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Updated MedicationAdministration DSTU2 Resource #1011

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Updated MedicationAdministration DSTU2 Resource #1011

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62b80ab
Updated MedicationAdministration DSTU2 Resource
kckeim Oct 27, 2023
2904fc8
Updates following Aaron's input
kckeim Nov 6, 2023
588abd4
`_count` example was wrong
kckeim Nov 6, 2023
7b65d84
PRODOC-203242: Style edits.
Nov 17, 2023
83cd4f5
Uppercasing on Medication resource
kckeim Nov 28, 2023
0814a89
update Immunization link to remove #overview
amcginn Dec 14, 2023
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89 changes: 40 additions & 49 deletions content/millennium/dstu2/medications/medication-administration.md
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Expand Up @@ -9,13 +9,11 @@ title: MedicationAdministration | DSTU 2 API

## Overview

The Medication Administration resource provides information about medications and vaccines administered to a patient or consumed by a patient including injections, intravenous solutions, and self administered oral medications.
<br/><br/>
The MedicationAdministration resource provides information about medications administered to a patient or consumed by a patient including injections, intravenous solutions, and self administered oral medications.
When using this resource, full administration details for vaccinations administered by the current healthcare system can be searched. For historically administered vaccines, or vaccines adminstered by other healthcare disciplines, care settings, or regions, the [`Immunization`] resource must be used for retrieving data.

* **IMPORTANT NOTE**: Infuse or Bolus administration results for continuous infusion orders may require additional calculations to determine the actual amount of medication administered per ingredient. An additional calculation is required when the dosage quantity does not equal the contained Medication product ingredient amount denominator. In this case, calculate the ratio between the ingredient’s numerator divided by the denominator and multiply by dosage quantity. This will be the actual amount of medication administered.
* **NOTE**: These corrections may be breaking changes for your use cases. Current users of the MedicationAdministration API should test in their non-production domains. Cerner will coordinate with you and your developers of 3rd party applications to enable in your production domains.
* **IMPORTANT NOTE**: Infuse or Bolus administration results for continuous infusion orders may require additional calculations to determine the actual amount of medication administered per ingredient. An additional calculation is required when the dosage dose does not equal the [contained] Medication ingredient strength denominator. In this case, calculate the ratio between the ingredient’s numerator divided by the denominator and multiply by dosage dose. This will be the actual amount of medication administered.
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<br/><br/>
The following fields are returned if valued:

* [Medication Administration id](http://hl7.org/fhir/DSTU2/medicationadministration-definitions.html#MedicationAdministration.identifier){:target="_blank"}
Expand All @@ -34,6 +32,15 @@ The following fields are returned if valued:
* [Site](http://hl7.org/fhir/DSTU2/medicationadministration-definitions.html#MedicationAdministration.dosage.site_x_){:target="_blank"}
* [Rate](http://hl7.org/fhir/DSTU2/medicationadministration-definitions.html#MedicationAdministration.dosage.rate_x_){:target="_blank"}
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* MedicationAdministration.medication may be a reference to a [contained] Medication when the Medication cannot be represented by a [CodeableConcept] because it contains a unique combination of ingredients. Medications in the system always exist within the context of a MedicationAdministration and cannot be referenced independently.


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<%= disclaimer %>

### Errors

The common [errors] and [OperationOutcomes] may be returned.

## Terminology Bindings

<%= terminology_table(:medication_administration, :dstu2) %>
Expand All @@ -50,22 +57,16 @@ The following fields are returned if valued:

All URLs for custom extensions are defined as `https://fhir-ehr.cerner.com/dstu2/StructureDefinition/{id}`
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ID | Value\[x] Type | Description
-----------------------|----------------|------------------------------------------------------------------------------------------------
`infuse-over-time` | [`Quantity`] | The length of time in minutes it took to infuse a medication.
ID | Value\[x] Type | Description
--------------------|----------------|------------------------------------------------------------------------------------------------
`infuse-over-time` | [`Quantity`] | The length of time in minutes it took to infuse a medication.

## Search

Search for MedicationAdministrations that meet supplied query parameters:

GET /MedicationAdministration?:parameters

_Implementation Notes_

* [MedicationAdministration.medication] may be a reference to a [contained] Medication when the Medication cannot be represented by a CodeableConcept because it contains a unique combination of ingredients. Medications in the system always exist within the context of a MedicationAdministration and cannot be referenced independently.
* **IMPORTANT NOTE**: Infuse or Bolus administration results for continuous infusion orders may require additional calculations to determine the actual amount of medication administered per ingredient. An additional calculation is required when the dosage quantity does not equal the contained Medication product ingredient amount denominator. In this case, calculate the ratio between the ingredient’s numerator divided by the denominator and multiply by dosage quantity. This will be the actual amount of medication administered.
* **NOTE**: These corrections may be breaking changes for your use cases. Current users of the MedicationAdministration API should test in their non-production domains. Cerner will coordinate with you and your developers of 3rd party applications to enable in your production domains.

### Authorization Types

<%= authorization_types(provider: true, patient: true, system: true) %>
Expand All @@ -74,21 +75,29 @@ _Implementation Notes_
### Parameters


Name | Required? | Type | Description
----------------|--------------------|---------------|-----------------------------------------------------------------------------------------------
`_id` | This, or `patient` | [`token`] | The logical resource id associated with the resource.
`patient` | This, or `_id` | [`reference`] | The patient who has received the medication administration. Example: `patient=12345`
`status` | N | [`token`] | The status of the medication administration, may be a list separated by commas. Example: `status=completed`
`practitioner` | N | [`reference`] | The performing clinician, may be a list separated by commas. Example: `practitioner=12345`
`notgiven` | N | [`token`] | Administrations that were not made. A value of 'true' will search for these, and a value of 'false' will exclude them. Example: `true`
`effectivetime` | N | [`date`] | The effectivetime search may be provided once with either the ge or le prefix or twice with the ge and le prefixes to indicate a specific range. Example: `effectivetime=ge2010-08-18` or `effectivetime=le2015-07-17` or `effectivetime=ge2010-08-18&effectivetime=le2015-07-17`
[`_count`] | N | [`number`] | The maximum number of results to return.

Name | Required? | Type | Description
----------------|---------------|---------------|-----------------------------------------------------------------------------------------------
`_id` | Conditionally | [`token`] | The logical resource id associated with the resource. It may be a list separated by commas. This parameter is required if the `patient` parameter is not used. Example: `_id=12345`
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`patient` | Conditionally | [`reference`] | The patient who has received the medication administration. This parameter is required if the `_id` parameter is not used. Example: `patient=1234`
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`status` | No | [`token`] | The status of the medication administration event. It may be a list separated by commas. Example: `status=completed,not-done`
`practitioner` | No | [`reference`] | The identity of the clinician who administered the medication. It may be a list separated by commas. Example: `practitioner=1245,7659`
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`notgiven` | No | [`token`] | Administrations that were not made. A value of `true` will search for these, and a value of `false` will exclude them.
`effectivetime` | No | [`date`] | A date range for when the administration happened. Example: `effectivetime=ge2014-05-19T20:54:02.000Z`
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[`_count`] | No | [`number`] | The maximum number of results to return. Example: `50`
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Notes:

- Either the `_id`, or a combination of `patient`, `status`, `practitioner`, `notgiven`, `effectivetime`, or `_count` parameters must be provided. Default sort is by administration end date time.
_Implementation Notes_

- When searching with the `_id` parameter
- It must not be provided with any other parameters.
- When searching with the `effectivetime` parameter:
- For a single `effectivetime` occurrence:
- It must be provided with a `ge` `gt` `le` or `lt` prefix to imply the date range to search for administrations within.
- The time component is required.
- Example: `effectivetime=ge2014-05-19T20:54:02.000Z`
- For two `effectivetime` occurences:
- It must be provided with `le` or `lt` and `ge` or `gt` prefixes to search for administrations within a specific range.
- The time component is required for both parameters.
- Example: `effectivetime=ge2014-05-19T20:54:02.000Z&effectivetime=le2014-05-20T20:54:02.000Z`

### Headers

Expand All @@ -114,24 +123,12 @@ Notes:
<%= headers status: 200 %>
<%= json(:dstu2_medication_administration_multiple_ingredients_bundle) %>

<%= disclaimer %>
## Retrieve by ID

### Errors

The common [errors] and [OperationOutcomes] may be returned.

## Retrieve by id

List an individual MedicationAdministration by its id:
List an individual MedicationAdministration by its ID:

GET /MedicationAdministration/:id

_Implementation Notes_

* [MedicationAdministration.medication] may be a reference to a [contained] Medication when the Medication cannot be represented by a CodeableConcept because it contains a unique combination of ingredients. Medications in the system always exist within the context of a MedicationAdministration and cannot be be referenced independently.
* **IMPORTANT NOTE**: Infuse or Bolus administration results for continuous infusion orders may require additional calculations to determine the actual amount of medication administered per ingredient. An additional calculation is required when the dosage quantity does not equal the contained Medication product ingredient amount denominator. In this case, calculate the ratio between the ingredient’s numerator divided by the denominator and multiply by dosage quantity. This will be the actual amount of medication administered.
* **NOTE**: These corrections may be breaking changes for your use cases. Current users of the MedicationAdministration API should test in their non-production domains. Cerner will coordinate with you and your developers of 3rd party applications to enable in your production domains.

### Authorization Types

<%= authorization_types(provider: true, patient: true, system: true) %>
Expand Down Expand Up @@ -160,21 +157,15 @@ _Implementation Notes_
<%= headers status: 200 %>
<%= json(:dstu2_medication_administration_multiple_ingredients_entry) %>

<%= disclaimer %>

### Errors

The common [errors] and [OperationOutcomes] may be returned.

[`reference`]: http://hl7.org/fhir/DSTU2/search.html#reference
[`token`]: http://hl7.org/fhir/DSTU2/search.html#token
[`date`]: http://hl7.org/fhir/DSTU2/search.html#date
[`quantity`]: http://hl7.org/fhir/DSTU2/search.html#quantity
[`_count`]: http://hl7.org/fhir/DSTU2/search.html#count
[`number`]: http://hl7.org/fhir/DSTU2/search.html#number
[`CodeableConcept`]: http://hl7.org/fhir/DSTU2/datatypes.html#codeableconcept
[CodeableConcept]: http://hl7.org/fhir/DSTU2/datatypes.html#codeableconcept
[contained]: http://hl7.org/fhir/DSTU2/references.html#contained
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[MedicationAdministration.medication]: http://hl7.org/fhir/DSTU2/medicationadministration-definitions.html#MedicationAdministration.medication_x_
[errors]: ../../#client-errors
[OperationOutcomes]: ../../#operation-outcomes
[Infuse Over Time]: #custom-extensions
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[`Immunization`]: ../immunization/#overview
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