceuticalTreatment.Identifier) (Extension Type: Identifier)
                  Standard StatusNormative (from Trial Use)
                  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. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.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
                  XML FormatIn the XML format, this property is represented as an attribute.
                  50. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.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..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Standard StatusNormative (from Trial Use)
                  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 MedicationAdministration.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 52. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.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
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier
                    54. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.value[x]
                    Definition

                    The identifier of the pharmaceutical treatment that this resource belongs to. This identifier is used to group the disparate resources that belong to a single pharmaceutical treatment.

                    ShortPharmaceutical Treatment Identifier
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Standard StatusNormative (from Trial Use)
                    Alternate NamesMedicamenteuze behandeling identificatie
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    56. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.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
                    XML FormatIn the XML format, this property is represented as an attribute.
                    58. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.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..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Standard StatusNormative (from Trial Use)
                    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 MedicationAdministration.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 60. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.value[x].use
                      Definition

                      The purpose of this identifier.

                      Shortusual | official | temp | secondary | old (If known)
                      Comments

                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      BindingThe codes SHALL be taken from IdentifierUse
                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                      Identifies the purpose for this identifier, if known .

                      Typecode
                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                      ShortDescription of identifier
                      Comments

                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                      TypeCodeableConcept
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Requirements

                      Allows users to make use of identifiers when the identifier system is not known.

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

                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      66. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.value[x].value
                      Definition

                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                      ShortThe value that is unique
                      Comments

                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Example<br/><b>General</b>:123456
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      68. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.value[x].period
                      Definition

                      Time period during which identifier is/was valid for use.

                      ShortTime period when id is/was valid for use
                      Comments

                      A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                      Period is not used for a duration (a measure of elapsed time). See Duration.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypePeriod
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                      70. MedicationAdministration.extension:pharmaceuticalTreatmentIdentifier.value[x].assigner
                      Definition

                      Organization that issued/manages the identifier.

                      ShortOrganization that issued id (may be just text)
                      Comments

                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeReference(Organization)
                      Standard StatusNormative (from Trial Use)
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                      72. MedicationAdministration.extension:injectionPatchSite
                      Slice NameinjectionPatchSite
                      Definition

                      Optional Extension Element - found in all resources.

                      ShortOptional Extensions Element
                      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..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(ext MedicationAdministration2.InjectionPatchSite) (Extension Type: CodeableConcept)
                      Standard StatusNormative (from Trial Use)
                      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())
                      74. MedicationAdministration.extension:injectionPatchSite.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
                      XML FormatIn the XML format, this property is represented as an attribute.
                      76. MedicationAdministration.extension:injectionPatchSite.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..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Standard StatusNormative (from Trial Use)
                      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 MedicationAdministration.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 78. MedicationAdministration.extension:injectionPatchSite.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
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAdministration2.InjectionPatchSite
                        80. MedicationAdministration.extension:injectionPatchSite.value[x]
                        Definition

                        Site of the patient's body where an injection has been administered or where adhesive medical dressing has been applied.

                        ShortInjectionPatchSite
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from PrikPlakLocatieCodeLijst
                        (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.53--20220323181942)
                        TypeCodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Standard StatusNormative (from Trial Use)
                        Alternate NamesPrikPlakLocatie
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        82. MedicationAdministration.extension:injectionPatchSite.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
                        XML FormatIn the XML format, this property is represented as an attribute.
                        84. MedicationAdministration.extension:injectionPatchSite.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..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Standard StatusNormative (from Trial Use)
                        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 MedicationAdministration.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 86. MedicationAdministration.extension:injectionPatchSite.value[x].extension:laterality
                          Slice Namelaterality
                          Definition

                          Optional Extension Element - found in all resources.

                          ShortOptional Extensions Element
                          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..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(ext AnatomicalLocation.Laterality) (Extension Type: CodeableConcept)
                          Standard StatusNormative (from Trial Use)
                          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. MedicationAdministration.extension:injectionPatchSite.value[x].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..*
                          This element is affected by the following invariants: ele-1
                          TypeCoding
                          Standard StatusNormative (from Trial Use)
                          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()))
                          90. MedicationAdministration.extension:injectionPatchSite.value[x].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
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          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()))
                          92. MedicationAdministration.extension:registrationDateTime
                          Slice NameregistrationDateTime
                          Definition

                          Optional Extension Element - found in all resources.

                          ShortOptional Extensions Element
                          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..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(ext RegistrationDateTime) (Extension Type: dateTime)
                          Standard StatusNormative (from Trial Use)
                          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())
                          94. MedicationAdministration.extension:registrationDateTime.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
                          XML FormatIn the XML format, this property is represented as an attribute.
                          96. MedicationAdministration.extension:registrationDateTime.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..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Standard StatusNormative (from Trial Use)
                          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 MedicationAdministration.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 98. MedicationAdministration.extension:registrationDateTime.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
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RegistrationDateTime
                            100. MedicationAdministration.extension:registrationDateTime.value[x]
                            Definition

                            Date and time the medication administration was recorded. Registration date + time are required (order of the registrations must be clear in cases with multiple registrations on one day).

                            ShortRegistrationDateTime
                            Control0..1
                            This element is affected by the following invariants: ele-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
                            Standard StatusNormative (from Trial Use)
                            Alternate NamesRegistratieDatumTijd
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. MedicationAdministration.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            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..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                            Standard StatusNormative (from Trial Use)
                            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())
                            SlicingThis element introduces a set of slices on MedicationAdministration.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 104. MedicationAdministration.identifier
                              Definition

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

                              ShortIdentification
                              Comments

                              This is a business identifier, not a resource identifier.

                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeIdentifier
                              Alternate NamesIdentificatie
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              106. MedicationAdministration.instantiates
                              Definition

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

                              ShortInstantiates protocol or definition
                              Comments

                              see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              Typeuri
                              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()))
                              108. MedicationAdministration.partOf
                              Definition

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

                              ShortPart of referenced event
                              Comments

                              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeReference(MedicationAdministration, Procedure)
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                              110. MedicationAdministration.status
                              Definition

                              The status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’.

                              When documenting this, the following interpretations are used:

                              • Active: The product is administered.
                              • Interrupted: Use has (temporarily) been interrupted, because of a side effect, for example. Later, the patient and/or doctor can decide whether or not to resume or discontinue use.
                              • Discontinued: Administration has stopped.
                              • Completed: Administration has been completed.
                              • Not started: The product was never administered.
                              ShortMedicationAdministrationStatus
                              Comments

                              If no value for MedicationAdministrationStatus is present, and the system is thus unable to infer the status, .status will be set to unknown.

                              Control1..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHALL be taken from MedicationAdministration Status Codes
                              (required to http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1)

                              Use ConceptMap 'MedicatieToedieningStatusCodelijst-to-MedicationAdministrationStatusCodes' to translate zib terminology to profile terminology in ValueSet 'MedicationAdministration Status Codes'

                              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
                              Summarytrue
                              Alternate NamesMedicatietoedieningStatus
                              Pattern Valuecompleted
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              112. MedicationAdministration.statusReason
                              Definition

                              A code indicating why the administration was not performed.

                              ShortReason administration not performed
                              Comments

                              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              BindingFor example codes, see SNOMEDCTReasonMedicationNotGivenCodes
                              (example to http://hl7.org/fhir/ValueSet/reason-medication-not-given-codes)

                              A set of codes indicating the reason why the MedicationAdministration is negated.

                              TypeCodeableConcept
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              114. MedicationAdministration.category
                              Definition

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

                              ShortType of medication usage
                              Comments

                              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                              Control1..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHOULD be taken from MedicationAdministration Category Codes
                              (preferred to http://hl7.org/fhir/ValueSet/medication-admin-category)

                              A coded concept describing where the medication administered is expected to occur.

                              TypeCodeableConcept
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://snomed.info/sct",
                                  "code" : "18629005"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              116. MedicationAdministration.category.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
                              XML FormatIn the XML format, this property is represented as an attribute.
                              118. MedicationAdministration.category.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..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Standard StatusNormative (from Trial Use)
                              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 MedicationAdministration.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 120. MedicationAdministration.category.extension:additionalCategory
                                Slice NameadditionalCategory
                                Definition

                                Optional Extension Element - found in all resources.

                                ShortOptional Extensions Element
                                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..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension(ext AdditionalCategory) (Extension Type: CodeableConcept)
                                Standard StatusNormative (from Trial Use)
                                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())
                                122. MedicationAdministration.category.extension:additionalCategory.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
                                XML FormatIn the XML format, this property is represented as an attribute.
                                124. MedicationAdministration.category.extension:additionalCategory.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..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension
                                Standard StatusNormative (from Trial Use)
                                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 MedicationAdministration.category.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 126. MedicationAdministration.category.extension:additionalCategory.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
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-AdditionalCategory
                                  128. MedicationAdministration.category.extension:additionalCategory.value[x]
                                  Definition

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

                                  ShortType of medication usage
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  BindingThe codes SHOULD be taken from MedicationAdministration Category Codes
                                  (preferred to http://hl7.org/fhir/ValueSet/medication-admin-category)
                                  TypeCodeableConcept
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Standard StatusNormative (from Trial Use)
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  130. MedicationAdministration.category.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..*
                                  This element is affected by the following invariants: ele-1
                                  TypeCoding
                                  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()))
                                  132. MedicationAdministration.category.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
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  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()))
                                  134. MedicationAdministration.medication[x]
                                  Definition

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

                                  ShortWhat was administered
                                  Comments

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

                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  BindingFor example codes, see SNOMEDCTMedicationCodes
                                  (example to http://hl7.org/fhir/ValueSet/medication-codes)

                                  Codes identifying substance or product that can be administered.

                                  TypeChoice of: CodeableConcept, Reference(Medication)
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  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 MedicationAdministration.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 136. MedicationAdministration.medication[x]:medicationReference
                                    Slice NamemedicationReference
                                    Definition

                                    The product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well.

                                    In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet.

                                    ShortAdministrationProduct
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeReference(NcrEhrMedication)
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Must Supporttrue
                                    Summarytrue
                                    Alternate NamesToedieningsProduct
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    138. MedicationAdministration.subject
                                    Definition

                                    The person or animal or group receiving the medication.

                                    ShortWho received medication
                                    Comments

                                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    TypeReference(NcrEhrPatient)
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                    140. MedicationAdministration.context
                                    Definition

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

                                    ShortRelationEncounter / RelationEpisodeOfCare
                                    Comments

                                    The ext-Context-EpisodeOfCare extension is used to capture a reference to a related EpisodeOfCare if both a reference to an Encounter and an EpisodeOfCare need to be exchanged, or to capture additional EpisodeOfCare resources if multiple related EpisodeOfCare resources need to be exchanged. This .context element will then contain the reference to the Encounter resource or the 'first' EpisodeOfCare, respectively.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeReference(Encounter, EpisodeOfCare, nl core Encounter, nl core EpisodeOfCare)
                                    Alternate NamesRelatieContact, RelatieZorgepisode
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                    142. MedicationAdministration.context.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    144. MedicationAdministration.context.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    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..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Standard StatusNormative (from Trial Use)
                                    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 MedicationAdministration.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 146. MedicationAdministration.context.extension:relationEpisodeOfCare
                                      Slice NamerelationEpisodeOfCare
                                      Definition

                                      Optional Extension Element - found in all resources.

                                      ShortOptional Extensions Element
                                      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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(ext Context EpisodeOfCare) (Extension Type: Reference(EpisodeOfCare, nl core EpisodeOfCare))
                                      Standard StatusNormative (from Trial Use)
                                      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())
                                      148. MedicationAdministration.context.extension:relationEpisodeOfCare.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
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      150. MedicationAdministration.context.extension:relationEpisodeOfCare.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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Standard StatusNormative (from Trial Use)
                                      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 MedicationAdministration.context.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 152. MedicationAdministration.context.extension:relationEpisodeOfCare.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
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Context-EpisodeOfCare
                                        154. MedicationAdministration.context.extension:relationEpisodeOfCare.value[x]
                                        Definition

                                        Identifies the episode(s) of care that this resource is relevant to. Establishes the EpisodeOfCare as a 'grouper' of resources that are relevant to that episode.

                                        ShortRelatedEpisodeOfCare
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(EpisodeOfCare, nl core EpisodeOfCare)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Standard StatusNormative (from Trial Use)
                                        Alternate NamesRelatieZorgepisode
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        156. MedicationAdministration.context.reference
                                        Definition

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

                                        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.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1, ref-1
                                        Typestring
                                        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()))
                                        158. MedicationAdministration.context.type
                                        Definition

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

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

                                        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
                                        This element is affected by the following invariants: ele-1
                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

                                        Typeuri
                                        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. MedicationAdministration.context.identifier
                                        Definition

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

                                        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
                                        This element is affected by the following invariants: ele-1
                                        TypeIdentifier
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        162. MedicationAdministration.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
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        164. MedicationAdministration.supportingInformation
                                        Definition

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

                                        ShortAdditional information to support administration
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Resource)
                                        Standard StatusNormative (from Trial Use)
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                        SlicingThis element introduces a set of slices on MedicationAdministration.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • profile @ resolve()
                                        • 166. MedicationAdministration.supportingInformation:administrationAgreement
                                          Slice NameadministrationAgreement
                                          Definition

                                          Administration agreement on which this administration is based.

                                          ShortAdministrationAgreement
                                          Comments

                                          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeReference(mp AdministrationAgreement)
                                          Standard StatusNormative (from Trial Use)
                                          Alternate NamesToedieningsafspraak
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                          168. MedicationAdministration.effective[x]
                                          Definition

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

                                          ShortStart and end time of administration
                                          Control1..1
                                          This element is affected by the following invariants: ele-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
                                          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 MedicationAdministration.effective[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 170. MedicationAdministration.effective[x]:effectiveDateTime
                                            Slice NameeffectiveDateTime
                                            Definition

                                            The date and time at which the medication was administered.

                                            ShortAdministrationDateTime
                                            Control1..1
                                            This element is affected by the following invariants: ele-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
                                            Summarytrue
                                            Alternate NamesToedieningsDatumTijd
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            172. MedicationAdministration.performer
                                            Definition

                                            The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the informal carer, for example.

                                            ShortAdministrator
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeBackboneElement
                                            Summarytrue
                                            Alternate NamesToediener
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            174. MedicationAdministration.performer.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            176. MedicationAdministration.performer.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            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..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standard StatusNormative (from Trial Use)
                                            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 MedicationAdministration.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 178. MedicationAdministration.performer.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              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..*
                                              This element is affected by the following invariants: ele-1
                                              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())
                                              180. MedicationAdministration.performer.function
                                              Definition

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

                                              ShortType of performance
                                              Comments

                                              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              BindingFor example codes, see MedicationAdministration Performer Function Codes
                                              (example to http://hl7.org/fhir/ValueSet/med-admin-perform-function)

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

                                              TypeCodeableConcept
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              182. MedicationAdministration.performer.actor
                                              Definition

                                              A reference from one resource to another.

                                              ShortPatient / HealthProfessional / Caregiver
                                              Comments

                                              Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

                                              In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

                                              Control1..1
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(Reference)(Practitioner, PractitionerRole, Patient, RelatedPerson, Device, nl core Patient, nl core HealthProfessional PractitionerRole, nl core ContactPerson)
                                              Summarytrue
                                              Alternate NamesPatiënt, Zorgverlener, Mantelzorger
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              184. MedicationAdministration.reasonCode
                                              Definition

                                              A code indicating why the medication was given.

                                              ShortReason administration performed
                                              Comments

                                              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              BindingFor example codes, see ReasonMedicationGivenCodes
                                              (example to http://hl7.org/fhir/ValueSet/reason-medication-given-codes)

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

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

                                              Condition or observation that supports why the medication was administered.

                                              ShortCondition or observation that supports why the medication was administered
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(Condition, Observation, DiagnosticReport)
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              188. MedicationAdministration.request
                                              Definition

                                              Medication agreement on which this administration is based.

                                              ShortMedicationAgreement
                                              Comments

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

                                              Control1..1
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(NcrEhrMedicationAgreement)
                                              Must Supporttrue
                                              Alternate NamesMedicatieafspraak
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              190. MedicationAdministration.request.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              192. MedicationAdministration.request.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              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..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Standard StatusNormative (from Trial Use)
                                              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 MedicationAdministration.request.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 194. MedicationAdministration.request.extension:resourceCategory
                                                Slice NameresourceCategory
                                                Definition

                                                Optional Extension Element - found in all resources.

                                                ShortOptional Extensions Element
                                                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..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(ext ResourceCategory) (Extension Type: CodeableConcept)
                                                Standard StatusNormative (from Trial Use)
                                                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())
                                                196. MedicationAdministration.request.reference
                                                Definition

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

                                                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.

                                                Control0..1
                                                This element is affected by the following invariants: ele-1, ref-1
                                                Typestring
                                                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()))
                                                198. MedicationAdministration.request.type
                                                Definition

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

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

                                                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
                                                This element is affected by the following invariants: ele-1
                                                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

                                                Typeuri
                                                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()))
                                                200. MedicationAdministration.request.identifier
                                                Definition

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

                                                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
                                                This element is affected by the following invariants: ele-1
                                                TypeIdentifier
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                202. MedicationAdministration.request.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
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                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()))
                                                204. MedicationAdministration.device
                                                Definition

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

                                                ShortDevice used to administer
                                                Comments

                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(Device)
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                206. MedicationAdministration.note
                                                Definition

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

                                                ShortInformation about the administration
                                                Comments

                                                For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeAnnotation
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                208. MedicationAdministration.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
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                210. MedicationAdministration.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..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Trial Use)
                                                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 MedicationAdministration.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 212. MedicationAdministration.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
                                                  This element is affected by the following invariants: ele-1
                                                  TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                                  [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
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  214. MedicationAdministration.note.time
                                                  Definition

                                                  Indicates when this particular annotation was made.

                                                  ShortWhen the annotation was made
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypedateTime
                                                  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()))
                                                  216. MedicationAdministration.note.text
                                                  Definition

                                                  Comments on administering the medication.

                                                  ShortComment
                                                  Comments

                                                  Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typemarkdown
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Alternate NamesToelichting
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  218. MedicationAdministration.dosage
                                                  Definition

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

                                                  ShortDetails of how medication was taken
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeBackboneElement
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  mad-1: SHALL have at least one of dosage.dose or dosage.rate[x] (dose.exists() or rate.exists())
                                                  220. MedicationAdministration.dosage.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  222. MedicationAdministration.dosage.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  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..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Standard StatusNormative (from Trial Use)
                                                  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 MedicationAdministration.dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 224. MedicationAdministration.dosage.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    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..*
                                                    This element is affected by the following invariants: ele-1
                                                    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())
                                                    226. MedicationAdministration.dosage.text
                                                    Definition

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

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

                                                    ShortFree text dosage instructions e.g. SIG
                                                    Comments

                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    228. MedicationAdministration.dosage.site
                                                    Definition

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

                                                    ShortBody site administered to
                                                    Comments

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

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                                    (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

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

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

                                                    The route through which the medication is administered (oral, nasal, intravenous,...).

                                                    ShortRouteOfAdministration
                                                    Comments

                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    BindingThe codes SHALL be taken from MedicatieToedieningToedieningswegCodelijst
                                                    (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.13.2--20200901000000)

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

                                                    TypeCodeableConcept
                                                    Alternate NamesToedieningsweg
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    232. MedicationAdministration.dosage.method
                                                    Definition

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

                                                    ShortHow drug was administered
                                                    Comments

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

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                                    (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

                                                    A coded concept describing the technique by which the medicine is administered.

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

                                                    Amount of the administered product.

                                                    ShortAdministeredAmount
                                                    Comments

                                                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeQuantity(G-Standard SimpleQuantity)
                                                    Is Modifierfalse
                                                    Alternate NamesToegediendeHoeveelheid
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                    236. MedicationAdministration.dosage.rate[x]
                                                    Definition

                                                    Identifies the speed with which the medication was or will be introduced into the patient. Typically, the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time, e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.

                                                    ShortDose quantity per unit of time
                                                    Comments

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

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeChoice of: Ratio, Quantity(SimpleQuantity)
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Standard StatusNormative (from Trial Use)
                                                    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 MedicationAdministration.dosage.rate[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • type @ $this
                                                    • 238. MedicationAdministration.dosage.rate[x]:rateQuantity
                                                      Slice NamerateQuantity
                                                      Definition

                                                      The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour.

                                                      For example, with an administering speed of 10ml/hour:

                                                      • value = 10
                                                      • unit = ml/hour
                                                      ShortAdministeringSpeed / nominalValue
                                                      Comments

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

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeQuantity(SimpleQuantity)
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Standard StatusNormative (from Trial Use)
                                                      Alternate NamesToedieningssnelheid, nominaleWaarde
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      240. MedicationAdministration.eventHistory
                                                      Definition

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

                                                      ShortA list of events of interest in the lifecycle
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeReference(Provenance)
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))