AU Core Implementation Guide
0.2.2-preview - Preview Australia flag

This page is part of the Australian Core IG (v0.2.2-preview: AU Core) based on FHIR R4. For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core MedicationAdministration

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationadministration Version: 0.2.2-preview
Standards status: Draft Maturity Level: 0 Computable Name: AUCoreMedicationAdministration

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for a MedicationAdministration resource to record, search, and fetch history of administration or consumption of non-vaccine medications associated with a patient. It is based on the AU Base Medication Administration profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the MedicationAdministration when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

Usage scenarios

The following are supported usage scenarios for this profile:

  • Query medications administered for a patient (current and historical)
  • Record or update a medication administration record for a patient

Comparison with other national and international specifications

No equivalent International Patient Access, International Patient Summary, or US Core profile.

Profile specific implementation guidance

  • See the Medicine information section for guidance
  • MedicationAdministration resources can represent a medication using either a code with MedicationAdministration.medicationCodeableConcept, or reference a Medication resource with MedicationAdministration.medicationReference.
    • Although both are marked as must support, servers are not required to support both a code and a reference, but they SHALL support at least one of these elements
    • A client application SHALL support both elements
    • When referencing a Medication resource, it is preferred the resource is contained but it may be an external resource

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from AUBaseMedicationAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationAdministration 0..*AUBaseMedicationAdministrationA record of medication administered to a patient in an Australian healthcare context
... status S1..1codein-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
... statusReason S0..*CodeableConceptReason administration not performed
... category S0..1CodeableConceptType of medication usage
.... medication[x]:medicationCodeableConcept 0..1CodeableConceptCoded Medication
..... Slices for coding 0..*CodingMedication Codes
Slice: Unordered, Open by value:system
...... coding:pbs S0..*CodingPBS Item Code
...... coding:amt S0..*CodingAMT Medicines
.... medication[x]:medicationReference 0..1Reference(AU Core Medication)Medication Reference
... subject S1..1Reference(AU Core Patient)Who received medication
... context S0..1Reference(AU Core Encounter)Encounter or Episode of Care administered as part of
... effective[x] S1..1dateTime, PeriodStart and end time of administration
... performer S0..*BackboneElementWho performed the medication administration and what they did
.... function S0..1CodeableConceptType of performance
.... actor S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core RelatedPerson | AU Core Patient)Who performed the medication administration
... reasonCode S0..*CodeableConceptReason administration performed
... reasonReference S0..*Reference(AU Core Condition | AU Core Observation | AU Core DiagnosticReport)Condition or observation that supports why the medication was administered
... note S0..*AnnotationInformation about the administration
... dosage S0..1BackboneElementDetails of how medication was taken
.... text S0..1stringFree text dosage instructions e.g. SIG
.... site S0..1CodeableConceptBody site administered to
.... route S0..1CodeableConceptPath of substance into body
.... method S0..1CodeableConceptHow drug was administered
.... dose S0..1SimpleQuantityAmount of medication per dose
.... rate[x] S0..1Ratio, SimpleQuantityDose quantity per unit of time

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. FHIR search operations and the syntax used to describe the interactions is described here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
patient SHALL reference The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both.
patient+status SHALL reference+token
patient+effective-time SHOULD reference+date
patient.identifier SHOULD reference.token The client SHALL provide both the system and code values. The server SHALL support both.

The client SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The server SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
patient+status+effective-time SHOULD reference+token+date
effective-time MAY date A client SHALL provide a value precise to the second + time offset. A server SHALL support a value precise to the second + time offset.
status MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.

Mandatory Search Parameters

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support searching using the patient search parameter:
    • SHOULD support these _include parameters: MedicationAdministration:medication
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

    GET [base]/MedicationAdministration?patient={Type/}[id] or optionally GET [base]/MedicationAdministration?patient.identifier=[system|][code]

    Example:

    1. GET [base]/MedicationAdministration?patient=5678
    2. GET [base]/MedicationAdministration?patient=5678&_include=MedicationAdministration:medication
    3. GET [base]/MedicationAdministration?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
    4. GET [base]/MedicationAdministration?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

    Implementation Notes: Fetches a bundle of all MedicationAdministration resources for the specified patient (how to search by reference and how to search by token)

  2. SHALL support searching using the combination of the patient and status search parameters:
    • SHOULD support these _include parameters: MedicationAdministration:medication
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
    • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

    GET [base]/MedicationAdministration?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/MedicationAdministration?patient=5678&status=completed

    Implementation Notes: Fetches a bundle of all MedicationAdministration resources for the specified patient and status (how to search by reference and how to search by token)

Optional Search Parameters

The following search parameters and search parameter combinations SHOULD be supported:

  1. SHOULD support searching using the combination of the patient and effective-time search parameters:
    • SHOULD support these _include parameters: MedicationAdministration:medication
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
    • SHALL support these effective-time comparators: gt,lt,ge,le
    • SHOULD support multipleAnd search on effective-time (e.g.effective-time=[date]&effective-time=[date]]&...)

    GET [base]/MedicationAdministration?patient={Type/}[id]&effective-time={gt|lt|ge|le}[date]{&effective-time={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/MedicationAdministration?patient=5678&effective-time=ge2020-01-01T00:00:00Z
    2. GET [base]/MedicationAdministration?patient=5678&effective-time=ge2020-01-01T00:00:00Z&_revinclude=Provenance:target
    3. GET [base]/MedicationAdministration?patient.identifier=http://example.org/fhir/mrn|12345&effective-time=ge2020-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all MedicationAdministration resources for the specified patient and date (how to search by reference and how to search by date)

  2. SHOULD support searching using the combination of the patient and status and effective-time search parameters:
    • SHOULD support these _include parameters: MedicationAdministration:medication
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
    • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)
    • SHALL support these effective-time comparators: gt,lt,ge,le
    • SHOULD support multipleAnd search on effective-time (e.g.effective-time=[date]&effective-time=[date]]&...)

    GET [base]/MedicationAdministration?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}&effective-time={gt|lt|ge|le}[date]{&effective-time={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/MedicationAdministration?patient=5678&status=completed&effective-time=ge2020-01-01T00:00:00Z
    2. GET [base]/MedicationAdministration?patient=5678&status=completed&effective-time=ge2020-01-01T00:00:00Z&_include=MedicationAdministration:medication
    3. GET [base]/MedicationAdministration?patient.identifier=http://example.org/fhir/mrn|12345&status=completed&effective-time=ge2020-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all MedicationAdministration resources for the specified patient and status and date (how to search by reference and how to search by token and how to search by date)