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Requisition Therapeutic Drug Monitoring Extension

Canonical../StructureDefinition/nexus-requisition-tdm
Statusdraft · 1.26.0
BaseExtension (constraint)
ContextServiceRequest (element)
SourceFSH · JSON

One therapeutic-drug-monitoring block on a laboratory requisition: the monitored drug and the collection, last-dose and next-dose times a serum level must be interpreted against.

Elements / Details

Every element this profile touches, with its full definition. Element names in the tables link here.

Extension

Short One drug-monitoring block: the drug, and the collection / last-dose / next-dose times
Definition One therapeutic-drug-monitoring block on a laboratory requisition: the monitored drug and the collection, last-dose and next-dose times a serum level must be interpreted against. It repeats, once per block. The printed requisition rules two drug-monitoring blocks. Each block a clinician filled in is written as its own occurrence of this extension, in the order the form prints them. A consumer that reads only the first occurrence reads the first block correctly. The three times are four-digit 24-hour clock readings (HHMM) held as strings, not FHIR time or dateTime values. They carry no date and no timezone: the clinician typed a wall-clock reading, and this preserves it as typed. Where a real collection instant is needed, read collection.collectedDateTime on the Specimen contained in the requisition, which is a fully-qualified zoned dateTime. Every part is optional; an empty block is not written. A producer emits an occurrence only when at least one of the four boxes was filled in, so an occurrence always carries something. A block with a drug and a collection time but no dose times is an ordinary partial entry, not an error. It is on the order, and only on the order. The monitoring times are not echoed onto the DiagnosticReport the requisition eventually produces; a consumer interpreting a level has to read them from the order.
Cardinality 0..*
Invariants ele-1, ext-1

Extension.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension

Short Additional content defined by implementations
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.
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.
Cardinality 0..*
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:drug

Short The monitored drug, as typed onto the form
Definition The drug whose level is being monitored, exactly as typed onto the requisition. Free text: it is not coded, not matched against a medication list, and not to be read as a resolvable medication.
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.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:drug.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:drug.extension

Short Additional content defined by implementations
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.
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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:drug.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
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.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value drug

Extension.extension:drug.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type string
Invariants ele-1

Extension.extension:timeCollected

Short Time the specimen was collected -- 24-hour HHMM, as typed
Definition The time the specimen was collected, as the four-digit 24-hour clock reading typed onto the form (for example 0730). No date and no timezone. This is not a FHIR time value. The requisition's contained Specimen carries the fully-qualified collection instant.
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.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:timeCollected.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:timeCollected.extension

Short Additional content defined by implementations
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.
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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:timeCollected.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
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.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value timeCollected

Extension.extension:timeCollected.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type string
Invariants ele-1

Extension.extension:lastDose

Short Time of the last dose -- 24-hour HHMM, as typed
Definition The time the patient's last dose was taken, as the four-digit 24-hour clock reading typed onto the form. No date and no timezone; it is not a FHIR time value.
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.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:lastDose.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:lastDose.extension

Short Additional content defined by implementations
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.
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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:lastDose.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
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.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value lastDose

Extension.extension:lastDose.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type string
Invariants ele-1

Extension.extension:nextDose

Short Time of the next dose -- 24-hour HHMM, as typed
Definition The time the patient's next dose is due, as the four-digit 24-hour clock reading typed onto the form. No date and no timezone; it is not a FHIR time value.
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.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:nextDose.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:nextDose.extension

Short Additional content defined by implementations
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.
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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:nextDose.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
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.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value nextDose

Extension.extension:nextDose.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type string
Invariants ele-1

Extension.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
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.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value ../StructureDefinition/nexus-requisition-tdm

Extension.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..0
Type base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Invariants ele-1