IE Medication Events Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Administration and Statements

Medication administration

IE MPD MedicationAdministration records a dose given to, or taken by, a patient under observation, in hospital, a GP practice, a pharmacy or the community. It also records a dose that was due but not given. There is no HL7 Europe MedicationAdministration profile, so it derives from the FHIR R4 resource and reuses this IG's patient, practitioner, medication and ePrescription profiles.

Element	Rule
status	1..1. completed = given; not-done = not given; in-progress for an infusion under way; entered-in-error to retract
statusReason	Required when the dose was not given (ie-mad-status-1), so a missed dose is always explained
medication[x]	1..1: an NMPC code, or a reference to a Medication
subject	1..1, a Patient
effective[x]	1..1: when the dose was given (or when it was due, if not given)
performer.actor	Practitioner, PractitionerRole, the patient (self-administration) or a related person (carer)
request	The ePrescription item being administered, when there is one
dosage	What was given: dose or dosage text, required for a given dose (ie-mad-dose-1); route, site and rate where known

Examples: dose given · dose not given.

Medication statement

IE MPD MedicationStatement records what a patient is taking, has taken or intends to take, as reported by the patient, a carer or a clinician: for example, at medicines reconciliation. It derives from the HL7 Europe Base MedicationStatement and traces to the HIQA draft Patient Summary Section 6.3 (Medication). This IG is not a Patient Summary IG; the PS mapping is carried in the element comments.

Element	Rule
status	1..1
medication[x]	1..1: an NMPC code, or a reference to a Medication
subject	1..1, a Patient
informationSource	Who reported it: patient, practitioner, role, related person or organisation
dosage	1..*, with dosage.text 1..1. The dose is MustSupport but not required: requiring it would reject "as directed" statements (OI-017)
derivedFrom	The prescription, dispense or administration the statement is based on

Example: as-needed salbutamol inhaler.

How the events link

flowchart LR
    RX["MedicationRequest<br/>(ePrescription)"] --> MD["MedicationDispense<br/>(eDispensation)"]
    RX --> MA["MedicationAdministration"]
    MD -. "derivedFrom" .-> MS["MedicationStatement"]
    RX -. "derivedFrom" .-> MS
    MA -. "derivedFrom" .-> MS

MedicationDispense.authorizingPrescription and MedicationAdministration.request point to the prescription item. A statement can point to any of the three through derivedFrom.