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11.5 Ресурс Medication - Назначение

Pharmacy Work GroupMaturity Level: 3 Trial UseSecurity Category: Business Compartments: Not linked to any defined compartments

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

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

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

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

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

На этот ресурс ссылаются ActivityDefinition, AdverseEvent, CarePlan, CatalogEntry, ChargeItem, ChargeItemDefinition, Flag, Group, itself, MedicationAdministration, MedicationDispense, MedicationKnowledge, MedicationRequest, MedicationStatement, MedicinalProductContraindication, MedicinalProductIndication, MedicinalProductInteraction, MedicinalProductUndesirableEffect, Procedure, SupplyDelivery и SupplyRequest

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. Medication TUDomainResourceОпределение лекарственного средства
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier for this medication
... code Σ0..1CodeableConceptКоды, которые идентифицируют это лекарственное средство
SNOMED CT Medication Codes (Example)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Medication status codes (Required)
... manufacturer Σ0..1Reference(Organization)Производитель изделия
... form 0..1CodeableConceptpowder | tablets | capsule +
SNOMED CT Form Codes (Example)
... amount Σ0..1RatioAmount of drug in package
... ingredient 0..*BackboneElementАктивный или неактивный ингредиент
.... item[x] 1..1The actual ingredient or content
..... itemCodeableConceptCodeableConcept
..... itemReferenceReference(Substance | Medication)
.... isActive 0..1booleanActive ingredient indicator
.... strength 0..1RatioКоличество содержащегося ингредиента
... batch 0..1BackboneElementСведения об упаковке лекарственного средства
.... lotNumber 0..1stringIdentifier assigned to batch
.... expirationDate 0..1dateTimeWhen batch will expire

doco Документация по этому формату

UML-диаграмма (Legend)

Medication (DomainResource)Business identifier for this medicationidentifier : Identifier [0..*]Код (или набор кодов), определяющий это лекарственное средство, или текстовое описание, если нет подходящих кодов. Примечание к использованию: это может быть стандартный код медикамента, например из RxNorm, SNOMED CT, IDMP. Также это может быть код из государственного или местного справочника, возможно с переводами в другие кодовые системыcode : CodeableConcept [0..1] « A coded concept that defines the type of a medication. (Strength=Example)SNOMEDCTMedicationCodes?? »A code to indicate if the medication is in active use (this element modifies the meaning of other elements)status : code [0..1] « A coded concept defining if the medication is in active use. (Strength=Required)Medication Status ! »Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication productmanufacturer : Reference [0..1] « Organization »Описание формы выпуска изделия. Порошок; таблетки; картонная коробкаform : CodeableConcept [0..1] « A coded concept defining the form of a medication. (Strength=Example)SNOMEDCTFormCodes?? »Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)amount : Ratio [0..1]IngredientНепосредственно сам ингредиент - либо ресурс Substance (для простого ингредиента), либо другой ресурс Medication of a medicationitem[x] : Type [1..1] « CodeableConcept|Reference(Substance| Medication) »Indication of whether this ingredient affects the therapeutic action of the drugisActive : boolean [0..1]Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tabletstrength : Ratio [0..1]BatchНомер партии данного продуктаlotNumber : string [0..1]Когда истекает срок годности партии указанного продуктаexpirationDate : dateTime [0..1]Идентифицирует конкретный компонент продукта, представляющий интересingredient[0..*]Сведения, относящиеся только к продуктам (но не упаковкам)batch[0..1]

XML-шаблон

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <code><!-- 0..1 CodeableConcept Коды, которые идентифицируют это лекарственное средство --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <manufacturer><!-- 0..1 Reference(Organization) Производитель изделия --></manufacturer>
 <form><!-- 0..1 CodeableConcept powder | tablets | capsule + --></form>
 <amount><!-- 0..1 Ratio Amount of drug in package --></amount>
 <ingredient>  <!-- 0..* Активный или неактивный ингредиент -->
  <item[x]><!-- 1..1 CodeableConcept|Reference(Substance|Medication) The actual ingredient or content --></item[x]>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <strength><!-- 0..1 Ratio Количество содержащегося ингредиента --></strength>
 </ingredient>
 <batch>  <!-- 0..1 Сведения об упаковке лекарственного средства -->
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
 </batch>
</Medication>

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.identifier [ Identifier ], ... ; # 0..* Business identifier for this medication
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Коды, которые идентифицируют это лекарственное средство
  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error
  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Производитель изделия
  fhir:Medication.form [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.amount [ Ratio ]; # 0..1 Amount of drug in package
  fhir:Medication.ingredient [ # 0..* Активный или неактивный ингредиент
    # Medication.ingredient.item[x] : 1..1 The actual ingredient or content. One of these 2
      fhir:Medication.ingredient.itemCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.itemReference [ Reference(Substance|Medication) ]
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    fhir:Medication.ingredient.strength [ Ratio ]; # 0..1 Количество содержащегося ингредиента
  ], ...;
  fhir:Medication.batch [ # 0..1 Сведения об упаковке лекарственного средства
    fhir:Medication.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
    fhir:Medication.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
  ];
]

Changes since R3

Medication
Medication.identifier
  • Added Element
Medication.status
  • Remove Codes active, inactive, entered-in-error
  • Add Codes active, inactive, entered-in-error
  • Now marked as Modifier
Medication.amount
  • Added Element
Medication.ingredient.strength
  • Added Element
Medication.batch
  • Added Element
Medication.batch.lotNumber
  • Added Element
Medication.batch.expirationDate
  • Added Element
Medication.isBrand
  • deleted
Medication.isOverTheCounter
  • deleted
Medication.ingredient.amount
  • deleted
Medication.package
  • deleted
Medication.image
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 22 fail round-trip testing and 16 r3 resources are invalid (0 errors).)

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. Medication TUDomainResourceОпределение лекарственного средства
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness identifier for this medication
... code Σ0..1CodeableConceptКоды, которые идентифицируют это лекарственное средство
SNOMED CT Medication Codes (Example)
... status ?!Σ0..1codeactive | inactive | entered-in-error
Medication status codes (Required)
... manufacturer Σ0..1Reference(Organization)Производитель изделия
... form 0..1CodeableConceptpowder | tablets | capsule +
SNOMED CT Form Codes (Example)
... amount Σ0..1RatioAmount of drug in package
... ingredient 0..*BackboneElementАктивный или неактивный ингредиент
.... item[x] 1..1The actual ingredient or content
..... itemCodeableConceptCodeableConcept
..... itemReferenceReference(Substance | Medication)
.... isActive 0..1booleanActive ingredient indicator
.... strength 0..1RatioКоличество содержащегося ингредиента
... batch 0..1BackboneElementСведения об упаковке лекарственного средства
.... lotNumber 0..1stringIdentifier assigned to batch
.... expirationDate 0..1dateTimeWhen batch will expire

doco Документация по этому формату

UML-диаграмма (Legend)

Medication (DomainResource)Business identifier for this medicationidentifier : Identifier [0..*]Код (или набор кодов), определяющий это лекарственное средство, или текстовое описание, если нет подходящих кодов. Примечание к использованию: это может быть стандартный код медикамента, например из RxNorm, SNOMED CT, IDMP. Также это может быть код из государственного или местного справочника, возможно с переводами в другие кодовые системыcode : CodeableConcept [0..1] « A coded concept that defines the type of a medication. (Strength=Example)SNOMEDCTMedicationCodes?? »A code to indicate if the medication is in active use (this element modifies the meaning of other elements)status : code [0..1] « A coded concept defining if the medication is in active use. (Strength=Required)Medication Status ! »Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication productmanufacturer : Reference [0..1] « Organization »Описание формы выпуска изделия. Порошок; таблетки; картонная коробкаform : CodeableConcept [0..1] « A coded concept defining the form of a medication. (Strength=Example)SNOMEDCTFormCodes?? »Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.)amount : Ratio [0..1]IngredientНепосредственно сам ингредиент - либо ресурс Substance (для простого ингредиента), либо другой ресурс Medication of a medicationitem[x] : Type [1..1] « CodeableConcept|Reference(Substance| Medication) »Indication of whether this ingredient affects the therapeutic action of the drugisActive : boolean [0..1]Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tabletstrength : Ratio [0..1]BatchНомер партии данного продуктаlotNumber : string [0..1]Когда истекает срок годности партии указанного продуктаexpirationDate : dateTime [0..1]Идентифицирует конкретный компонент продукта, представляющий интересingredient[0..*]Сведения, относящиеся только к продуктам (но не упаковкам)batch[0..1]

XML-шаблон

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this medication --></identifier>
 <code><!-- 0..1 CodeableConcept Коды, которые идентифицируют это лекарственное средство --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <manufacturer><!-- 0..1 Reference(Organization) Производитель изделия --></manufacturer>
 <form><!-- 0..1 CodeableConcept powder | tablets | capsule + --></form>
 <amount><!-- 0..1 Ratio Amount of drug in package --></amount>
 <ingredient>  <!-- 0..* Активный или неактивный ингредиент -->
  <item[x]><!-- 1..1 CodeableConcept|Reference(Substance|Medication) The actual ingredient or content --></item[x]>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <strength><!-- 0..1 Ratio Количество содержащегося ингредиента --></strength>
 </ingredient>
 <batch>  <!-- 0..1 Сведения об упаковке лекарственного средства -->
  <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
  <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
 </batch>
</Medication>

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.identifier [ Identifier ], ... ; # 0..* Business identifier for this medication
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Коды, которые идентифицируют это лекарственное средство
  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error
  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Производитель изделия
  fhir:Medication.form [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.amount [ Ratio ]; # 0..1 Amount of drug in package
  fhir:Medication.ingredient [ # 0..* Активный или неактивный ингредиент
    # Medication.ingredient.item[x] : 1..1 The actual ingredient or content. One of these 2
      fhir:Medication.ingredient.itemCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.itemReference [ Reference(Substance|Medication) ]
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    fhir:Medication.ingredient.strength [ Ratio ]; # 0..1 Количество содержащегося ингредиента
  ], ...;
  fhir:Medication.batch [ # 0..1 Сведения об упаковке лекарственного средства
    fhir:Medication.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
    fhir:Medication.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
  ];
]

Changes since Release 3

Medication
Medication.identifier
  • Added Element
Medication.status
  • Remove Codes active, inactive, entered-in-error
  • Add Codes active, inactive, entered-in-error
  • Now marked as Modifier
Medication.amount
  • Added Element
Medication.ingredient.strength
  • Added Element
Medication.batch
  • Added Element
Medication.batch.lotNumber
  • Added Element
Medication.batch.expirationDate
  • Added Element
Medication.isBrand
  • deleted
Medication.isOverTheCounter
  • deleted
Medication.ingredient.amount
  • deleted
Medication.package
  • deleted
Medication.image
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 23 tests that all execute ok. 22 fail round-trip testing and 16 r3 resources are invalid (0 errors).)

 

See the Profiles & Extensions and the Альтернативные определения: Основное определение XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the Анализ зависимостей

PathОписаниеТипСсылка
Medication.code A coded concept that defines the type of a medication.ExampleSNOMEDCTMedicationCodes
Medication.status A coded concept defining if the medication is in active use.RequiredMedication Status Codes
Medication.form A coded concept defining the form of a medication.ExampleSNOMEDCTFormCodes

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

Параметры поиска для этого ресурса. Также к нему применяются общие параметры. Более подробную информацию о поиске в REST, обмене сообщениями и сервисах см. в разделе Поиск.

ИмяТипОпределениеВыражениеIn Common
codetokenReturns medications for a specific codeMedication.code13 Resources
expiration-datedateReturns medications in a batch with this expiration dateMedication.batch.expirationDate
formtokenReturns medications for a specific dose formMedication.form
identifiertokenReturns medications with this external identifierMedication.identifier
ingredientreferenceReturns medications for this ingredient reference(Medication.ingredient.item as Reference)
(Medication, Substance)
ingredient-codetokenReturns medications for this ingredient code(Medication.ingredient.item as CodeableConcept)
lot-numbertokenReturns medications in a batch with this lot numberMedication.batch.lotNumber
manufacturerreferenceReturns medications made or sold for this manufacturerMedication.manufacturer
(Organization)
statustokenReturns medications for this statusMedication.status