Medication Rendered Dosage Instruction

3.4 Extension: Medication Rendered Dosage Instruction

The official URL for this extension is:

http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage

Status: draft
Extension maintained by:

Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)

Context of Use

This extension may be used on the following element(s):

{"type"=>"MedicationOrder"}
{"type"=>"MedicationDispense"}

Usage info

Yet to be done: xref

3.4.2 Formal Views of Extension Content

Download Excel representation

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

This structure is derived from Extension

Name	Card.	Type	Constraints and Usage
Extension	0..1		Definition: Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance) Comments: Usage Note: This is intended to provide the dosage instructions to the Pharmacist for dispensing. This will be displayed to the Pharmacist upon receipt of the ePrescription. The EMR may not provide individual/structured dosage instructions so all data that would have been conveyed as structured dosage data is provided here as well in human readable form. This is also used to convey the dosage instructions when a fax is used, as there will be no structured prescription on the fax. The rendered dosage instruction must contain all dosage instructions and must be able to stand on its own. Conformance Rule: This field is made up of structured dosage information as well as patient instructions, assembled into one field and formatted as human-readable, meaning that codes should not be used (e.g. 'days' should be used instead of 'd'). Conformance Rule: MUST allow all printable characters and carriage return/line feeds. 5000 character max. Conformance Rule: The following MUST be included if available, in human-readable form: Dosage quantity, dosage unit, dosage frequency, form, strength, max quantity per period, minimal interval between dispense, route of administration and where applicable, the administration site. Note: Any additional patient instructions that are specified at the dosage line level (e.g. take with food, starting one day before dental appointment) should be included. If an EMR only supports a single separate/discrete field to capture patient instructions in the EMR, this should not be included here. Conformance Rule: If an EMR sends discrete data elements they must also popuate this with a textual view of the SIG (as per the MIF definition). E.g. PO value for RouteofAdministration will be conveyed as 'oral' in this field. Conformance Rule: If an EMR has discrete field for Pharmacy Notes (Dispenser Instructions), they should not be included here. If EMR's have both concepts combined into one field, they can both be included here. Usage Note: It is recognized that very complex instructions may be conveyed as text only (not as structured data). Example: take 500 mg twice a day at breakfast and at lunch AND 250 mg once a day at bedtime - THEN (new dosage line).....). The pharmacy will receive as text, enter it in their system and do the dosage checking. If the EMR submits the structured frequency in the message, this should be consistent with the textual instructions. The PMS may ignore the structured frequency, or override it to align with the textual instructions. Example: the EMR may enter frequency (multiplier of the dose) in their system like this (2 qam and 3 qhs ), in the structured frequency. The textual instructions could say Take 2 tablets in the morning and 3 at bedtime.
url	1..1	uri	"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
valueString	1..1	string	Max Length: 5000 Definition: Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)

This structure is derived from Extension

Summary

Mandatory: 2 elements
Must-Support: 2 elements
Fixed Value: 1 element
Prohibited: 1 element

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints
Extension	S	0..1		Rendered Dosage Instruction
extension		0..0
url	S	1..1	uri	"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
valueString	S	1..1	string	Rendered Dosage Instruction Max Length: 5000
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Extension	S	0..1		Rendered Dosage Instruction
id		0..1	id	xml:id (or equivalent in JSON)
url	S	1..1	uri	"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
valueString	S	1..1	string	Rendered Dosage Instruction Max Length: 5000
Documentation for this format

Grid View

This structure is derived from Extension

Name	Card.	Type	Constraints and Usage
Extension	0..1		Definition: Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance) Comments: Usage Note: This is intended to provide the dosage instructions to the Pharmacist for dispensing. This will be displayed to the Pharmacist upon receipt of the ePrescription. The EMR may not provide individual/structured dosage instructions so all data that would have been conveyed as structured dosage data is provided here as well in human readable form. This is also used to convey the dosage instructions when a fax is used, as there will be no structured prescription on the fax. The rendered dosage instruction must contain all dosage instructions and must be able to stand on its own. Conformance Rule: This field is made up of structured dosage information as well as patient instructions, assembled into one field and formatted as human-readable, meaning that codes should not be used (e.g. 'days' should be used instead of 'd'). Conformance Rule: MUST allow all printable characters and carriage return/line feeds. 5000 character max. Conformance Rule: The following MUST be included if available, in human-readable form: Dosage quantity, dosage unit, dosage frequency, form, strength, max quantity per period, minimal interval between dispense, route of administration and where applicable, the administration site. Note: Any additional patient instructions that are specified at the dosage line level (e.g. take with food, starting one day before dental appointment) should be included. If an EMR only supports a single separate/discrete field to capture patient instructions in the EMR, this should not be included here. Conformance Rule: If an EMR sends discrete data elements they must also popuate this with a textual view of the SIG (as per the MIF definition). E.g. PO value for RouteofAdministration will be conveyed as 'oral' in this field. Conformance Rule: If an EMR has discrete field for Pharmacy Notes (Dispenser Instructions), they should not be included here. If EMR's have both concepts combined into one field, they can both be included here. Usage Note: It is recognized that very complex instructions may be conveyed as text only (not as structured data). Example: take 500 mg twice a day at breakfast and at lunch AND 250 mg once a day at bedtime - THEN (new dosage line).....). The pharmacy will receive as text, enter it in their system and do the dosage checking. If the EMR submits the structured frequency in the message, this should be consistent with the textual instructions. The PMS may ignore the structured frequency, or override it to align with the textual instructions. Example: the EMR may enter frequency (multiplier of the dose) in their system like this (2 qam and 3 qhs ), in the structured frequency. The textual instructions could say Take 2 tablets in the morning and 3 at bedtime.
url	1..1	uri	"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
valueString	1..1	string	Max Length: 5000 Definition: Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)

This structure is derived from Extension

Summary

Mandatory: 2 elements
Must-Support: 2 elements
Fixed Value: 1 element
Prohibited: 1 element

Differential View

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints
Extension	S	0..1		Rendered Dosage Instruction
extension		0..0
url	S	1..1	uri	"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
valueString	S	1..1	string	Rendered Dosage Instruction Max Length: 5000
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Extension	S	0..1		Rendered Dosage Instruction
id		0..1	id	xml:id (or equivalent in JSON)
url	S	1..1	uri	"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
valueString	S	1..1	string	Rendered Dosage Instruction Max Length: 5000
Documentation for this format

Other representations of extension: Schematron

3.4.3 Terminology Bindings

3.4.4 Constraints

Constraints

Path

Details

Requirements