An administration agreement is the use (or administering) instructions from the pharmacist to the patient (or their representative or administrator), whereby a medication agreement is structured at a concrete level.

The time at which the agreement was made.

Reason for this agreement. This will often be the same reason as the one for the medication agreement. This field has the option to - if applicable - enter a specific reason for the administration agreement. Examples include: substitution, transfer to GDS, patient request for different product, etc

Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original administration agreement. The end date indicates from when the medication is to be discontinued.

End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

With medication for an indefinite period only a start date is indicated.

According to the HCIM TimeInterval, a time interval is defined by either a start and end time, a start time and duration, or a duration and end time. As this HCIM is expressed by the periodOfUse and usageDuration extensions in this profile, this means that precisely two elements out of .valuePeriod.start, .valuePeriod.end (both in the periodOfUse extension) and .valueDuration (in the usageDuration extension) should be present in order to correctly represent the time interval in which the agreement is used (and in particular not all three elements).

The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

According to the HCIM TimeInterval, a time interval is defined by either a start and end time, a start time and duration, or a duration and end time. As this HCIM is expressed by the periodOfUse and usageDuration extensions in this profile, this means that precisely two elements out of .valuePeriod.start, .valuePeriod.end (both in the periodOfUse extension) and .valueDuration (in the usageDuration extension) should be present in order to correctly represent the time interval in which the agreement is used (and in particular not all three elements).

Additional information includes details on the structure of the agreement made.

This element mainly contains information that until now has been structured with ZZ rules. The medication-related topics that are now supported by the ZZ rules are best supported with a system functionality. A process has been started for this by Z-index/KNMP. For now, the following list will be used. This list will be replaced by a thesaurus in the G standard at a later stage.

AdministrationAgreementAdditionalInformation

This extension is to describe which overarching medication treatment this information is part of. This is done by the use of an identifier of that medication treatment.

No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.

The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.

Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days. RepeatPeriodCyclicalSchedule

In the event of an error correction, the value of this element shall be 'entered-in-error'.

Category SNOMED code used for indexing/retrieval of the HCIM AdministrationAgreement. The SNOMED code 422037009 for this resource is stated in the Medication Process v09.

Medicine in the AdministrationAgreement.

The supplier (pharmacist) that entered the administration agreement.

The health professional's speciality, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

Relationship to the medication agreement on which the administration agreement is based.

Comments on the administration agreement.

An administration agreement is the use (or administering) instructions from the pharmacist to the patient (or their representative or administrator), whereby a medication agreement is structured at a concrete level.

The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html).

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

An Extension

The time at which the agreement was made.

Reason for this agreement. This will often be the same reason as the one for the medication agreement. This field has the option to - if applicable - enter a specific reason for the administration agreement. Examples include: substitution, transfer to GDS, patient request for different product, etc

Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original administration agreement. The end date indicates from when the medication is to be discontinued.

End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

With medication for an indefinite period only a start date is indicated.

According to the HCIM TimeInterval, a time interval is defined by either a start and end time, a start time and duration, or a duration and end time. As this HCIM is expressed by the periodOfUse and usageDuration extensions in this profile, this means that precisely two elements out of .valuePeriod.start, .valuePeriod.end (both in the periodOfUse extension) and .valueDuration (in the usageDuration extension) should be present in order to correctly represent the time interval in which the agreement is used (and in particular not all three elements).

The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

According to the HCIM TimeInterval, a time interval is defined by either a start and end time, a start time and duration, or a duration and end time. As this HCIM is expressed by the periodOfUse and usageDuration extensions in this profile, this means that precisely two elements out of .valuePeriod.start, .valuePeriod.end (both in the periodOfUse extension) and .valueDuration (in the usageDuration extension) should be present in order to correctly represent the time interval in which the agreement is used (and in particular not all three elements).

Additional information includes details on the structure of the agreement made.

This element mainly contains information that until now has been structured with ZZ rules. The medication-related topics that are now supported by the ZZ rules are best supported with a system functionality. A process has been started for this by Z-index/KNMP. For now, the following list will be used. This list will be replaced by a thesaurus in the G standard at a later stage.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

AdministrationAgreementAdditionalInformation

This extension is to describe which overarching medication treatment this information is part of. This is done by the use of an identifier of that medication treatment.

No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.

An Extension

The manner in which (and indicator that) this medication is discontinued (temporarily or permanently).

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.

Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days. RepeatPeriodCyclicalSchedule

Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.

In the event of an error correction, the value of this element shall be 'entered-in-error'.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A coded concept specifying the state of the dispense event.

Indicates type of medication dispense and where the medication is expected to be consumed or administered.

A code describing where the dispensed medication is expected to be consumed or administered

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Category SNOMED code used for indexing/retrieval of the HCIM AdministrationAgreement. The SNOMED code 422037009 for this resource is stated in the Medication Process v09.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .

Medicine in the AdministrationAgreement.

A link to a resource representing the person or the group to whom the medication will be given.

SubstanceAdministration->subject->Patient.

The encounter or episode of care that establishes the context for this event.

The supplier (pharmacist) that entered the administration agreement.

The performer will be reviewed as part of STU4.

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

The health professional's speciality, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

An Extension

Optional Extension Element - found in all resources.

The organization the device or practitioner was acting on behalf of.

Relationship to the medication agreement on which the administration agreement is based.

Maps to basedOn in Event logical model.

Comments on the administration agreement.

Indicates how the medication is to be used by the patient.

When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

An administration agreement is the use (or administering) instructions from the pharmacist to the patient (or their representative or administrator), whereby a medication agreement is structured at a concrete level.

The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html).

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

An Extension

The time at which the agreement was made.

Reason for this agreement. This will often be the same reason as the one for the medication agreement. This field has the option to - if applicable - enter a specific reason for the administration agreement. Examples include: substitution, transfer to GDS, patient request for different product, etc

Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original administration agreement. The end date indicates from when the medication is to be discontinued.

End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

With medication for an indefinite period only a start date is indicated.

According to the HCIM TimeInterval, a time interval is defined by either a start and end time, a start time and duration, or a duration and end time. As this HCIM is expressed by the periodOfUse and usageDuration extensions in this profile, this means that precisely two elements out of .valuePeriod.start, .valuePeriod.end (both in the periodOfUse extension) and .valueDuration (in the usageDuration extension) should be present in order to correctly represent the time interval in which the agreement is used (and in particular not all three elements).

The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

According to the HCIM TimeInterval, a time interval is defined by either a start and end time, a start time and duration, or a duration and end time. As this HCIM is expressed by the periodOfUse and usageDuration extensions in this profile, this means that precisely two elements out of .valuePeriod.start, .valuePeriod.end (both in the periodOfUse extension) and .valueDuration (in the usageDuration extension) should be present in order to correctly represent the time interval in which the agreement is used (and in particular not all three elements).

Additional information includes details on the structure of the agreement made.

This element mainly contains information that until now has been structured with ZZ rules. The medication-related topics that are now supported by the ZZ rules are best supported with a system functionality. A process has been started for this by Z-index/KNMP. For now, the following list will be used. This list will be replaced by a thesaurus in the G standard at a later stage.

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

AdministrationAgreementAdditionalInformation

This extension is to describe which overarching medication treatment this information is part of. This is done by the use of an identifier of that medication treatment.

No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided.

An Extension

The manner in which (and indicator that) this medication is discontinued (temporarily or permanently).

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclic schedule is noted in days, the corresponding dosing duration is also in days.

Examples of a cyclical schedule: contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days. RepeatPeriodCyclicalSchedule

Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.

The procedure that the dispense is done because of.

In the event of an error correction, the value of this element shall be 'entered-in-error'.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A coded concept specifying the state of the dispense event.

Indicates type of medication dispense and where the medication is expected to be consumed or administered.

A code describing where the dispensed medication is expected to be consumed or administered

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Category SNOMED code used for indexing/retrieval of the HCIM AdministrationAgreement. The SNOMED code 422037009 for this resource is stated in the Medication Process v09.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .

Medicine in the AdministrationAgreement.

A link to a resource representing the person or the group to whom the medication will be given.

SubstanceAdministration->subject->Patient.

The encounter or episode of care that establishes the context for this event.

Additional information that supports the medication being dispensed.

The supplier (pharmacist) that entered the administration agreement.

The performer will be reviewed as part of STU4.

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

The health professional's speciality, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile.

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

Optional Extension Element - found in all resources.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

The organization the device or practitioner was acting on behalf of.

Relationship to the medication agreement on which the administration agreement is based.

Maps to basedOn in Event logical model.

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

The amount of medication that has been dispensed. Includes unit of measure.

The amount of medication expressed as a timing amount.

The time when the dispensed product was packaged and reviewed.

The time the dispensed product was provided to the patient or their representative.

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

Comments on the administration agreement.

Indicates how the medication is to be used by the patient.

When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

True if the dispenser dispensed a different drug or product from what was prescribed.

A code signifying whether a different drug was dispensed from what was prescribed.

A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription

Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.

A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed

The person or organization that has primary responsibility for the substitution.

Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

True if the dispense was not performed for some reason.

Indicates the reason why a dispense was not performed.

A summary of the events of interest that have occurred, such as when the dispense was verified.

This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).