IL Core Implementation Guide
0.18.0 - draft Israel flag

This page is part of the IL-Core IG (v0.18.0: draft-1 Draft) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Data Type Profile: ILCoreDosage - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the il-core-dosage data type profile.

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

0. Dosage
2. Dosage.text
Must Supporttrue
4. Dosage.additionalInstruction
BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTAdditionalDosageInstructions
(extensible to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

6. Dosage.asNeeded[x]
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on Dosage.asNeeded[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 8. Dosage.asNeeded[x]:asNeededCodeableConcept
    Slice NameasNeededCodeableConcept
    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTMedicationAsNeededReasonCodes
    (extensible to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

    A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

    TypeCodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    10. Dosage.site
    BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
    (extensible to http://hl7.org/fhir/ValueSet/approach-site-codes)

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

    12. Dosage.route
    BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTRouteCodes
    (extensible to http://hl7.org/fhir/ValueSet/route-codes)

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

    14. Dosage.method
    BindingThe codes SHOULD be taken from SNOMEDCTAdministrationMethodCodes
    (preferred to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

    16. Dosage.doseAndRate
    18. Dosage.doseAndRate.type
    BindingUnless not suitable, these codes SHALL be taken from DoseAndRateType
    (extensible to http://hl7.org/fhir/ValueSet/dose-rate-type)

    The kind of dose or rate specified.

    20. Dosage.doseAndRate.dose[x]
    BindingUnless not suitable, these codes SHALL be taken from IL Core Units Of Measure Codes
    (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
    Additional BindingsPurpose
    IL Core Units Of Measure CodesMax Binding
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    22. Dosage.maxDosePerAdministration
    BindingUnless not suitable, these codes SHALL be taken from IL Core Units Of Measure Codes
    (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
    Additional BindingsPurpose
    IL Core Units Of Measure CodesMax Binding
    24. Dosage.maxDosePerLifetime
    BindingUnless not suitable, these codes SHALL be taken from IL Core Units Of Measure Codes
    (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
    Additional BindingsPurpose
    IL Core Units Of Measure CodesMax Binding

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

    0. Dosage
    Definition

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

    ShortHow the medication is/was taken or should be taken
    Control0..*
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    2. Dosage.modifierExtension
    Definition

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

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    4. Dosage.text
    Definition

    Free text dosage instructions e.g. SIG.

    ShortFree text dosage instructions e.g. SIG
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

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

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

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

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

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

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes
    (extensible to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. Dosage.asNeeded[x]
    Definition

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

    ShortTake "as needed" (for x)
    Comments

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

    Control0..1
    BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
    (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

    A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

    TypeChoice of: boolean, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    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 Dosage.asNeeded[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 10. Dosage.asNeeded[x]:asNeededCodeableConcept
      Slice NameasNeededCodeableConcept
      Definition

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

      ShortTake "as needed" (for x)
      Comments

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

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
      (extensible to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

      A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

      TypeCodeableConcept, boolean
      [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()))
      12. Dosage.site
      Definition

      Body site to administer to.

      ShortBody site to administer to
      Comments

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

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes
      (extensible 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
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      How drug should enter body.

      ShortHow drug should enter body
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes
      (extensible to http://hl7.org/fhir/ValueSet/route-codes)

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

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Dosage.method
      Definition

      Technique for administering medication.

      ShortTechnique for administering medication
      Comments

      Terminologies used often pre-coordinate this term with the route and or form of administration.

      Control0..1
      BindingThe codes SHOULD be taken from For example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes
      (preferred to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Dosage.maxDosePerAdministration
      Definition

      Upper limit on medication per administration.

      ShortUpper limit on medication per administration
      Comments

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

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see IL Core Units Of Measure Codes
      (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
      Additional BindingsPurpose
      IL Core Units Of Measure CodesMax Binding
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Dosage.maxDosePerLifetime
      Definition

      Upper limit on medication per lifetime of the patient.

      ShortUpper limit on medication per lifetime of the patient
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see IL Core Units Of Measure Codes
      (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
      Additional BindingsPurpose
      IL Core Units Of Measure CodesMax Binding
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Summarytrue
      Requirements

      The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

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

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

      0. Dosage
      Definition

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

      ShortHow the medication is/was taken or should be taken
      Control0..*
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      2. Dosage.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      4. 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..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Dosage.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Dosage.sequence
        Definition

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

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

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

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

        Free text dosage instructions e.g. SIG.

        ShortFree text dosage instructions e.g. SIG
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

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

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

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

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

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

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTAdditionalDosageInstructions
        (extensible to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

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

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

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

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

        When medication should be administered.

        ShortWhen medication should be administered
        Comments

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

        Control0..1
        TypeTiming
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Dosage.asNeeded[x]
        Definition

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

        ShortTake "as needed" (for x)
        Comments

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

        Control0..1
        BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
        (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

        A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

        TypeChoice of: boolean, CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        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 Dosage.asNeeded[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 20. Dosage.asNeeded[x]:asNeededCodeableConcept
          Slice NameasNeededCodeableConcept
          Definition

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

          ShortTake "as needed" (for x)
          Comments

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

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTMedicationAsNeededReasonCodes
          (extensible to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

          A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

          TypeCodeableConcept
          [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()))
          22. Dosage.site
          Definition

          Body site to administer to.

          ShortBody site to administer to
          Comments

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

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
          (extensible 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
          Is Modifierfalse
          Summarytrue
          Requirements

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

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

          How drug should enter body.

          ShortHow drug should enter body
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from SNOMEDCTRouteCodes
          (extensible to http://hl7.org/fhir/ValueSet/route-codes)

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

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Dosage.method
          Definition

          Technique for administering medication.

          ShortTechnique for administering medication
          Comments

          Terminologies used often pre-coordinate this term with the route and or form of administration.

          Control0..1
          BindingThe codes SHOULD be taken from SNOMEDCTAdministrationMethodCodes
          (preferred to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

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

          The amount of medication administered.

          ShortAmount of medication administered
          Control0..*
          TypeElement
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Dosage.doseAndRate.id
          Definition

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

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

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

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 34. Dosage.doseAndRate.type
            Definition

            The kind of dose or rate specified, for example, ordered or calculated.

            ShortThe kind of dose or rate specified
            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from DoseAndRateType
            (extensible to http://hl7.org/fhir/ValueSet/dose-rate-type)

            The kind of dose or rate specified.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            If the type is not populated, assume to be "ordered".

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

            Amount of medication per dose.

            ShortAmount of medication per dose
            Comments

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

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from IL Core Units Of Measure Codes
            (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
            Additional BindingsPurpose
            IL Core Units Of Measure CodesMax Binding
            TypeChoice of: Range, Quantity(SimpleQuantity)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Dosage.doseAndRate.rate[x]
            Definition

            Amount of medication per unit of time.

            ShortAmount of medication per unit of time
            Comments

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

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

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

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

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

            Upper limit on medication per unit of time.

            ShortUpper limit on medication per unit of time
            Comments

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

            Control0..1
            TypeRatio
            Is Modifierfalse
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Dosage.maxDosePerAdministration
            Definition

            Upper limit on medication per administration.

            ShortUpper limit on medication per administration
            Comments

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

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from IL Core Units Of Measure Codes
            (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
            Additional BindingsPurpose
            IL Core Units Of Measure CodesMax Binding
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. Dosage.maxDosePerLifetime
            Definition

            Upper limit on medication per lifetime of the patient.

            ShortUpper limit on medication per lifetime of the patient
            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from IL Core Units Of Measure Codes
            (extensible to http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure)
            Additional BindingsPurpose
            IL Core Units Of Measure CodesMax Binding
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Summarytrue
            Requirements

            The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

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