Medication IG DE
1.1.0 - STU1

Medication IG DE - Local Development build (v1.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Data Type Profile: DosageDgMP - Detailed Descriptions

Active as of 2026-07-06

Definitions for the DosageDgMP data type profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Dosage
Definition

Indicates how the medication is/was taken or should be taken by the patient.

ShortHow the medication is/was taken or should be taken
Control0..*
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. Für reine Bedarfsdosierungen darf doseAndRate auch ohne timing angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies ( timing.exists() or asNeeded.ofType(boolean) = true or extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').exists() )) ))
DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Quantity).code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).low.code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).high.code ).distinct().count() = 1 ))
DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. (text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())
FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
dos-1: AsNeededFor can only be set if AsNeeded is empty or true (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').empty() or asNeeded.empty() or asNeeded)
DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ))
FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer) UND die Extension renderedDosageInstruction befüllt ist, muss der Wert in dosageInstruction.text mit dem Wert in der Extension übereinstimmen. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationDispense).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationStatement).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) ) ))
PatientInstructionIdentical: Wenn patientInstruction in einer Ressource mit mehreren Dosierungen verwendet wird, muss das Feld in allen Dosage-Elementen identisch befüllt sein. (( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).patientInstruction.distinct().count() <= 1 ) and ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).patientInstruction.exists() ) implies ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all(patientInstruction.exists()) ) ))
MaxDoseSameUnitAsDose: maxDosePerPeriod muss die gleiche Einheit, den gleichen Code und das gleiche System wie doseQuantity verwenden. ( maxDosePerPeriod.empty() or ( ( doseAndRate.dose.ofType(Quantity).exists() and doseAndRate.dose.ofType(Quantity).system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Quantity).code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Quantity).unit = maxDosePerPeriod.numerator.unit ) or ( doseAndRate.dose.ofType(Range).exists() and ( doseAndRate.dose.ofType(Range).low.empty() or ( doseAndRate.dose.ofType(Range).low.system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Range).low.code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Range).low.unit = maxDosePerPeriod.numerator.unit ) ) and ( doseAndRate.dose.ofType(Range).high.empty() or ( doseAndRate.dose.ofType(Range).high.system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Range).high.code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Range).high.unit = maxDosePerPeriod.numerator.unit ) ) ) ) )
MaxDosePerPeriodOnly24hOr1d: maxDosePerPeriod ist nur mit einem Bezugszeitraum von 24 Stunden (24 h) oder 1 Tag (1 d) zulässig. Andere Perioden (z. B. maximal 3 alle 6 h) sind nicht erlaubt. (maxDosePerPeriod.empty() or ( (maxDosePerPeriod.denominator.value = 24 and maxDosePerPeriod.denominator.code = 'h') or (maxDosePerPeriod.denominator.value = 1 and maxDosePerPeriod.denominator.code = 'd') ))
DoseRangeHighRequiredWhenLowPresent: Wenn bei doseRange eine Untergrenze angegeben wird, muss auch eine Obergrenze angegeben werden. (doseAndRate.dose.ofType(Range).low.empty() or doseAndRate.dose.ofType(Range).high.exists())
DoseRangeLowAndHighSameUnit: Unter- und Obergrenze einer variablen Einzeldosis müssen dieselbe Maßeinheit verwenden. (doseAndRate.dose.ofType(Range).low.empty() or doseAndRate.dose.ofType(Range).high.empty() or ( doseAndRate.dose.ofType(Range).low.system = doseAndRate.dose.ofType(Range).high.system and doseAndRate.dose.ofType(Range).low.code = doseAndRate.dose.ofType(Range).high.code and doseAndRate.dose.ofType(Range).low.unit = doseAndRate.dose.ofType(Range).high.unit ))
DoseRangeNoVarPeriod: Eine variable Einzeldosis und eine variable Periode sollten nicht gemeinsam verwendet werden. (doseAndRate.dose.ofType(Range).empty() or timing.repeat.periodMax.empty())
VarFreqNoMaxDose: Variable Frequenz und maximale Dosis pro Zeitraum dürfen nicht gemeinsam verwendet werden. (timing.repeat.frequencyMax.empty() or maxDosePerPeriod.empty())
VarPeriodNoMindestabstand: Variable Periode und Mindestabstand zwischen zwei Einzelgaben dürfen nicht gemeinsam verwendet werden. (timing.repeat.periodMax.empty() or modifierExtension.where(url='http://ig.fhir.de/igs/medication/StructureDefinition/MindestabstandZwischenGaben').empty())
AsNeededForRequiresAsNeeded: Ein Einnahmeanlass (asNeededFor) darf nur bei einer Bedarfsdosierung (asNeededBoolean=true) angegeben werden. Eine Bedarfsdosierung selbst benötigt keinen Einnahmeanlass. (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').exists() implies asNeeded.ofType(boolean) = true)
2. Dosage.extension:asNeededFor
Slice NameasNeededFor
Definition

Indicates whether the medication is only taken based on a precondition for taking the medication.

ShortDosage asNeededFor
Control0..*
TypeExtension(Dosage asNeededFor) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
4. Dosage.extension:asNeededFor.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control0..0*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Dosage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Dosage.extension:asNeededFor.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

    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.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor
    8. Dosage.extension:asNeededFor.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control0..1
    BindingFor example codes, see For codes, see SNOMEDCTMedicationAsNeededReasonCodes
    (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)
    TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Dosage.extension:asNeededFor.value[x].coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Begründung Einschränkung Kardinalität: Eine Codierung der Indikation für die Bedarfsdosierung ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


    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.

    Control0..0*
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Dosage.extension:asNeededFor.value[x].text
    Definition

    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.

    ShortPlain text representation of the concept
    Comments

    Indikation für die Bedarfsdosierung.


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

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Dosage.modifierExtension
    Definition

    An Extension


    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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensionExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Dosage.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 16. Dosage.modifierExtension:mindestabstandZwischenGaben
      Slice NamemindestabstandZwischenGaben
      Definition

      Gibt den Mindestabstand zwischen zwei Gaben einer Bedarfsmedikation an.

      ShortMindestabstand zwischen Gaben
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Mindestabstand zwischen Gaben) (Extension Type: Duration)
      Is Modifiertrue because Der Mindestabstand zwischen Gaben verändert die zulässige Interpretation und Anwendung der Dosierung.
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Dosage.modifierExtension:mindestabstandZwischenGaben.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      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.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Dosage.modifierExtension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 20. Dosage.modifierExtension:mindestabstandZwischenGaben.url
        Definition

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

        Shortidentifies the meaning of the extension
        Comments

        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.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://ig.fhir.de/igs/medication/StructureDefinition/MindestabstandZwischenGaben
        22. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x]
        Definition

        Zeitlicher Mindestabstand, der zwischen zwei Gaben einer Bedarfsmedikation einzuhalten ist.


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortMindestabstand zwischen zwei GabenValue of extension
        Control10..1
        TypeDuration, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].comparator
        Definition

        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

        Short< | <= | >= | > - how to understand the value
        Control0..1
        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].unit
        Definition

        A human-readable form of the unit.

        ShortUnit representation
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].system
        Definition

        The identification of the system that provides the coded form of the unit.

        ShortSystem that defines coded unit form
        Control10..1
        This element is affected by the following invariants: qty-3
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to know the system that defines the coded form of the unit.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].code
        Definition

        A computer processable form of the unit in some unit representation system.

        ShortCoded form of the unit
        Comments

        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Dosage.sequence
        Definition

        Indicates the order in which the dosage instructions should be applied or interpreted.

        ShortThe order of the dosage instructions
        Comments

        Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

        Control0..01
        Typeinteger
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Dosage.text
        Definition

        Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker


        Free text dosage instructions e.g. SIG.

        ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'Free text dosage instructions e.g. SIG
        Comments

        Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Dosage.additionalInstruction
        Definition

        Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

        ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
        Comments

        Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

        Control0..0*
        BindingFor example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1
        (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

        A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Dosage.patientInstruction
        Definition

        Ergänzende, nicht strukturiert abbildbare Anwendungshinweise für die sichere, korrekte oder verständliche Anwendung des Arzneimittels.


        Instructions in terms that are understood by the patient or consumer.

        ShortErgänzende Anwendungshinweise für Patientinnen und PatientenPatient or consumer oriented instructions
        Comments

        Wenn mehrere Dosage-Elemente in einer Ressource vorhanden sind, muss patientInstruction in allen Dosierungen identisch befüllt werden.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Dosage.timing
        Definition

        Wann das Medikament verabreicht werden soll.


        When medication should be administered.

        ShortWann das Medikament verabreicht werden sollWhen medication should be administered
        Comments

        Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.


        This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

        Control0..1
        TypeTiming(Timing dgMP)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Dosage.asNeeded[x]
        Definition

        Gibt an, ob es sich um eine Bedarfsdosierung handelt. Es ist nur eine Ja/Nein-Angabe erlaubt. Die Abbildung der Indikation erfolgt über die Extension asNeededFor.


        Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

        ShortBedarfsdosierung (nur Ja/Nein-Angabe)Take "as needed" (for x)
        Comments

        Bedarfsdosierung, Bedingung kann mit der Extension asNeededFor näher spezifiziert werden.


        Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

        Control0..1
        Typeboolean, CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Dosage.site
        Definition

        Body site to administer to.

        ShortBody site to administer to
        Comments

        Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


        If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

        Control0..01
        BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1
        (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

        A coded concept describing the site location the medicine enters into or onto the body.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        A coded specification of the anatomic site where the medication first enters the body.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Dosage.route
        Definition

        How drug should enter body.

        ShortHow drug should enter body
        Comments

        Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

        Control0..01
        BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
        (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

        A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Dosage.method
        Definition

        Technique for administering medication.

        ShortTechnique for administering medication
        Comments

        Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


        Terminologies used often pre-coordinate this term with the route and or form of administration.

        Control0..01
        BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1
        (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

        A coded concept describing the technique by which the medicine is administered.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Dosage.doseAndRate
        Definition

        Die verabreichte Menge des Medikaments.


        The amount of medication administered.

        ShortMenge des verabreichten MedikamentsAmount of medication administered
        Comments

        Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

        Control0..1*
        TypeElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Dosage.doseAndRate.type
        Definition

        The kind of dose or rate specified, for example, ordered or calculated.

        ShortThe kind of dose or rate specified
        Comments

        Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

        Control0..01
        BindingFor example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1
        (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

        The kind of dose or rate specified.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        If the type is not populated, assume to be "ordered".

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Dosage.doseAndRate.dose[x]
        Definition

        Amount of medication per dose.

        ShortAmount of medication per dose
        Comments

        Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

        Control0..1
        TypeChoice of: Range, Quantity(SimpleQuantity)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Requirements

        The amount of therapeutic or other substance given at one administration event.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 56. Dosage.doseAndRate.dose[x]:doseQuantity
          Slice NamedoseQuantity
          Definition

          Menge des Medikaments pro Dosis.


          Amount of medication per dose.

          ShortMenge des Medikaments pro DosisAmount of medication per dose
          Comments

          Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.


          Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

          Control0..1
          BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          TypeQuantity(SimpleQuantity, SimpleQuantity), Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          The amount of therapeutic or other substance given at one administration event.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. Dosage.doseAndRate.dose[x]:doseQuantity.comparator
          Definition

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Control0..01
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Dosage.doseAndRate.dose[x]:doseQuantity.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. Dosage.doseAndRate.dose[x]:doseQuantity.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Control10..1
          This element is affected by the following invariants: qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. Dosage.doseAndRate.dose[x]:doseQuantity.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control10..1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. Dosage.doseAndRate.dose[x]:doseRange
          Slice NamedoseRange
          Definition

          Amount of medication per dose.

          ShortAmount of medication per dose
          Comments

          Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

          Control0..1
          TypeRange, Quantity(SimpleQuantity)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          The amount of therapeutic or other substance given at one administration event.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. Dosage.doseAndRate.dose[x]:doseRange.low
          Definition

          The low limit. The boundary is inclusive.

          ShortLow limit
          Comments

          If the low element is missing, the low boundary is not known.

          Control0..1
          BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Dosage.doseAndRate.dose[x]:doseRange.low.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control10..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. Dosage.doseAndRate.dose[x]:doseRange.low.comparator
          Definition

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Control0..01
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. Dosage.doseAndRate.dose[x]:doseRange.low.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. Dosage.doseAndRate.dose[x]:doseRange.low.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Control10..1
          This element is affected by the following invariants: qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. Dosage.doseAndRate.dose[x]:doseRange.low.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control10..1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Dosage.doseAndRate.dose[x]:doseRange.high
          Definition

          The high limit. The boundary is inclusive.

          ShortHigh limit
          Comments

          If the high element is missing, the high boundary is not known.

          Control0..1
          BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Dosage.doseAndRate.dose[x]:doseRange.high.value
          Definition

          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control10..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. Dosage.doseAndRate.dose[x]:doseRange.high.comparator
          Definition

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Control0..01
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. Dosage.doseAndRate.dose[x]:doseRange.high.unit
          Definition

          A human-readable form of the unit.

          ShortUnit representation
          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. Dosage.doseAndRate.dose[x]:doseRange.high.system
          Definition

          The identification of the system that provides the coded form of the unit.

          ShortSystem that defines coded unit form
          Control10..1
          This element is affected by the following invariants: qty-3
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know the system that defines the coded form of the unit.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. Dosage.doseAndRate.dose[x]:doseRange.high.code
          Definition

          A computer processable form of the unit in some unit representation system.

          ShortCoded form of the unit
          Comments

          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

          Control10..1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. Dosage.doseAndRate.rate[x]
          Definition

          Amount of medication per unit of time.

          ShortAmount of medication per unit of time
          Comments

          Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


          It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

          It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

          Control0..01
          TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
          Is Modifierfalse
          Summarytrue
          Requirements

          Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. Dosage.maxDosePerPeriod
          Definition

          Upper limit on medication per unit of time.

          ShortMaximale Dosis pro ZeitraumUpper limit on medication per unit of time
          Comments

          This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

          Control0..1
          TypeRatio
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. Dosage.maxDosePerAdministration
          Definition

          Upper limit on medication per administration.

          ShortUpper limit on medication per administration
          Comments

          Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


          This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

          Control0..01
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summarytrue
          Requirements

          The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. Dosage.maxDosePerLifetime
          Definition

          Upper limit on medication per lifetime of the patient.

          ShortUpper limit on medication per lifetime of the patient
          Comments

          Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..01
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summarytrue
          Requirements

          The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be foundhere

          0. Dosage
          InvariantsDosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
          DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ))
          FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
          FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer) UND die Extension renderedDosageInstruction befüllt ist, muss der Wert in dosageInstruction.text mit dem Wert in der Extension übereinstimmen. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationDispense).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationStatement).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) ) ))
          PatientInstructionIdentical: Wenn patientInstruction in einer Ressource mit mehreren Dosierungen verwendet wird, muss das Feld in allen Dosage-Elementen identisch befüllt sein. (( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).patientInstruction.distinct().count() <= 1 ) and ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).patientInstruction.exists() ) implies ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all(patientInstruction.exists()) ) ))
          MaxDoseSameUnitAsDose: maxDosePerPeriod muss die gleiche Einheit, den gleichen Code und das gleiche System wie doseQuantity verwenden. ( maxDosePerPeriod.empty() or ( ( doseAndRate.dose.ofType(Quantity).exists() and doseAndRate.dose.ofType(Quantity).system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Quantity).code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Quantity).unit = maxDosePerPeriod.numerator.unit ) or ( doseAndRate.dose.ofType(Range).exists() and ( doseAndRate.dose.ofType(Range).low.empty() or ( doseAndRate.dose.ofType(Range).low.system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Range).low.code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Range).low.unit = maxDosePerPeriod.numerator.unit ) ) and ( doseAndRate.dose.ofType(Range).high.empty() or ( doseAndRate.dose.ofType(Range).high.system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Range).high.code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Range).high.unit = maxDosePerPeriod.numerator.unit ) ) ) ) )
          MaxDosePerPeriodOnly24hOr1d: maxDosePerPeriod ist nur mit einem Bezugszeitraum von 24 Stunden (24 h) oder 1 Tag (1 d) zulässig. Andere Perioden (z. B. maximal 3 alle 6 h) sind nicht erlaubt. (maxDosePerPeriod.empty() or ( (maxDosePerPeriod.denominator.value = 24 and maxDosePerPeriod.denominator.code = 'h') or (maxDosePerPeriod.denominator.value = 1 and maxDosePerPeriod.denominator.code = 'd') ))
          DoseRangeHighRequiredWhenLowPresent: Wenn bei doseRange eine Untergrenze angegeben wird, muss auch eine Obergrenze angegeben werden. (doseAndRate.dose.ofType(Range).low.empty() or doseAndRate.dose.ofType(Range).high.exists())
          DoseRangeLowAndHighSameUnit: Unter- und Obergrenze einer variablen Einzeldosis müssen dieselbe Maßeinheit verwenden. (doseAndRate.dose.ofType(Range).low.empty() or doseAndRate.dose.ofType(Range).high.empty() or ( doseAndRate.dose.ofType(Range).low.system = doseAndRate.dose.ofType(Range).high.system and doseAndRate.dose.ofType(Range).low.code = doseAndRate.dose.ofType(Range).high.code and doseAndRate.dose.ofType(Range).low.unit = doseAndRate.dose.ofType(Range).high.unit ))
          DoseRangeNoVarPeriod: Eine variable Einzeldosis und eine variable Periode sollten nicht gemeinsam verwendet werden. (doseAndRate.dose.ofType(Range).empty() or timing.repeat.periodMax.empty())
          VarFreqNoMaxDose: Variable Frequenz und maximale Dosis pro Zeitraum dürfen nicht gemeinsam verwendet werden. (timing.repeat.frequencyMax.empty() or maxDosePerPeriod.empty())
          VarPeriodNoMindestabstand: Variable Periode und Mindestabstand zwischen zwei Einzelgaben dürfen nicht gemeinsam verwendet werden. (timing.repeat.periodMax.empty() or modifierExtension.where(url='http://ig.fhir.de/igs/medication/StructureDefinition/MindestabstandZwischenGaben').empty())
          AsNeededForRequiresAsNeeded: Ein Einnahmeanlass (asNeededFor) darf nur bei einer Bedarfsdosierung (asNeededBoolean=true) angegeben werden. Eine Bedarfsdosierung selbst benötigt keinen Einnahmeanlass. (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').exists() implies asNeeded.ofType(boolean) = true)
          2. Dosage.extension:asNeededFor
          Slice NameasNeededFor
          4. Dosage.extension:asNeededFor.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          6. Dosage.extension:asNeededFor.value[x].coding
          Comments

          Begründung Einschränkung Kardinalität: Eine Codierung der Indikation für die Bedarfsdosierung ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          8. Dosage.extension:asNeededFor.value[x].text
          Comments

          Indikation für die Bedarfsdosierung.

          Control1..?
          10. Dosage.modifierExtension:mindestabstandZwischenGaben
          Slice NamemindestabstandZwischenGaben
          12. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          14. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].unit
          Control1..?
          16. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].system
          Control1..?
          18. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].code
          Control1..?
          20. Dosage.sequence
          Comments

          Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          22. Dosage.additionalInstruction
          Control0..0
          24. Dosage.patientInstruction
          Comments

          Wenn mehrere Dosage-Elemente in einer Ressource vorhanden sind, muss patientInstruction in allen Dosierungen identisch befüllt werden.

          26. Dosage.timing
          TypeTiming(Timing dgMP)
          28. Dosage.asNeeded[x]
          Comments

          Bedarfsdosierung, Bedingung kann mit der Extension asNeededFor näher spezifiziert werden.

          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          30. Dosage.site
          Comments

          Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          32. Dosage.route
          Comments

          Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          34. Dosage.method
          Comments

          Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          36. Dosage.doseAndRate
          Comments

          Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..1
          38. Dosage.doseAndRate.type
          Comments

          Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          40. Dosage.doseAndRate.dose[x]:doseQuantity
          Slice NamedoseQuantity
          BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          TypeQuantity(SimpleQuantity)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          42. Dosage.doseAndRate.dose[x]:doseQuantity.unit
          Control1..?
          44. Dosage.doseAndRate.dose[x]:doseQuantity.system
          Control1..?
          46. Dosage.doseAndRate.dose[x]:doseQuantity.code
          Control1..?
          48. Dosage.doseAndRate.dose[x]:doseRange
          Slice NamedoseRange
          TypeRange
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          50. Dosage.doseAndRate.dose[x]:doseRange.low
          BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          52. Dosage.doseAndRate.dose[x]:doseRange.low.value
          Control1..?
          54. Dosage.doseAndRate.dose[x]:doseRange.low.unit
          Control1..?
          56. Dosage.doseAndRate.dose[x]:doseRange.low.system
          Control1..?
          58. Dosage.doseAndRate.dose[x]:doseRange.low.code
          Control1..?
          60. Dosage.doseAndRate.dose[x]:doseRange.high
          BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
          62. Dosage.doseAndRate.dose[x]:doseRange.high.value
          Control1..?
          64. Dosage.doseAndRate.dose[x]:doseRange.high.unit
          Control1..?
          66. Dosage.doseAndRate.dose[x]:doseRange.high.system
          Control1..?
          68. Dosage.doseAndRate.dose[x]:doseRange.high.code
          Control1..?
          70. Dosage.doseAndRate.rate[x]
          Comments

          Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          72. Dosage.maxDosePerAdministration
          Comments

          Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0
          74. Dosage.maxDosePerLifetime
          Comments

          Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

          Control0..0

          Guidance on how to interpret the contents of this table can be foundhere

          0. Dosage
          Definition

          Indicates how the medication is/was taken or should be taken by the patient.

          ShortHow the medication is/was taken or should be taken
          Control0..*
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
          DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. Für reine Bedarfsdosierungen darf doseAndRate auch ohne timing angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies ( timing.exists() or asNeeded.ofType(boolean) = true or extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').exists() )) ))
          DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Quantity).code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).low.code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).high.code ).distinct().count() = 1 ))
          DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. (text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())
          FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
          dos-1: AsNeededFor can only be set if AsNeeded is empty or true (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').empty() or asNeeded.empty() or asNeeded)
          DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
          DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ))
          FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
          FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer) UND die Extension renderedDosageInstruction befüllt ist, muss der Wert in dosageInstruction.text mit dem Wert in der Extension übereinstimmen. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationDispense).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationStatement).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) ) ))
          PatientInstructionIdentical: Wenn patientInstruction in einer Ressource mit mehreren Dosierungen verwendet wird, muss das Feld in allen Dosage-Elementen identisch befüllt sein. (( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).patientInstruction.distinct().count() <= 1 ) and ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).patientInstruction.exists() ) implies ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all(patientInstruction.exists()) ) ))
          MaxDoseSameUnitAsDose: maxDosePerPeriod muss die gleiche Einheit, den gleichen Code und das gleiche System wie doseQuantity verwenden. ( maxDosePerPeriod.empty() or ( ( doseAndRate.dose.ofType(Quantity).exists() and doseAndRate.dose.ofType(Quantity).system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Quantity).code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Quantity).unit = maxDosePerPeriod.numerator.unit ) or ( doseAndRate.dose.ofType(Range).exists() and ( doseAndRate.dose.ofType(Range).low.empty() or ( doseAndRate.dose.ofType(Range).low.system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Range).low.code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Range).low.unit = maxDosePerPeriod.numerator.unit ) ) and ( doseAndRate.dose.ofType(Range).high.empty() or ( doseAndRate.dose.ofType(Range).high.system = maxDosePerPeriod.numerator.system and doseAndRate.dose.ofType(Range).high.code = maxDosePerPeriod.numerator.code and doseAndRate.dose.ofType(Range).high.unit = maxDosePerPeriod.numerator.unit ) ) ) ) )
          MaxDosePerPeriodOnly24hOr1d: maxDosePerPeriod ist nur mit einem Bezugszeitraum von 24 Stunden (24 h) oder 1 Tag (1 d) zulässig. Andere Perioden (z. B. maximal 3 alle 6 h) sind nicht erlaubt. (maxDosePerPeriod.empty() or ( (maxDosePerPeriod.denominator.value = 24 and maxDosePerPeriod.denominator.code = 'h') or (maxDosePerPeriod.denominator.value = 1 and maxDosePerPeriod.denominator.code = 'd') ))
          DoseRangeHighRequiredWhenLowPresent: Wenn bei doseRange eine Untergrenze angegeben wird, muss auch eine Obergrenze angegeben werden. (doseAndRate.dose.ofType(Range).low.empty() or doseAndRate.dose.ofType(Range).high.exists())
          DoseRangeLowAndHighSameUnit: Unter- und Obergrenze einer variablen Einzeldosis müssen dieselbe Maßeinheit verwenden. (doseAndRate.dose.ofType(Range).low.empty() or doseAndRate.dose.ofType(Range).high.empty() or ( doseAndRate.dose.ofType(Range).low.system = doseAndRate.dose.ofType(Range).high.system and doseAndRate.dose.ofType(Range).low.code = doseAndRate.dose.ofType(Range).high.code and doseAndRate.dose.ofType(Range).low.unit = doseAndRate.dose.ofType(Range).high.unit ))
          DoseRangeNoVarPeriod: Eine variable Einzeldosis und eine variable Periode sollten nicht gemeinsam verwendet werden. (doseAndRate.dose.ofType(Range).empty() or timing.repeat.periodMax.empty())
          VarFreqNoMaxDose: Variable Frequenz und maximale Dosis pro Zeitraum dürfen nicht gemeinsam verwendet werden. (timing.repeat.frequencyMax.empty() or maxDosePerPeriod.empty())
          VarPeriodNoMindestabstand: Variable Periode und Mindestabstand zwischen zwei Einzelgaben dürfen nicht gemeinsam verwendet werden. (timing.repeat.periodMax.empty() or modifierExtension.where(url='http://ig.fhir.de/igs/medication/StructureDefinition/MindestabstandZwischenGaben').empty())
          AsNeededForRequiresAsNeeded: Ein Einnahmeanlass (asNeededFor) darf nur bei einer Bedarfsdosierung (asNeededBoolean=true) angegeben werden. Eine Bedarfsdosierung selbst benötigt keinen Einnahmeanlass. (extension.where(url='http://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor').exists() implies asNeeded.ofType(boolean) = true)
          2. Dosage.id
          Definition

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

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          4. Dosage.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 6. Dosage.extension:asNeededFor
            Slice NameasNeededFor
            Definition

            Indicates whether the medication is only taken based on a precondition for taking the medication.

            ShortDosage asNeededFor
            Control0..*
            TypeExtension(Dosage asNeededFor) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            8. Dosage.extension:asNeededFor.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            10. Dosage.extension:asNeededFor.extension
            Definition

            An Extension

            ShortExtension
            Control0..0
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Dosage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 12. Dosage.extension:asNeededFor.url
              Definition

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

              Shortidentifies the meaning of the extension
              Comments

              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.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Dosage.asNeededFor
              14. Dosage.extension:asNeededFor.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control0..1
              BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
              (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)
              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              16. Dosage.extension:asNeededFor.value[x].id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              18. Dosage.extension:asNeededFor.value[x].extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Dosage.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 20. Dosage.extension:asNeededFor.value[x].coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Begründung Einschränkung Kardinalität: Eine Codierung der Indikation für die Bedarfsdosierung ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                Control0..0
                TypeCoding
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                22. Dosage.extension:asNeededFor.value[x].text
                Definition

                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.

                ShortPlain text representation of the concept
                Comments

                Indikation für die Bedarfsdosierung.

                Control1..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. Dosage.modifierExtension
                Definition

                An Extension

                ShortExtension
                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Dosage.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 26. Dosage.modifierExtension:mindestabstandZwischenGaben
                  Slice NamemindestabstandZwischenGaben
                  Definition

                  Gibt den Mindestabstand zwischen zwei Gaben einer Bedarfsmedikation an.

                  ShortMindestabstand zwischen Gaben
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Mindestabstand zwischen Gaben) (Extension Type: Duration)
                  Is Modifiertrue because Der Mindestabstand zwischen Gaben verändert die zulässige Interpretation und Anwendung der Dosierung.
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  28. Dosage.modifierExtension:mindestabstandZwischenGaben.id
                  Definition

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  30. Dosage.modifierExtension:mindestabstandZwischenGaben.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..0
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Dosage.modifierExtension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 32. Dosage.modifierExtension:mindestabstandZwischenGaben.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

                    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.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valuehttp://ig.fhir.de/igs/medication/StructureDefinition/MindestabstandZwischenGaben
                    34. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x]
                    Definition

                    Zeitlicher Mindestabstand, der zwischen zwei Gaben einer Bedarfsmedikation einzuhalten ist.

                    ShortMindestabstand zwischen zwei Gaben
                    Control1..1
                    TypeDuration
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    36. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    38. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    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.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Dosage.modifierExtension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 40. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].value
                      Definition

                      The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                      ShortNumerical value (with implicit precision)
                      Comments

                      The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Precision is handled implicitly in almost all cases of measurement.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      42. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].comparator
                      Definition

                      How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                      Short< | <= | >= | > - how to understand the value
                      Control0..1
                      BindingThe codes SHALL be taken from QuantityComparator
                      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                      How the Quantity should be understood and represented.

                      Typecode
                      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                      Meaning if MissingIf there is no comparator, then there is no modification of the value
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      44. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].unit
                      Definition

                      A human-readable form of the unit.

                      ShortUnit representation
                      Control1..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      46. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].system
                      Definition

                      The identification of the system that provides the coded form of the unit.

                      ShortSystem that defines coded unit form
                      Control1..1
                      This element is affected by the following invariants: qty-3
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Need to know the system that defines the coded form of the unit.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. Dosage.modifierExtension:mindestabstandZwischenGaben.value[x].code
                      Definition

                      A computer processable form of the unit in some unit representation system.

                      ShortCoded form of the unit
                      Comments

                      The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                      Control1..1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. Dosage.sequence
                      Definition

                      Indicates the order in which the dosage instructions should be applied or interpreted.

                      ShortThe order of the dosage instructions
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      Typeinteger
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      52. Dosage.text
                      Definition

                      Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker

                      ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'
                      Comments

                      Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      54. Dosage.additionalInstruction
                      Definition

                      Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                      ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                      Comments

                      Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                      Control0..0
                      BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                      (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

                      A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      56. Dosage.patientInstruction
                      Definition

                      Ergänzende, nicht strukturiert abbildbare Anwendungshinweise für die sichere, korrekte oder verständliche Anwendung des Arzneimittels.

                      ShortErgänzende Anwendungshinweise für Patientinnen und Patienten
                      Comments

                      Wenn mehrere Dosage-Elemente in einer Ressource vorhanden sind, muss patientInstruction in allen Dosierungen identisch befüllt werden.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      58. Dosage.timing
                      Definition

                      Wann das Medikament verabreicht werden soll.

                      ShortWann das Medikament verabreicht werden soll
                      Comments

                      Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.

                      Control0..1
                      TypeTiming(Timing dgMP)
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      60. Dosage.asNeeded[x]
                      Definition

                      Gibt an, ob es sich um eine Bedarfsdosierung handelt. Es ist nur eine Ja/Nein-Angabe erlaubt. Die Abbildung der Indikation erfolgt über die Extension asNeededFor.

                      ShortBedarfsdosierung (nur Ja/Nein-Angabe)
                      Comments

                      Bedarfsdosierung, Bedingung kann mit der Extension asNeededFor näher spezifiziert werden.

                      Control0..1
                      Typeboolean
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      62. Dosage.site
                      Definition

                      Body site to administer to.

                      ShortBody site to administer to
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                      (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

                      A coded concept describing the site location the medicine enters into or onto the body.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      A coded specification of the anatomic site where the medication first enters the body.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      64. Dosage.route
                      Definition

                      How drug should enter body.

                      ShortHow drug should enter body
                      Comments

                      Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      BindingFor example codes, see SNOMEDCTRouteCodes
                      (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                      A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      66. Dosage.method
                      Definition

                      Technique for administering medication.

                      ShortTechnique for administering medication
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                      (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

                      A coded concept describing the technique by which the medicine is administered.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      68. Dosage.doseAndRate
                      Definition

                      Die verabreichte Menge des Medikaments.

                      ShortMenge des verabreichten Medikaments
                      Comments

                      Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..1
                      TypeElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      70. Dosage.doseAndRate.id
                      Definition

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

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      72. Dosage.doseAndRate.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 74. Dosage.doseAndRate.type
                        Definition

                        The kind of dose or rate specified, for example, ordered or calculated.

                        ShortThe kind of dose or rate specified
                        Comments

                        Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                        Control0..0
                        BindingFor example codes, see DoseAndRateType
                        (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                        The kind of dose or rate specified.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        If the type is not populated, assume to be "ordered".

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        76. Dosage.doseAndRate.dose[x]
                        Definition

                        Amount of medication per dose.

                        ShortAmount of medication per dose
                        Comments

                        Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                        Control0..1
                        TypeChoice of: Range, Quantity(SimpleQuantity)
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summarytrue
                        Requirements

                        The amount of therapeutic or other substance given at one administration event.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 78. Dosage.doseAndRate.dose[x]:doseQuantity
                          Slice NamedoseQuantity
                          Definition

                          Menge des Medikaments pro Dosis.

                          ShortMenge des Medikaments pro Dosis
                          Comments

                          Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.

                          Control0..1
                          BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
                          (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                          TypeQuantity(SimpleQuantity)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          The amount of therapeutic or other substance given at one administration event.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. Dosage.doseAndRate.dose[x]:doseQuantity.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          82. Dosage.doseAndRate.dose[x]:doseQuantity.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 84. Dosage.doseAndRate.dose[x]:doseQuantity.value
                            Definition

                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                            ShortNumerical value (with implicit precision)
                            Comments

                            The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                            Control0..1
                            Typedecimal
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Precision is handled implicitly in almost all cases of measurement.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            86. Dosage.doseAndRate.dose[x]:doseQuantity.comparator
                            Definition

                            Not allowed to be used in this context

                            Short< | <= | >= | > - how to understand the value
                            Control0..0
                            BindingThe codes SHALL be taken from QuantityComparator
                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                            How the Quantity should be understood and represented.

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            88. Dosage.doseAndRate.dose[x]:doseQuantity.unit
                            Definition

                            A human-readable form of the unit.

                            ShortUnit representation
                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            90. Dosage.doseAndRate.dose[x]:doseQuantity.system
                            Definition

                            The identification of the system that provides the coded form of the unit.

                            ShortSystem that defines coded unit form
                            Control1..1
                            This element is affected by the following invariants: qty-3
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Need to know the system that defines the coded form of the unit.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            92. Dosage.doseAndRate.dose[x]:doseQuantity.code
                            Definition

                            A computer processable form of the unit in some unit representation system.

                            ShortCoded form of the unit
                            Comments

                            The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                            Control1..1
                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            94. Dosage.doseAndRate.dose[x]:doseRange
                            Slice NamedoseRange
                            Definition

                            Amount of medication per dose.

                            ShortAmount of medication per dose
                            Comments

                            Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                            Control0..1
                            TypeRange
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            The amount of therapeutic or other substance given at one administration event.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            96. Dosage.doseAndRate.dose[x]:doseRange.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            98. Dosage.doseAndRate.dose[x]:doseRange.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 100. Dosage.doseAndRate.dose[x]:doseRange.low
                              Definition

                              The low limit. The boundary is inclusive.

                              ShortLow limit
                              Comments

                              If the low element is missing, the low boundary is not known.

                              Control0..1
                              BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
                              (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                              TypeQuantity(SimpleQuantity)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              102. Dosage.doseAndRate.dose[x]:doseRange.low.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              104. Dosage.doseAndRate.dose[x]:doseRange.low.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x].low.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 106. Dosage.doseAndRate.dose[x]:doseRange.low.value
                                Definition

                                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                ShortNumerical value (with implicit precision)
                                Comments

                                The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                Control1..1
                                Typedecimal
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Precision is handled implicitly in almost all cases of measurement.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                108. Dosage.doseAndRate.dose[x]:doseRange.low.comparator
                                Definition

                                Not allowed to be used in this context

                                Short< | <= | >= | > - how to understand the value
                                Control0..0
                                BindingThe codes SHALL be taken from QuantityComparator
                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                How the Quantity should be understood and represented.

                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                110. Dosage.doseAndRate.dose[x]:doseRange.low.unit
                                Definition

                                A human-readable form of the unit.

                                ShortUnit representation
                                Control1..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                112. Dosage.doseAndRate.dose[x]:doseRange.low.system
                                Definition

                                The identification of the system that provides the coded form of the unit.

                                ShortSystem that defines coded unit form
                                Control1..1
                                This element is affected by the following invariants: qty-3
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Need to know the system that defines the coded form of the unit.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                114. Dosage.doseAndRate.dose[x]:doseRange.low.code
                                Definition

                                A computer processable form of the unit in some unit representation system.

                                ShortCoded form of the unit
                                Comments

                                The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                Control1..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                116. Dosage.doseAndRate.dose[x]:doseRange.high
                                Definition

                                The high limit. The boundary is inclusive.

                                ShortHigh limit
                                Comments

                                If the high element is missing, the high boundary is not known.

                                Control0..1
                                BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
                                (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                                TypeQuantity(SimpleQuantity)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                118. Dosage.doseAndRate.dose[x]:doseRange.high.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                120. Dosage.doseAndRate.dose[x]:doseRange.high.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Dosage.doseAndRate.dose[x].high.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 122. Dosage.doseAndRate.dose[x]:doseRange.high.value
                                  Definition

                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                  ShortNumerical value (with implicit precision)
                                  Comments

                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                  Control1..1
                                  Typedecimal
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Precision is handled implicitly in almost all cases of measurement.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  124. Dosage.doseAndRate.dose[x]:doseRange.high.comparator
                                  Definition

                                  Not allowed to be used in this context

                                  Short< | <= | >= | > - how to understand the value
                                  Control0..0
                                  BindingThe codes SHALL be taken from QuantityComparator
                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                  How the Quantity should be understood and represented.

                                  Typecode
                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  126. Dosage.doseAndRate.dose[x]:doseRange.high.unit
                                  Definition

                                  A human-readable form of the unit.

                                  ShortUnit representation
                                  Control1..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  128. Dosage.doseAndRate.dose[x]:doseRange.high.system
                                  Definition

                                  The identification of the system that provides the coded form of the unit.

                                  ShortSystem that defines coded unit form
                                  Control1..1
                                  This element is affected by the following invariants: qty-3
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Need to know the system that defines the coded form of the unit.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  130. Dosage.doseAndRate.dose[x]:doseRange.high.code
                                  Definition

                                  A computer processable form of the unit in some unit representation system.

                                  ShortCoded form of the unit
                                  Comments

                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                  Control1..1
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  132. Dosage.doseAndRate.rate[x]
                                  Definition

                                  Amount of medication per unit of time.

                                  ShortAmount of medication per unit of time
                                  Comments

                                  Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                  Control0..0
                                  TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  134. Dosage.maxDosePerPeriod
                                  Definition

                                  Upper limit on medication per unit of time.

                                  ShortMaximale Dosis pro Zeitraum
                                  Comments

                                  This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                  Control0..1
                                  TypeRatio
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  136. Dosage.maxDosePerAdministration
                                  Definition

                                  Upper limit on medication per administration.

                                  ShortUpper limit on medication per administration
                                  Comments

                                  Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                  Control0..0
                                  TypeQuantity(SimpleQuantity)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  138. Dosage.maxDosePerLifetime
                                  Definition

                                  Upper limit on medication per lifetime of the patient.

                                  ShortUpper limit on medication per lifetime of the patient
                                  Comments

                                  Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der aktuellen Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                  Control0..0
                                  TypeQuantity(SimpleQuantity)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))