2026 US Quality Core Implementation Guide
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2026 US Quality Core Implementation Guide - Downloaded Version 0.5.0 See the Directory of published versions

Resource Profile: US Quality Core MedicationAdministration Not Done

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationadministrationnotdone Version: 0.5.0
Active as of 2026-06-05 Computable Name: USQualityCoreMedicationAdministrationNotDone

Negation profile of MedicationAdministration for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

  • status: (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
  • statusReason: (USCDI+ Quality) Reason administration not performed

The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Profile Specific Implementation Guidance

This profile represents a medication administration that intentionally did not occur for a medical, patient, or system reason. To represent medication administrations that did occur, use the US Quality Core MedicationAdministration profile.

Additional informational guidance for authoring CQL using this profile is provided in the CQL Authoring Usage (Informational) section of this page.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
Constraints: mna-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recorded 1..1 dateTime Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason 1..* CodeableConcept (USCDI+ Quality) Reason administration not performed
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... medication[x] ΣC 1..1 CodeableConcept What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) Url of a value set of activities not requested or performed
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject Σ 1..1 Reference(US Quality Core Patient) Who received medication
... context 0..1 Reference(US Quality Core Encounter | EpisodeOfCare) Encounter or Episode of Care administered as part of
... effective[x] Σ 1..1 Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... request 0..1 Reference(US Quality Core MedicationRequest) Request administration performed against
... dosage C 0..1 BackboneElement Details of how medication was taken
Constraints: mad-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... route 0..1 CodeableConcept Path of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... dose 0..1 SimpleQuantity(4.0.1) Amount of medication per dose

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationAdministration.​status Base required Medication administration status codes 📍4.0.1 FHIR Std.
MedicationAdministration.​statusReason Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationAdministration.​medication[x] Base preferred Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationAdministration.​dosage.route Base example SNOMED CT Route Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationAdministration If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationAdministration If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationAdministration A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mad-1 error MedicationAdministration.dosage SHALL have at least one of dosage.dose or dosage.rate[x] dose.exists() or rate.exists()
mna-1 error MedicationAdministration To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
Constraints: mna-1
... implicitRules 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:recorded 1..1 dateTime Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded
... status 1..1 code (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Fixed Value: not-done
... medication[x] C 1..1 CodeableConcept What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) Url of a value set of activities not requested or performed
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject 1..1 Reference(US Quality Core Patient) Who received medication
... context 0..1 Reference(US Quality Core Encounter | EpisodeOfCare) Encounter or Episode of Care administered as part of
... effective[x] 1..1 dateTime, Period Start and end time of administration
... request 0..1 Reference(US Quality Core MedicationRequest) Request administration performed against
... dosage 0..1 BackboneElement Details of how medication was taken
.... route 0..1 CodeableConcept Path of substance into body
.... dose 0..1 SimpleQuantity(4.0.1) Amount of medication per dose

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationAdministration.​statusReason Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationAdministration.​medication[x] Base preferred Medication Clinical Drug . 📦20170601 VSAC v0.18

Constraints

Id Grade Path(s) Description Expression
mna-1 error MedicationAdministration To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
Constraints: mna-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recorded 1..1 dateTime Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External identifier
... instantiates Σ 0..* uri Instantiates protocol or definition
... partOf Σ 0..* Reference(MedicationAdministration | Procedure) Part of referenced event
... status ?!Σ 1..1 code (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.
Fixed Value: not-done
... statusReason 1..* CodeableConcept (USCDI+ Quality) Reason administration not performed
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... category 0..1 CodeableConcept Type of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
... medication[x] ΣC 1..1 CodeableConcept What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) Url of a value set of activities not requested or performed
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(US Quality Core Patient) Who received medication
... context 0..1 Reference(US Quality Core Encounter | EpisodeOfCare) Encounter or Episode of Care administered as part of
... supportingInformation 0..* Reference(Resource) Additional information to support administration
... effective[x] Σ 1..1 Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer Σ 0..* BackboneElement Who performed the medication administration and what they did
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function 0..1 CodeableConcept Type of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) Who performed the medication administration
... reasonCode 0..* CodeableConcept Reason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.
... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication was administered
... request 0..1 Reference(US Quality Core MedicationRequest) Request administration performed against
... device 0..* Reference(Device) Device used to administer
... note 0..* Annotation Information about the administration
... dosage C 0..1 BackboneElement Details of how medication was taken
Constraints: mad-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text 0..1 string Free text dosage instructions e.g. SIG
.... site 0..1 CodeableConcept Body site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
.... route 0..1 CodeableConcept Path of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... method 0..1 CodeableConcept How drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
.... dose 0..1 SimpleQuantity(4.0.1) Amount of medication per dose
.... rate[x] 0..1 Dose quantity per unit of time
..... rateRatio Ratio
..... rateQuantity Quantity(SimpleQuantity)
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationAdministration.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
MedicationAdministration.​status Base required Medication administration status codes 📍4.0.1 FHIR Std.
MedicationAdministration.​statusReason Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationAdministration.​category Base preferred Medication administration category codes 📍4.0.1 FHIR Std.
MedicationAdministration.​medication[x] Base preferred Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationAdministration.​performer.function Base example Medication administration performer function codes 📍4.0.1 FHIR Std.
MedicationAdministration.​reasonCode Base example Reason Medication Given Codes 📍4.0.1 FHIR Std.
MedicationAdministration.​dosage.site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📍4.0.1 FHIR Std.
MedicationAdministration.​dosage.route Base example SNOMED CT Route Codes 📍4.0.1 FHIR Std.
MedicationAdministration.​dosage.method Base example SNOMED CT Administration Method Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationAdministration If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationAdministration If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationAdministration A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mad-1 error MedicationAdministration.dosage SHALL have at least one of dosage.dose or dosage.rate[x] dose.exists() or rate.exists()
mna-1 error MedicationAdministration To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
Constraints: mna-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recorded 1..1 dateTime Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason 1..* CodeableConcept (USCDI+ Quality) Reason administration not performed
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... medication[x] ΣC 1..1 CodeableConcept What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) Url of a value set of activities not requested or performed
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject Σ 1..1 Reference(US Quality Core Patient) Who received medication
... context 0..1 Reference(US Quality Core Encounter | EpisodeOfCare) Encounter or Episode of Care administered as part of
... effective[x] Σ 1..1 Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... request 0..1 Reference(US Quality Core MedicationRequest) Request administration performed against
... dosage C 0..1 BackboneElement Details of how medication was taken
Constraints: mad-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... route 0..1 CodeableConcept Path of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... dose 0..1 SimpleQuantity(4.0.1) Amount of medication per dose

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationAdministration.​status Base required Medication administration status codes 📍4.0.1 FHIR Std.
MedicationAdministration.​statusReason Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationAdministration.​medication[x] Base preferred Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationAdministration.​dosage.route Base example SNOMED CT Route Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationAdministration If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationAdministration If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationAdministration A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mad-1 error MedicationAdministration.dosage SHALL have at least one of dosage.dose or dosage.rate[x] dose.exists() or rate.exists()
mna-1 error MedicationAdministration To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
Constraints: mna-1
... implicitRules 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:recorded 1..1 dateTime Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded
... status 1..1 code (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Fixed Value: not-done
... medication[x] C 1..1 CodeableConcept What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) Url of a value set of activities not requested or performed
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject 1..1 Reference(US Quality Core Patient) Who received medication
... context 0..1 Reference(US Quality Core Encounter | EpisodeOfCare) Encounter or Episode of Care administered as part of
... effective[x] 1..1 dateTime, Period Start and end time of administration
... request 0..1 Reference(US Quality Core MedicationRequest) Request administration performed against
... dosage 0..1 BackboneElement Details of how medication was taken
.... route 0..1 CodeableConcept Path of substance into body
.... dose 0..1 SimpleQuantity(4.0.1) Amount of medication per dose

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationAdministration.​statusReason Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationAdministration.​medication[x] Base preferred Medication Clinical Drug . 📦20170601 VSAC v0.18

Constraints

Id Grade Path(s) Description Expression
mna-1 error MedicationAdministration To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationAdministration C 0..* MedicationAdministration Administration of medication to a patient
Constraints: mna-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recorded 1..1 dateTime Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External identifier
... instantiates Σ 0..* uri Instantiates protocol or definition
... partOf Σ 0..* Reference(MedicationAdministration | Procedure) Part of referenced event
... status ?!Σ 1..1 code (USCDI+ Quality) in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.
Fixed Value: not-done
... statusReason 1..* CodeableConcept (USCDI+ Quality) Reason administration not performed
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... category 0..1 CodeableConcept Type of medication usage
Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
... medication[x] ΣC 1..1 CodeableConcept What was administered
Binding: Medication Clinical Drug . (preferred): The set of RxNorm codes to represent medications
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) Url of a value set of activities not requested or performed
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(US Quality Core Patient) Who received medication
... context 0..1 Reference(US Quality Core Encounter | EpisodeOfCare) Encounter or Episode of Care administered as part of
... supportingInformation 0..* Reference(Resource) Additional information to support administration
... effective[x] Σ 1..1 Start and end time of administration
.... effectiveDateTime dateTime
.... effectivePeriod Period
... performer Σ 0..* BackboneElement Who performed the medication administration and what they did
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function 0..1 CodeableConcept Type of performance
Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) Who performed the medication administration
... reasonCode 0..* CodeableConcept Reason administration performed
Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.
... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport) Condition or observation that supports why the medication was administered
... request 0..1 Reference(US Quality Core MedicationRequest) Request administration performed against
... device 0..* Reference(Device) Device used to administer
... note 0..* Annotation Information about the administration
... dosage C 0..1 BackboneElement Details of how medication was taken
Constraints: mad-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text 0..1 string Free text dosage instructions e.g. SIG
.... site 0..1 CodeableConcept Body site administered to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
.... route 0..1 CodeableConcept Path of substance into body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... method 0..1 CodeableConcept How drug was administered
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
.... dose 0..1 SimpleQuantity(4.0.1) Amount of medication per dose
.... rate[x] 0..1 Dose quantity per unit of time
..... rateRatio Ratio
..... rateQuantity Quantity(SimpleQuantity)
... eventHistory 0..* Reference(Provenance) A list of events of interest in the lifecycle

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationAdministration.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
MedicationAdministration.​status Base required Medication administration status codes 📍4.0.1 FHIR Std.
MedicationAdministration.​statusReason Base extensible USQualityCore Negation Reason Codes 📦0.5.0 This IG
MedicationAdministration.​category Base preferred Medication administration category codes 📍4.0.1 FHIR Std.
MedicationAdministration.​medication[x] Base preferred Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationAdministration.​performer.function Base example Medication administration performer function codes 📍4.0.1 FHIR Std.
MedicationAdministration.​reasonCode Base example Reason Medication Given Codes 📍4.0.1 FHIR Std.
MedicationAdministration.​dosage.site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📍4.0.1 FHIR Std.
MedicationAdministration.​dosage.route Base example SNOMED CT Route Codes 📍4.0.1 FHIR Std.
MedicationAdministration.​dosage.method Base example SNOMED CT Administration Method Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationAdministration If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationAdministration If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationAdministration If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationAdministration A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mad-1 error MedicationAdministration.dosage SHALL have at least one of dosage.dose or dosage.rate[x] dose.exists() or rate.exists()
mna-1 error MedicationAdministration To indicate what medication was not administered, either at least one coding in the medication or a notDoneValueSet extension shall be provided medication.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor medication.coding.exists()

 

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Notes:

CQL Authoring Usage (Informational)

The following illustrative CQL shows an exclusion pattern for medication administrations not performed:

define "Low Dose Unfractionated Heparin for VTE Prophylaxis Not Administered":
  ["MedicationAdministrationNotDone": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
    where VTEMedication.reasonCode in "Medical Reason" or VTEMedication.reasonCode in "Patient Refusal"

For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.