3.4.8 Extension: Medication Rendered Dosage Instruction - XML Profile
XML representation of the ext-medication-rendered-dosage Extension
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="ext-medication-rendered-dosage"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/2016may/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medication-rendered-dosage-definitions.html#Extension" title="Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)">Extension</a><a name="Extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span>..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Rendered Dosage Instruction</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy"/> <span style="text-decoration:line-through">extension</span><a name="Extension.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="text-decoration:line-through"/><span style="text-decoration:line-through">0</span><span style="text-decoration:line-through">..</span><span style="text-decoration:line-through">0</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medication-rendered-dosage-definitions.html#Extension.url">url</a><a name="Extension.url"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/2016may/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="color: darkgreen">"http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="extension-ext-medication-rendered-dosage-definitions.html#Extension.value[x]" title="Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)">value[x]</a><a name="Extension.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Rendered Dosage Instruction<br/><span style="font-weight:bold">Max Length: </span><span style="color: darkgreen">5000</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/2016may/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<url
value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"/>
<version value="5.0"/>
<name value="Medication Rendered Dosage Instruction"/>
<status value="draft"/>
<date value="2016-03-30T17:01:25-04:00"/>
<description
value="Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)"/>
<requirements
value="The ability to add extensions in a structured way is what keeps FHIR resources simple."/>
<fhirVersion value="1.4.0"/>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM"/>
</mapping>
<kind value="datatype"/>
<abstract value="false"/>
<contextType value="resource"/>
<context value="MedicationOrder"/>
<context value="MedicationDispense"/>
<baseType value="Extension"/>
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension"/>
<derivation value="constraint"/>
<snapshot>
<element id="Extension">
<path value="Extension"/>
<short value="Rendered Dosage Instruction"/>
<definition
value="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
value="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.
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."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Extension"/>
<min value="0"/>
<max value="*"/>
</base>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.id">
<path value="Extension.id"/>
<representation value="xmlAttr"/>
<short value="xml:id (or equivalent in JSON)"/>
<definition
value="unique id for the element within a resource (for internal references)."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="id"/>
</type>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="Extension.extension">
<path value="Extension.extension"/>
<short value="Extension"/>
<definition value="An Extension"/>
<min value="0"/>
<max value="0"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
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<type>
<code value="Extension"/>
</type>
<mustSupport value="false"/>
<isModifier value="false"/>
<isSummary value="false"/>
</element>
<element id="Extension.url">
<path value="Extension.url"/>
<representation value="xmlAttr"/>
<short value="identifies the meaning of the extension"/>
<definition
value="Source of the definition for the extension code - a logical name or a URL."/>
<comments
value="Fixed value: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.url"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="uri"/>
</type>
<fixedUri
value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"/>
<mustSupport value="true"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]"/>
<short value="Rendered Dosage Instruction"/>
<definition
value="Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="Extension.value[x]"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
<maxLength value="5000"/>
<mustSupport value="true"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
</snapshot>
<differential>
<element id="Extension">
<path value="Extension"/>
<short value="Rendered Dosage Instruction"/>
<definition
value="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
value="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.
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."/>
<max value="1"/>
</element>
<element id="Extension.extension">
<path value="Extension.extension"/>
<max value="0"/>
<mustSupport value="false"/>
</element>
<element id="Extension.url">
<path value="Extension.url"/>
<comments
value="Fixed value: http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"/>
<min value="1"/>
<fixedUri
value="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"/>
<mustSupport value="true"/>
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]"/>
<short value="Rendered Dosage Instruction"/>
<definition
value="Provides a complete text rendering of the dosage instruction lines for an order or dispense (separate from the rendering of the overall resource instance)"/>
<min value="1"/>
<type>
<code value="string"/>
</type>
<maxLength value="5000"/>
<mustSupport value="true"/>
</element>
</differential>
</StructureDefinition>