{
  "description": "Dieses Profil ermöglicht die Abbildung der Verabreichung von Medikamenten für einen Patienten in ISiK Szenarien.",
  "_filename": "StructureDefinition-ISiKMedikationsVerabreichung.json",
  "package_name": "de.gematik.isik-medikation",
  "date": "2025-02-24",
  "derivation": "constraint",
  "publisher": "gematik GmbH",
  "fhirVersion": "4.0.1",
  "name": "ISiKMedikationsVerabreichung",
  "abstract": false,
  "type": "MedicationAdministration",
  "experimental": "false",
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "3.0.5",
  "status": "active",
  "id": "59a92040-ff7f-4a8d-bca1-79099235607e",
  "kind": "resource",
  "url": "https://gematik.de/fhir/isik/v3/Medikation/StructureDefinition/ISiKMedikationsVerabreichung",
  "version": "3.0.5",
  "differential": {
    "element": [ {
      "id": "MedicationAdministration.status",
      "path": "MedicationAdministration.status",
      "short": "Status der Verabreichungsinformation",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]",
      "path": "MedicationAdministration.medication[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "path": "MedicationAdministration.medication[x]",
      "min": 0,
      "short": "Medikament in codierter Form oder ggf. als Freitext",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "sliceName": "medicationCodeableConcept",
      "max": "1",
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept",
      "comment": "kann verwendet werden, wenn keine detaillierten Informationen zum Medikament (z.B. Rezepturen) existieren."
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding",
      "path": "MedicationAdministration.medication[x].coding",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.medication[x].coding",
      "sliceName": "PZN",
      "mustSupport": true,
      "patternCoding": {
        "system": "http://fhir.de/CodeSystem/ifa/pzn"
      }
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN.system",
      "min": 1,
      "path": "MedicationAdministration.medication[x].coding.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN.code",
      "min": 1,
      "path": "MedicationAdministration.medication[x].coding.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:PZN.display",
      "path": "MedicationAdministration.medication[x].coding.display",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.medication[x].coding",
      "sliceName": "ATC-DE",
      "mustSupport": true,
      "patternCoding": {
        "system": "http://fhir.de/CodeSystem/bfarm/atc"
      }
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE.system",
      "min": 1,
      "path": "MedicationAdministration.medication[x].coding.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE.code",
      "min": 1,
      "path": "MedicationAdministration.medication[x].coding.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:ATC-DE.display",
      "path": "MedicationAdministration.medication[x].coding.display",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.medication[x].coding",
      "sliceName": "WG14",
      "mustSupport": true,
      "patternCoding": {
        "system": "http://fhir.de/CodeSystem/abdata/wg14"
      }
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14.system",
      "min": 1,
      "path": "MedicationAdministration.medication[x].coding.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14.code",
      "min": 1,
      "path": "MedicationAdministration.medication[x].coding.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.coding:WG14.display",
      "path": "MedicationAdministration.medication[x].coding.display",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.medication[x]:medicationCodeableConcept.text",
      "path": "MedicationAdministration.medication[x].text",
      "mustSupport": true
    }, {
      "path": "MedicationAdministration.medication[x]",
      "min": 0,
      "short": "Referenz auf das Medikament (Medication-Ressource)",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication" ]
      } ],
      "mustSupport": true,
      "sliceName": "medicationReference",
      "max": "1",
      "id": "MedicationAdministration.medication[x]:medicationReference",
      "comment": "wird verwendet, wenn detaillierte Informationen zum Medikament vorliegen"
    }, {
      "id": "MedicationAdministration.medication[x]:medicationReference.reference",
      "min": 1,
      "path": "MedicationAdministration.medication[x].reference",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.subject",
      "path": "MedicationAdministration.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient" ]
      } ],
      "short": "Referenz auf den Patienten",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.subject.reference",
      "min": 1,
      "path": "MedicationAdministration.subject.reference",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.context",
      "path": "MedicationAdministration.context",
      "short": "Referenz auf den Abteilungskontakt",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.context.reference",
      "min": 1,
      "path": "MedicationAdministration.context.reference",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.effective[x]",
      "path": "MedicationAdministration.effective[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "MedicationAdministration.effective[x]:effectiveDateTime",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.effective[x]",
      "type": [ {
        "code": "dateTime"
      } ],
      "short": "Zeitpunkt der Verabreichung",
      "sliceName": "effectiveDateTime",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.effective[x]:effectivePeriod",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.effective[x]",
      "type": [ {
        "code": "Period"
      } ],
      "short": "Zeitraum der Verabreichung",
      "sliceName": "effectivePeriod",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.effective[x]:effectivePeriod.start",
      "path": "MedicationAdministration.effective[x].start",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.effective[x]:effectivePeriod.end",
      "path": "MedicationAdministration.effective[x].end",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.performer",
      "path": "MedicationAdministration.performer",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.performer.actor",
      "path": "MedicationAdministration.performer.actor",
      "short": "Referenz auf die verabreichende Person",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.performer.actor.reference",
      "min": 1,
      "path": "MedicationAdministration.performer.actor.reference",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.reasonReference",
      "path": "MedicationAdministration.reasonReference",
      "short": "Grund der Medikation (Referenz)",
      "comment": "Festlegung zum MS: Die Elemente .reasonCode und .reasonReference MÜSSEN nach OR-Logik in der Ausgabe verwendet werden, d.h. nur eines MUSS geliefert werden können. Ein System KANN demnach statt .reasonReference auch .reasonCode in der Ausgabe verwenden. .reasonReference MUSS aber weiterhin interpretiert werden können.\n\n  Begründung zu Must-Support: Konsolidierung mit MII.",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.reasonReference.reference",
      "min": 1,
      "path": "MedicationAdministration.reasonReference.reference",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.note",
      "path": "MedicationAdministration.note",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.note.text",
      "path": "MedicationAdministration.note.text",
      "short": "Freitext-Notiz",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage",
      "path": "MedicationAdministration.dosage",
      "short": "Dosierungsangaben",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.text",
      "path": "MedicationAdministration.dosage.text",
      "short": "Freitext-Dosierungsangabe",
      "comment": "Festlegung zum Must-Support: Die Verarbeitung MUSS unterstützt werden, indem empfangende Systeme  die Freitext-Dosierungsinformation entweder direkt in der Textform persistieren, ODER die Informationen in eine alternative (strukturierte) Form umwandeln (ggf. unter Einwirkung geeigneter Nutzer). Im letzteren Fall KANN auf eine Persistierung in Textform verzichtet werden, um Inkonsistenzen zu vermeiden.\n\n    Ein System KANN jedoch strukturierte Dosierungsinformationen in Freitext-Dosierungsinformationen umwandeln, um sie in einem Dokument oder einer Benutzeroberfläche anzuzeigen - dabei ist auf Konsistenzwahrung zu allen strukturierten Elementen zu achten.\n\n    Hinweis: Diese Festlegung folgt und spezifiziert folgende MS-Festlegung aus dem [ISiK Basismodul](https://simplifier.net/guide/isik-basis-401/Einfuehrung/UebergreifendeFestlegungen/UebergreifendeFestlegungen_Must-Support-Flags.page.md?version=current): 'Systeme KÖNNEN es darüber hinaus ermöglichen, dass die jeweiligen Informationen vom Anwender ergänzt oder editiert werden.' \n\n    Zum Beispiel kann die textuelle Information '1L Infusion mit Rate 50ml/h' in eine entsprechende, strukturierte Form überführt werden - d.h. in die Angabe von 'dose' und 'rateQuantity'.",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.site",
      "path": "MedicationAdministration.dosage.site",
      "short": "Körperstelle der Verabreichung",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.site.coding",
      "path": "MedicationAdministration.dosage.site.coding",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.dosage.site.coding",
      "sliceName": "SNOMED-CT",
      "mustSupport": true,
      "patternCoding": {
        "system": "http://snomed.info/sct"
      }
    }, {
      "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.site.coding.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.site.coding.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.site.coding:SNOMED-CT.display",
      "path": "MedicationAdministration.dosage.site.coding.display",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.site.text",
      "path": "MedicationAdministration.dosage.site.text",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route",
      "path": "MedicationAdministration.dosage.route",
      "short": "Route",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding",
      "path": "MedicationAdministration.dosage.route.coding",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding:EDQM",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.dosage.route.coding",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration"
      },
      "sliceName": "EDQM",
      "mustSupport": true,
      "patternCoding": {
        "system": "http://standardterms.edqm.eu"
      }
    }, {
      "id": "MedicationAdministration.dosage.route.coding:EDQM.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.route.coding.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding:EDQM.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.route.coding.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding:EDQM.display",
      "path": "MedicationAdministration.dosage.route.coding.display",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.dosage.route.coding",
      "binding": {
        "strength": "required",
        "valueSet": "https://gematik.de/fhir/isik/v3/Medikation/ValueSet/SctRouteOfAdministration"
      },
      "sliceName": "SNOMED-CT",
      "mustSupport": true,
      "patternCoding": {
        "system": "http://snomed.info/sct"
      }
    }, {
      "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.route.coding.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.route.coding.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.coding:SNOMED-CT.display",
      "path": "MedicationAdministration.dosage.route.coding.display",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.route.text",
      "path": "MedicationAdministration.dosage.route.text",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.dose",
      "path": "MedicationAdministration.dosage.dose",
      "short": "verabreichte Dosis",
      "mustSupport": true,
      "patternQuantity": {
        "system": "http://unitsofmeasure.org"
      }
    }, {
      "id": "MedicationAdministration.dosage.dose.value",
      "min": 1,
      "path": "MedicationAdministration.dosage.dose.value",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.dose.unit",
      "path": "MedicationAdministration.dosage.dose.unit",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.dose.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.dose.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.dose.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.dose.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]",
      "path": "MedicationAdministration.dosage.rate[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio",
      "max": "1",
      "min": 0,
      "path": "MedicationAdministration.dosage.rate[x]",
      "type": [ {
        "code": "Ratio"
      } ],
      "short": "Verabreichungs-Rate (Verhältnis)",
      "sliceName": "rateRatio",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator",
      "path": "MedicationAdministration.dosage.rate[x].numerator",
      "mustSupport": true,
      "patternQuantity": {
        "system": "http://unitsofmeasure.org"
      }
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.value",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].numerator.value",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.unit",
      "path": "MedicationAdministration.dosage.rate[x].numerator.unit",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].numerator.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.numerator.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].numerator.code",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator",
      "path": "MedicationAdministration.dosage.rate[x].denominator",
      "mustSupport": true,
      "patternQuantity": {
        "system": "http://unitsofmeasure.org"
      }
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.value",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].denominator.value",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.unit",
      "path": "MedicationAdministration.dosage.rate[x].denominator.unit",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].denominator.system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateRatio.denominator.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].denominator.code",
      "mustSupport": true
    }, {
      "path": "MedicationAdministration.dosage.rate[x]",
      "min": 0,
      "short": "Verabreichungs-Rate",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "mustSupport": true,
      "sliceName": "rateQuantity",
      "max": "1",
      "id": "MedicationAdministration.dosage.rate[x]:rateQuantity",
      "patternQuantity": {
        "system": "http://unitsofmeasure.org"
      }
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.value",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].value",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.unit",
      "path": "MedicationAdministration.dosage.rate[x].unit",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.system",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].system",
      "mustSupport": true
    }, {
      "id": "MedicationAdministration.dosage.rate[x]:rateQuantity.code",
      "min": 1,
      "path": "MedicationAdministration.dosage.rate[x].code",
      "mustSupport": true
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
}