ELGA e-Medikation (R4) ENTWURF
0.1.1 - ci-build

ELGA e-Medikation (R4) ENTWURF - Local Development build (v0.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Data Type Profile: AtEmedDosage - Detailed Descriptions

Draft as of 2026-03-03

Definitions for the at-emed-dosage data type profile.

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

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.sequence
Definition

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

ShortDie Reihenfolge der Dosierungsanweisungen. Entfällt bei Einzeldosierung.The order of the dosage instructions
Control0..1
Typeinteger
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
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()))
6. Dosage.text
Definition

Free text dosage instructions e.g. SIG.

ShortFreitext-Dosierungsanweisung, wenn keine strukturierte Angabe möglich ist.Free 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()))
8. 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").

ShortCodierte Anweisungen oder Warnhinweise für den Patienten, z.B. zur Einnahme oder zur Aufbewahrung des Arzneimittels. (ex): https://hl7.org/fhir/R4/valueset-additional-instruction-codes.html. TODO: Nur wenn nicht ohnehin im Beipackzettel enthalten oder zusätzlich? Evtl. f. magistrale Zubereitungen, da kein Beipackzettel.Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Comments

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

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

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

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

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

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

ShortFreitext Anweisungen für den Patienten, z.B. zur Einnahme oder zur Aufbewahrung des Arzneimittels.Patient 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()))
12. Dosage.timing
Definition

When medication should be administered.

ShortZeitpunkt oder Zeitraum der Einnahme des Medikaments. Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen.When 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(ELGA e-Med Timing)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. 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|4.0.1
(example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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.

Typeboolean, CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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 Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 16. Dosage.asNeeded[x]:asNeededBoolean
    Slice NameasNeededBoolean
    Definition

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

    ShortBedarfsmedikation: Ja/NeinTake "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
    Typeboolean, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. 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).

    ShortBedarfsmedikation: Grund für die Bedarfsmedikation; Vermutlich reicht ein genereller Grund für die Medikation im Planeintrag (wenn e-Diagnose verfügbar).Take "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..01
    BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1
    (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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

    Body site to administer to.

    ShortKörperstelle, an der das Medikament angewendet wird, z.B. Haut, Auge, Ohr etc.Body site to administer to
    Comments

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

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

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

    TypeCodeableConcept
    Is Modifierfalse
    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()))
    22. Dosage.route
    Definition

    How drug should enter body.

    ShortArt der Anwendung der Arznei. (z.B. oral, nasal, intravenös, subkutan) Kann bei codierten Arzneien aus der ASP-Liste entnommen werden.How drug should enter body
    Control0..1
    BindingThe codes SHALL be taken from For example codes, see https://termgit.elga.gv.at/CodeSystem/medikationartanwendunghttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
    (required to https://termgit.elga.gv.at/CodeSystem/medikationartanwendung)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

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

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

    Technique for administering medication.

    ShortVerabreichungsmethode, z.B. Infusion, Injektion, Tablette, Salbe etc. Technique for administering medication
    Comments

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

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

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

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    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()))
    26. Dosage.doseAndRate
    Definition

    The amount of medication administered.

    ShortMenge des verabreichten MedikamentsAmount of medication administered
    Control0..1*
    TypeElement
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Dosage.doseAndRate.type
    Definition

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

    ShortArt der Dosierung, z.B. berechnet, wie verordnet (ex): https://hl7.org/fhir/R4/valueset-dose-rate-type.htmlThe kind of dose or rate specified
    Control0..1
    BindingFor example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1
    (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

    The kind of dose or rate specified.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

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

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

    Amount of medication per dose.

    ShortMenge des verabreichten Medikaments pro Zeiteinheit.Amount of medication per dose
    Comments

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

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

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

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

      Amount of medication per dose.

      ShortDosierungsspanne wird mit low und high angegeben, z.B. 5-10 mg.Amount of medication per dose
      Comments

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

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

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

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

      Amount of medication per dose.

      ShortMapping auf doseQuantityAmount 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
      TypeQuantity(SimpleQuantity, SimpleQuantity), Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

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

      Not allowed to be used in this context


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

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

      How the Quantity should be understood and represented.

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

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

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

      A human-readable form of the unit.

      ShortUnit representation
      Control0..1
      BindingThe codes SHALL be taken from For codes, see https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart
      (required to https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart)
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

      Amount of medication per unit of time.

      ShortAmount of medication per unit of time
      Comments

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

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

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

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

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

        Amount of medication per unit of time.

        ShortTODO: prüfenAmount 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
        TypeRatio, Quantity(SimpleQuantity), Range
        [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()))
        44. Dosage.doseAndRate.rate[x]:rateRange
        Slice NamerateRange
        Definition

        Amount of medication per unit of time.

        ShortTODO: prüfenAmount of medication per unit of time
        Comments

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

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

        Control0..1
        TypeRange, Quantity(SimpleQuantity), Ratio
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        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()))
        46. Dosage.doseAndRate.rate[x]:rateQuantity
        Slice NamerateQuantity
        Definition

        Amount of medication per unit of time.

        ShortTODO: prüfenAmount 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
        TypeQuantity(SimpleQuantity, SimpleQuantity), Ratio, Range
        [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()))

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

        0. Dosage
        2. Dosage.sequence
        ShortDie Reihenfolge der Dosierungsanweisungen. Entfällt bei Einzeldosierung.
        Must Supporttrue
        4. Dosage.text
        ShortFreitext-Dosierungsanweisung, wenn keine strukturierte Angabe möglich ist.
        Must Supporttrue
        6. Dosage.additionalInstruction
        ShortCodierte Anweisungen oder Warnhinweise für den Patienten, z.B. zur Einnahme oder zur Aufbewahrung des Arzneimittels. (ex): https://hl7.org/fhir/R4/valueset-additional-instruction-codes.html. TODO: Nur wenn nicht ohnehin im Beipackzettel enthalten oder zusätzlich? Evtl. f. magistrale Zubereitungen, da kein Beipackzettel.
        8. Dosage.patientInstruction
        ShortFreitext Anweisungen für den Patienten, z.B. zur Einnahme oder zur Aufbewahrung des Arzneimittels.
        10. Dosage.timing
        ShortZeitpunkt oder Zeitraum der Einnahme des Medikaments. Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen.
        TypeTiming(ELGA e-Med Timing)
        Must Supporttrue
        12. 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
        • 14. Dosage.asNeeded[x]:asNeededBoolean
          Slice NameasNeededBoolean
          ShortBedarfsmedikation: Ja/Nein
          Control0..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
          Must Supporttrue
          16. Dosage.asNeeded[x]:asNeededCodeableConcept
          Slice NameasNeededCodeableConcept
          ShortBedarfsmedikation: Grund für die Bedarfsmedikation; Vermutlich reicht ein genereller Grund für die Medikation im Planeintrag (wenn e-Diagnose verfügbar).
          Control0..0
          TypeCodeableConcept
          18. Dosage.site
          ShortKörperstelle, an der das Medikament angewendet wird, z.B. Haut, Auge, Ohr etc.
          20. Dosage.route
          ShortArt der Anwendung der Arznei. (z.B. oral, nasal, intravenös, subkutan) Kann bei codierten Arzneien aus der ASP-Liste entnommen werden.
          BindingThe codes SHALL be taken from https://termgit.elga.gv.at/CodeSystem/medikationartanwendung
          (required to https://termgit.elga.gv.at/CodeSystem/medikationartanwendung)
          Must Supporttrue
          22. Dosage.method
          ShortVerabreichungsmethode, z.B. Infusion, Injektion, Tablette, Salbe etc.
          Must Supporttrue
          24. Dosage.doseAndRate
          ShortMenge des verabreichten Medikaments
          Control0..1
          Must Supporttrue
          26. Dosage.doseAndRate.type
          ShortArt der Dosierung, z.B. berechnet, wie verordnet (ex): https://hl7.org/fhir/R4/valueset-dose-rate-type.html
          28. Dosage.doseAndRate.dose[x]
          ShortMenge des verabreichten Medikaments pro Zeiteinheit.
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 30. Dosage.doseAndRate.dose[x]:doseRange
            Slice NamedoseRange
            ShortDosierungsspanne wird mit low und high angegeben, z.B. 5-10 mg.
            Control0..1
            TypeRange
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Must Supporttrue
            32. Dosage.doseAndRate.dose[x]:doseQuantity
            Slice NamedoseQuantity
            ShortMapping auf doseQuantity
            Control0..1
            TypeQuantity(SimpleQuantity)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Must Supporttrue
            34. Dosage.doseAndRate.dose[x]:doseQuantity.unit
            BindingThe codes SHALL be taken from https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart
            (required to https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart)
            36. Dosage.doseAndRate.rate[x]
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on Dosage.doseAndRate.rate[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 38. Dosage.doseAndRate.rate[x]:rateRatio
              Slice NamerateRatio
              ShortTODO: prüfen
              Control0..1
              TypeRatio
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              40. Dosage.doseAndRate.rate[x]:rateRange
              Slice NamerateRange
              ShortTODO: prüfen
              Control0..1
              TypeRange
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              42. Dosage.doseAndRate.rate[x]:rateQuantity
              Slice NamerateQuantity
              ShortTODO: prüfen
              Control0..1
              TypeQuantity(SimpleQuantity)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]

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

              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.

                ShortDie Reihenfolge der Dosierungsanweisungen. Entfällt bei Einzeldosierung.
                Control0..1
                Typeinteger
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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.

                ShortFreitext-Dosierungsanweisung, wenn keine strukturierte Angabe möglich ist.
                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").

                ShortCodierte Anweisungen oder Warnhinweise für den Patienten, z.B. zur Einnahme oder zur Aufbewahrung des Arzneimittels. (ex): https://hl7.org/fhir/R4/valueset-additional-instruction-codes.html. TODO: Nur wenn nicht ohnehin im Beipackzettel enthalten oder zusätzlich? Evtl. f. magistrale Zubereitungen, da kein Beipackzettel.
                Comments

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

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

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

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

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

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

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

                ShortFreitext Anweisungen für den Patienten, z.B. zur Einnahme oder zur Aufbewahrung des Arzneimittels.
                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.

                ShortZeitpunkt oder Zeitraum der Einnahme des Medikaments. Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen.
                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(ELGA e-Med Timing)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                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|4.0.1)

                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.

                Typeboolean
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                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 Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 20. Dosage.asNeeded[x]:asNeededBoolean
                  Slice NameasNeededBoolean
                  Definition

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

                  ShortBedarfsmedikation: Ja/Nein
                  Comments

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

                  Control0..1
                  Typeboolean
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. 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).

                  ShortBedarfsmedikation: Grund für die Bedarfsmedikation; Vermutlich reicht ein genereller Grund für die Medikation im Planeintrag (wenn e-Diagnose verfügbar).
                  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..0
                  BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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

                  Body site to administer to.

                  ShortKörperstelle, an der das Medikament angewendet wird, z.B. Haut, Auge, Ohr etc.
                  Comments

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

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

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  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()))
                  26. Dosage.route
                  Definition

                  How drug should enter body.

                  ShortArt der Anwendung der Arznei. (z.B. oral, nasal, intravenös, subkutan) Kann bei codierten Arzneien aus der ASP-Liste entnommen werden.
                  Control0..1
                  BindingThe codes SHALL be taken from https://termgit.elga.gv.at/CodeSystem/medikationartanwendung
                  (required to https://termgit.elga.gv.at/CodeSystem/medikationartanwendung)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

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

                  Technique for administering medication.

                  ShortVerabreichungsmethode, z.B. Infusion, Injektion, Tablette, Salbe etc.
                  Comments

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

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

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  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()))
                  30. Dosage.doseAndRate
                  Definition

                  The amount of medication administered.

                  ShortMenge des verabreichten Medikaments
                  Control0..1
                  TypeElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  32. 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
                  34. 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
                  • 36. Dosage.doseAndRate.type
                    Definition

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

                    ShortArt der Dosierung, z.B. berechnet, wie verordnet (ex): https://hl7.org/fhir/R4/valueset-dose-rate-type.html
                    Control0..1
                    BindingFor example codes, see DoseAndRateType
                    (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                    The kind of dose or rate specified.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

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

                    Amount of medication per dose.

                    ShortMenge des verabreichten Medikaments pro Zeiteinheit.
                    Comments

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

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

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

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

                      Amount of medication per dose.

                      ShortDosierungsspanne wird mit low und high angegeben, z.B. 5-10 mg.
                      Comments

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

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

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

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

                      Amount of medication per dose.

                      ShortMapping auf doseQuantity
                      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
                      TypeQuantity(SimpleQuantity)
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

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

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

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

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      46. Dosage.doseAndRate.dose[x]:doseQuantity.extension
                      Definition

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

                      ShortAdditional content defined by implementations
                      Comments

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

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

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

                        ShortNumerical value (with implicit precision)
                        Comments

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

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

                        Precision is handled implicitly in almost all cases of measurement.

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

                        Not allowed to be used in this context

                        Short< | <= | >= | > - how to understand the value
                        Control0..0
                        BindingThe codes SHALL be taken from QuantityComparator
                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                        How the Quantity should be understood and represented.

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

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

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

                        A human-readable form of the unit.

                        ShortUnit representation
                        Control0..1
                        BindingThe codes SHALL be taken from https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart
                        (required to https://termgit.elga.gv.at/ValueSet-elga-medikationmengenart)
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

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

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

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

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

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

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

                        ShortCoded form of the unit
                        Comments

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

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

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

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

                        Amount of medication per unit of time.

                        ShortAmount of medication per unit of time
                        Comments

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

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

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

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

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

                          Amount of medication per unit of time.

                          ShortTODO: prüfen
                          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
                          TypeRatio
                          [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()))
                          62. Dosage.doseAndRate.rate[x]:rateRange
                          Slice NamerateRange
                          Definition

                          Amount of medication per unit of time.

                          ShortTODO: prüfen
                          Comments

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

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

                          Control0..1
                          TypeRange
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          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()))
                          64. Dosage.doseAndRate.rate[x]:rateQuantity
                          Slice NamerateQuantity
                          Definition

                          Amount of medication per unit of time.

                          ShortTODO: prüfen
                          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
                          TypeQuantity(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()))
                          66. 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()))
                          68. 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
                          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()))
                          70. Dosage.maxDosePerLifetime
                          Definition

                          Upper limit on medication per lifetime of the patient.

                          ShortUpper limit on medication per lifetime of the patient
                          Control0..1
                          TypeQuantity(SimpleQuantity)
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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