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Medication Order / Administration

vr.wm-act-048 · wm-act-048-medication-order-administration

Represent a source-qualified medication lifecycle aggregate so agents can distinguish clinical request, supply, actual administration or non-administration, reported use, reconciliation and safety evidence without conflating intent with exposure or consequence.

World Models Activities and processes ACT.HCR
Bundle → Layer → Finding → QuestionsClassifiersWhat it isWhy it existsDistinguishing featuresWhat robots and AI may and may not doMoral aspectsOwnersLinks to other meta-modelsIdentity and identifiersDirect propertiesRecognitionCapabilities and actionsHazards and failure modesStandards and interfacesContext of useSources

Bundle → Layer → Finding → Questions Filled

6 bundles · 12 layers · 24 findings · 72 questions

Aggregate identity, boundary, subject and medication Groups governed medication context for aggregate identity, boundary, subject and medication.

Aggregate profile, identifiers, sources and lineage

Groups source-qualified medication context for aggregate profile, identifiers, sources and lineage.

Medication lifecycle profile, root boundary and constituent kinds

Records medication lifecycle profile, root boundary and constituent kinds as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish medication lifecycle profile, root boundary and constituent kinds? classification
  2. Who requested, authorized, performed, supplied, received, recorded or reported medication lifecycle profile, root boundary and constituent kinds, with which role, evidence and limits? composition
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to medication lifecycle profile, root boundary and constituent kinds, and how is it validated or corrected? privacy

Aggregate and child identifiers, source records, versions and lineage

Records aggregate and child identifiers, source records, versions and lineage as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish aggregate and child identifiers, source records, versions and lineage? identity
  2. Who requested, authorized, performed, supplied, received, recorded or reported aggregate and child identifiers, source records, versions and lineage, with which role, evidence and limits? evidence
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to aggregate and child identifiers, source records, versions and lineage, and how is it validated or corrected? lifecycle

Subject, medication, encounter, plan and context bindings

Groups source-qualified medication context for subject, medication, encounter, plan and context bindings.

Subject, encounter, care plan, episode and care team references

Records subject, encounter, care plan, episode and care team references as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish subject, encounter, care plan, episode and care team references? relationship
  2. Who requested, authorized, performed, supplied, received, recorded or reported subject, encounter, care plan, episode and care team references, with which role, evidence and limits? ownership
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to subject, encounter, care plan, episode and care team references, and how is it validated or corrected? quality

Medication, substance, product, pack, strength, form and terminology binding

Records medication, substance, product, pack, strength, form and terminology binding as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish medication, substance, product, pack, strength, form and terminology binding? classification
  2. Who requested, authorized, performed, supplied, received, recorded or reported medication, substance, product, pack, strength, form and terminology binding, with which role, evidence and limits? measurement
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to medication, substance, product, pack, strength, form and terminology binding, and how is it validated or corrected? security
Request, prescription authority and dosage intent Groups governed medication context for request, prescription authority and dosage intent.

Request intent, status, priority, authority and indication

Groups source-qualified medication context for request intent, status, priority, authority and indication.

Request intent, status, priority, authored time, requester and recorder

Records request intent, status, priority, authored time, requester and recorder as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish request intent, status, priority, authored time, requester and recorder? lifecycle
  2. Who requested, authorized, performed, supplied, received, recorded or reported request intent, status, priority, authored time, requester and recorder, with which role, evidence and limits? exception
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to request intent, status, priority, authored time, requester and recorder, and how is it validated or corrected? retention

Indication, goal, supporting evidence, clinical authority and decision basis

Records indication, goal, supporting evidence, clinical authority and decision basis as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish indication, goal, supporting evidence, clinical authority and decision basis? authority
  2. Who requested, authorized, performed, supplied, received, recorded or reported indication, goal, supporting evidence, clinical authority and decision basis, with which role, evidence and limits? provenance
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to indication, goal, supporting evidence, clinical authority and decision basis, and how is it validated or corrected? interoperability

Dosage, therapy, dispense authorization and substitution intent

Groups source-qualified medication context for dosage, therapy, dispense authorization and substitution intent.

Dose, timing, frequency, duration, route, site, method, rate, PRN and therapy course

Records dose, timing, frequency, duration, route, site, method, rate, prn and therapy course as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish dose, timing, frequency, duration, route, site, method, rate, prn and therapy course? requirement
  2. Who requested, authorized, performed, supplied, received, recorded or reported dose, timing, frequency, duration, route, site, method, rate, prn and therapy course, with which role, evidence and limits? process
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to dose, timing, frequency, duration, route, site, method, rate, prn and therapy course, and how is it validated or corrected? decision

Initial fill, quantity, supply duration, refills, validity, dispenser and substitution limits

Records initial fill, quantity, supply duration, refills, validity, dispenser and substitution limits as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish initial fill, quantity, supply duration, refills, validity, dispenser and substitution limits? constraint
  2. Who requested, authorized, performed, supplied, received, recorded or reported initial fill, quantity, supply duration, refills, validity, dispenser and substitution limits, with which role, evidence and limits? validation
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to initial fill, quantity, supply duration, refills, validity, dispenser and substitution limits, and how is it validated or corrected? state
Dispense preparation, supply, handover and substitution Groups governed medication context for dispense preparation, supply, handover and substitution.

Dispense event authorization, status, performer, place and times

Groups source-qualified medication context for dispense event authorization, status, performer, place and times.

Dispense identity, authorizing request, status, not-performed reason and type

Records dispense identity, authorizing request, status, not-performed reason and type as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish dispense identity, authorizing request, status, not-performed reason and type? event
  2. Who requested, authorized, performed, supplied, received, recorded or reported dispense identity, authorizing request, status, not-performed reason and type, with which role, evidence and limits? privacy
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to dispense identity, authorizing request, status, not-performed reason and type, and how is it validated or corrected? identity

Dispenser role, location, recorded, prepared, handover, destination and receiver

Records dispenser role, location, recorded, prepared, handover, destination and receiver as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish dispenser role, location, recorded, prepared, handover, destination and receiver? temporal
  2. Who requested, authorized, performed, supplied, received, recorded or reported dispenser role, location, recorded, prepared, handover, destination and receiver, with which role, evidence and limits? lifecycle
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to dispenser role, location, recorded, prepared, handover, destination and receiver, and how is it validated or corrected? classification

Supplied product, quantity, instructions and substitution evidence

Groups source-qualified medication context for supplied product, quantity, instructions and substitution evidence.

Actual product, package, lot, expiry, quantity, days supply and dose aid

Records actual product, package, lot, expiry, quantity, days supply and dose aid as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish actual product, package, lot, expiry, quantity, days supply and dose aid? composition
  2. Who requested, authorized, performed, supplied, received, recorded or reported actual product, package, lot, expiry, quantity, days supply and dose aid, with which role, evidence and limits? quality
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to actual product, package, lot, expiry, quantity, days supply and dose aid, and how is it validated or corrected? relationship

Dispense instructions, substitution type, reason, responsible party and difference

Records dispense instructions, substitution type, reason, responsible party and difference as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish dispense instructions, substitution type, reason, responsible party and difference? evidence
  2. Who requested, authorized, performed, supplied, received, recorded or reported dispense instructions, substitution type, reason, responsible party and difference, with which role, evidence and limits? security
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to dispense instructions, substitution type, reason, responsible party and difference, and how is it validated or corrected? authority
Administration, non-administration, partial dose and waste Groups governed medication context for administration, non-administration, partial dose and waste.

Administration event, status, occurrence, actor and order link

Groups source-qualified medication context for administration event, status, occurrence, actor and order link.

Administration identity, status, occurrence, recorded time, request and part-of

Records administration identity, status, occurrence, recorded time, request and part-of as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish administration identity, status, occurrence, recorded time, request and part-of? event
  2. Who requested, authorized, performed, supplied, received, recorded or reported administration identity, status, occurrence, recorded time, request and part-of, with which role, evidence and limits? retention
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to administration identity, status, occurrence, recorded time, request and part-of, and how is it validated or corrected? requirement

Recipient, performer role, encounter, reason, support and device reference

Records recipient, performer role, encounter, reason, support and device reference as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish recipient, performer role, encounter, reason, support and device reference? ownership
  2. Who requested, authorized, performed, supplied, received, recorded or reported recipient, performer role, encounter, reason, support and device reference, with which role, evidence and limits? interoperability
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to recipient, performer role, encounter, reason, support and device reference, and how is it validated or corrected? constraint

Actual dose, route, site, method, rate, exceptions and waste

Groups source-qualified medication context for actual dose, route, site, method, rate, exceptions and waste.

Actual dose, unit, route, site, method, rate, duration and administration device

Records actual dose, unit, route, site, method, rate, duration and administration device as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish actual dose, unit, route, site, method, rate, duration and administration device? measurement
  2. Who requested, authorized, performed, supplied, received, recorded or reported actual dose, unit, route, site, method, rate, duration and administration device, with which role, evidence and limits? decision
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to actual dose, unit, route, site, method, rate, duration and administration device, and how is it validated or corrected? event

Not-done, omitted, refused, held, stopped, subpotent, spilled and wasted dose

Records not-done, omitted, refused, held, stopped, subpotent, spilled and wasted dose as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish not-done, omitted, refused, held, stopped, subpotent, spilled and wasted dose? exception
  2. Who requested, authorized, performed, supplied, received, recorded or reported not-done, omitted, refused, held, stopped, subpotent, spilled and wasted dose, with which role, evidence and limits? state
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to not-done, omitted, refused, held, stopped, subpotent, spilled and wasted dose, and how is it validated or corrected? temporal
Reported use, reconciliation, safety, response and harm Groups governed medication context for reported use, reconciliation, safety, response and harm.

Medication statements, histories, discrepancies and reconciliation

Groups source-qualified medication context for medication statements, histories, discrepancies and reconciliation.

Reported use, information source, period, adherence, confidence and derived-from

Records reported use, information source, period, adherence, confidence and derived-from as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish reported use, information source, period, adherence, confidence and derived-from? provenance
  2. Who requested, authorized, performed, supplied, received, recorded or reported reported use, information source, period, adherence, confidence and derived-from, with which role, evidence and limits? identity
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to reported use, information source, period, adherence, confidence and derived-from, and how is it validated or corrected? composition

Best possible history, source comparison, discrepancy resolution and communication

Records best possible history, source comparison, discrepancy resolution and communication as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish best possible history, source comparison, discrepancy resolution and communication? process
  2. Who requested, authorized, performed, supplied, received, recorded or reported best possible history, source comparison, discrepancy resolution and communication, with which role, evidence and limits? classification
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to best possible history, source comparison, discrepancy resolution and communication, and how is it validated or corrected? evidence

Safety checks, effectiveness, observations and adverse events

Groups source-qualified medication context for safety checks, effectiveness, observations and adverse events.

Allergy, contraindication, interaction, duplicate therapy, risk check and response

Records allergy, contraindication, interaction, duplicate therapy, risk check and response as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish allergy, contraindication, interaction, duplicate therapy, risk check and response? validation
  2. Who requested, authorized, performed, supplied, received, recorded or reported allergy, contraindication, interaction, duplicate therapy, risk check and response, with which role, evidence and limits? relationship
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to allergy, contraindication, interaction, duplicate therapy, risk check and response, and how is it validated or corrected? ownership

Clinical response, observation, effectiveness, side effect, adverse event and causality status

Records clinical response, observation, effectiveness, side effect, adverse event and causality status as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish clinical response, observation, effectiveness, side effect, adverse event and causality status? evidence
  2. Who requested, authorized, performed, supplied, received, recorded or reported clinical response, observation, effectiveness, side effect, adverse event and causality status, with which role, evidence and limits? authority
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to clinical response, observation, effectiveness, side effect, adverse event and causality status, and how is it validated or corrected? measurement
Composition, correction, governance, retention and interoperability Groups governed medication context for composition, correction, governance, retention and interoperability.

Cross-stage composition, status, cancellation and correction lineage

Groups source-qualified medication context for cross-stage composition, status, cancellation and correction lineage.

Request, dispense, administration, statement and care-plan composition

Records request, dispense, administration, statement and care-plan composition as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish request, dispense, administration, statement and care-plan composition? relationship
  2. Who requested, authorized, performed, supplied, received, recorded or reported request, dispense, administration, statement and care-plan composition, with which role, evidence and limits? requirement
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to request, dispense, administration, statement and care-plan composition, and how is it validated or corrected? exception

Independent status, cancel, stop, replace, amend, error, correction and non-cascade

Records independent status, cancel, stop, replace, amend, error, correction and non-cascade as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish independent status, cancel, stop, replace, amend, error, correction and non-cascade? lifecycle
  2. Who requested, authorized, performed, supplied, received, recorded or reported independent status, cancel, stop, replace, amend, error, correction and non-cascade, with which role, evidence and limits? constraint
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to independent status, cancel, stop, replace, amend, error, correction and non-cascade, and how is it validated or corrected? provenance

Provenance, privacy, retention, projection and agent controls

Groups source-qualified medication context for provenance, privacy, retention, projection and agent controls.

Source quality, consent, purpose, access, redaction, disclosure, audit and retention

Records source quality, consent, purpose, access, redaction, disclosure, audit and retention as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish source quality, consent, purpose, access, redaction, disclosure, audit and retention? privacy
  2. Who requested, authorized, performed, supplied, received, recorded or reported source quality, consent, purpose, access, redaction, disclosure, audit and retention, with which role, evidence and limits? event
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to source quality, consent, purpose, access, redaction, disclosure, audit and retention, and how is it validated or corrected? process

FHIR, IDMP, SNOMED, RxNorm, OMOP, UCUM projection, version, loss and round-trip

Records fhir, idmp, snomed, rxnorm, omop, ucum projection, version, loss and round-trip as source-qualified medication-lifecycle context while preserving the distinctions among request, dispense, administration, statement, product knowledge and clinical consequence.

  1. Which stable identities, record class, source-qualified values and explicit unknowns establish fhir, idmp, snomed, rxnorm, omop, ucum projection, version, loss and round-trip? interoperability
  2. Who requested, authorized, performed, supplied, received, recorded or reported fhir, idmp, snomed, rxnorm, omop, ucum projection, version, loss and round-trip, with which role, evidence and limits? temporal
  3. Which event, authored, prepared, handover, occurrence, recorded, reported, ingested and knowledge times apply to fhir, idmp, snomed, rxnorm, omop, ucum projection, version, loss and round-trip, and how is it validated or corrected? validation

Classifiers Filled

Family
World Models
Category
Activities and processes
Entry kind
aggregate
Navigation path
NAV.ACT.HCR
Domain
ACT.HCR
Industry
Cross-industry
Tags
medicationorderadministrationact.hcr

What it is Filled

Owns the aggregate identity and links among medication request, dispense, administration or explicit non-administration, medication statement, discrepancy, reconciliation and safety-check records. Each child keeps its own identity, source, status, actors and times. Patient, practitioner, organization, encounter, care plan, medication and product definition, clinical knowledge, condition, observation, allergy, adverse event, detected issue, coverage, claim, inventory, device, consent, provenance, audit and record masters remain external.

In scope

  • Aggregate and child-record identity, medication and subject bindings, request intent, dosage and dispense authorization, dispense events, administration or non-administration events, reported use and reconciliation
  • Independent status and time axes, substitution and actual dose differences, safety evidence, clinical consequence links, correction, privacy, retention and loss-aware projections

Out of scope

  • Independent patient, practitioner, organization, encounter, care plan, medication, medicinal product, medication knowledge, condition, observation, allergy, adverse event, detected issue, coverage, claim, inventory, device, consent, provenance, audit and record lifecycles
  • Treating a medication request as proof of dispense or exposure, dispense as proof of administration, medication statement as formal event evidence, completed as effective, or association as causation
  • Providing medical advice, prescribing, changing dose, authorizing substitution, dispensing, administering, overriding safety or deciding adherence and causality

Why it exists Filled

Represent a source-qualified medication lifecycle aggregate so agents can distinguish clinical request, supply, actual administration or non-administration, reported use, reconciliation and safety evidence without conflating intent with exposure or consequence.

Distinguishing features Filled

  • Aggregates the whole medication lifecycle for one course, while each request, dispense and administration keeps its own record and status.
  • Separates intent (request), supply (dispense), exposure (administration) and reported use (statement), unlike a medication list that flattens them.
  • Differs from a Care Plan / Episode, which plans and coordinates care but does not record drug supply or doses given.
  • Differs from the medication or product definition, which describes a substance in general and not its use for one patient.

What robots and AI may and may not do Filled

Must not

  • Prescribe, change a dose, authorize substitution, dispense or administer a medicine.
  • Record an administration from a request or a dispense alone.
  • Mark a safety alert as overridden or a patient as adherent by inference.
  • Attribute an adverse event to a medicine as a causal finding.
  • Disclose medication history beyond the permitted purpose, especially for sensitive drug classes.

Only with a human decision

  • Resolving a reconciliation discrepancy or accepting a substitution.
  • Overriding or dismissing a drug interaction or allergy alert.
  • Correcting or retracting a recorded administration.

May

  • Link request, dispense, administration and statement records that share the same source-qualified course.
  • Flag discrepancies between ordered, dispensed and administered dose, product or time for human review.
  • Prepare a reconciliation worksheet from source records for a clinician.
  • Return the minimum necessary medication view to a caller whose purpose is permitted.

Moral aspects Filled

  • Medication errors cause direct physical harm, so a wrong link or a missing non-administration record is a safety issue, not only a data issue.
  • Medication history reveals sensitive conditions such as mental health, HIV or substance use treatment and needs strict purpose limits.
  • Adherence labels can stigmatize patients and affect coverage; they must stay evidence-based and attributable.

Who is affected

  • Patients and their carers
  • Prescribers, pharmacists and nurses accountable for each step
  • Payers and safety reviewers relying on the record

Owners Filled

Steward

Dimension owner and medication-governance mandate

Roles

Medication aggregate steward
Own aggregate boundary, namespace, composition and quality rules.
Authorized requester or prescriber
Own request intent, authority, indication and dosage intent within scope.
Dispenser
Own source-qualified supply, product, quantity, substitution and handover evidence.
Administrator or self-administrator
Own actual administration or explicit non-performance evidence within authority.
Medication reconciliation reviewer
Own source comparison, discrepancy resolution and communication evidence.
Clinical safety reviewer
Own versioned safety-check interpretation, override and escalation review.
Terminology and interoperability steward
Own versioned product, terminology, unit and projection mappings with loss declarations.
Privacy, records and assurance steward
Own protected views, disclosures, holds, retention and auditability.

Links to other meta-models Filled

references

  • WM-ACT-049 Care Plan / Episode - Record candidate inverse containment and planning context without approving the ledger edge or cascade semantics.
  • Patient, Practitioner, Organization, Encounter, CarePlan and Consent models - Resolve authoritative subjects, actors, care context and authority without copying their lifecycle.
  • Medication, substance, medicinal-product, package, inventory and device models - Resolve authoritative product and item identity while retaining actual supplied and administered bindings.
  • Observation, Condition, AllergyIntolerance, DetectedIssue, AdverseEvent, evidence, provenance, audit and record models - Bind safety and clinical consequences without owning their lifecycle or causal adjudication.

aligned

  • FHIR R5, ISO IDMP, SNOMED CT, RxNorm, OMOP CDM 5.4 and UCUM 2.2 - Project version-pinned clinical, regulatory, terminology, analytic and unit views with maturity, regional and information-loss declarations.

neighbor

  • WM-ACT-049 Care Plan / Episode - A care plan may contain medication-request references, but owns goals and planning lifecycle. The ledger relation is candidate and creates no cascade behavior.
  • Medication and medicinal-product definitions - Product masters own substance, strength, dose form, authorization, packaging and knowledge. This aggregate stores versioned references and actual supplied or administered distinctions.
  • MedicationRequest, MedicationDispense and MedicationAdministration - These are separately identifiable intent, supply and exposure records with independent states and event times; the aggregate only composes them.
  • MedicationStatement and medication list - A statement is source-attributed reported or derived belief and is not a prescribe, dispense or administer event. A list is a view over such records, not the aggregate root.
  • Observation, Condition, AllergyIntolerance, DetectedIssue and AdverseEvent - External clinical and safety records own findings, diagnoses, allergies, detected issues and harm assertions. The aggregate keeps typed links and uncertainty without inventing causality.
  • Inventory, supply chain, billing and coverage - External masters own stock, logistics, claims, payment and coverage. Dispense records bind the supplied product, quantity, lot and authorization without absorbing those lifecycles.

parent

  • WM-OBJ-005

What else AI and robots need to interact with it Filled

Identity and identifiers required Filled

  • Authoritative master-system identifier for each medication request, dispense, administration or statement, qualified by source organization and record kind.
  • Governed globally resolvable medication record IRI.
  • Dimension UUID when neither preceding identifier exists.

Direct properties not applicable Not applicable

Not applicable

Institutional or informational subject: no invented physical properties.

Recognition optional Filled

  • A medication record names a patient, a medicine, a dose and route, and one of request, dispense, administration or statement as its kind.
  • Often confused with a prescription document, a medication list, a pharmacy stock movement or a billing claim line.

Capabilities and actions required Filled

  • Register medication lifecycle aggregate: Governed operation to register medication lifecycle aggregate without hidden mutation of external clinical masters.
  • Create or import medication request: Governed operation to create or import medication request without hidden mutation of external clinical masters.
  • Record dispense or non-dispense: Governed operation to record dispense or non-dispense without hidden mutation of external clinical masters.
  • Record administration, non-administration or waste: Governed operation to record administration, non-administration or waste without hidden mutation of external clinical masters.
  • Reconcile medication context: Governed operation to reconcile medication context without hidden mutation of external clinical masters.
  • Record medication safety check: Governed operation to record medication safety check without hidden mutation of external clinical masters.
  • Link response, observation and adverse event: Governed operation to link response, observation and adverse event without hidden mutation of external clinical masters.
  • Cancel, hold, stop or supersede: Governed operation to cancel, hold, stop or supersede without hidden mutation of external clinical masters.
  • Correct medication record: Governed operation to correct medication record without hidden mutation of external clinical masters.
  • Project, retain, disclose and audit: Governed operation to project, retain, disclose and audit without hidden mutation of external clinical masters.

Hazards and failure modes required Filled

  • Wrong patient, wrong drug, wrong dose, wrong route or wrong time when records are mislinked.
  • Double dosing when an administration is not recorded or is recorded twice.
  • Missed allergy or interaction when safety evidence is detached from the order.
  • Privacy breach exposing sensitive treatment history.

Standards and interfaces required Filled

  • HL7 FHIR R5 MedicationRequest, MedicationDispense, MedicationAdministration and MedicationStatement resources.
  • ISO IDMP standards ISO 11615 and ISO 11616 for medicinal product identification.
  • SNOMED CT and the WHO ATC classification for coding medicines.
  • NCPDP SCRIPT for electronic prescribing in the United States.
  • GS1 GTIN and DataMatrix for product and pack identification at the point of dispense or administration.

Context of use required Filled

  • Prescribing authority, substitution, dispensing, controlled substances, self-administration, consent, reporting, retention and disclosure depend on jurisdiction and setting.
  • EMA IDMP and NLM RxNorm are important regional implementations or vocabularies, not universal proof of product identity or authorization.
  • Local formularies, packages, product identifiers, safety knowledge and interaction rules require versioned institutional or jurisdictional profiles.

Sources Filled

  1. FHIR R5 MedicationRequest - Health Level Seven International
  2. FHIR R5 MedicationDispense - Health Level Seven International
  3. FHIR R5 MedicationAdministration - Health Level Seven International
  4. FHIR R5 MedicationStatement - Health Level Seven International
  5. FHIR R5 Medication - Health Level Seven International
  6. FHIR R5 Medications Module - Health Level Seven International
  7. Medication safety in transitions of care - World Health Organization
  8. Medication safety in high-risk situations - World Health Organization
  9. International Nonproprietary Names Programme and Classification of Medical Products - World Health Organization
  10. Data on medicines: ISO IDMP standards overview - European Medicines Agency
  11. SNOMED CT Pharmaceutical and Biologic Product - SNOMED International
  12. RxNorm Overview - United States National Library of Medicine
  13. OMOP Common Data Model v5.4 - Observational Health Data Sciences and Informatics
  14. Unified Code for Units of Measure - Regenstrief Institute and UCUM Organization
  15. Regulation (EU) 2016/679 General Data Protection Regulation - European Union
  16. PROV-O: The PROV Ontology - World Wide Web Consortium
  17. Date and Time on the Internet: Timestamps - Internet Engineering Task Force

Open questions

  • Approve or reject the WM-ACT-049 containment edge and define cardinality, plan membership and non-cascade semantics.
  • Create specialty profiles for pediatric, oncology, renal, pregnancy, anesthesia, infusion, controlled-substance and veterinary medication lifecycles.
  • Create jurisdiction and institution profiles for prescribing, substitution, dispensing, administration, reconciliation, safety, reporting, retention and access.
  • Test release-pinned FHIR, IDMP, SNOMED CT, RxNorm, OMOP CDM and UCUM mappings with round-trip and mapping-loss evidence.
  • Obtain supplemental independent external review and resolve any material challenge before canonical promotion.
  • Claude and Grok each timed out on one bounded attempt; no independent external result was admitted.
  • WM-ACT-049 Care Plan / Episode CONTAINS WM-ACT-048 is candidate metadata and not an approved composition edge.
  • Pediatric, oncology, renal, pregnancy, anesthesia, infusion, controlled-substance, veterinary and other medication domains require specialty and jurisdiction profiles.
  • FHIR R5 medication resources are Trial Use at varied maturity; full IDMP, SNOMED CT, RxNorm, OMOP and UCUM mappings require release-pinned testing.

Machine files

Card as JSON Specification AGENTS.md Source Card backlog vercy.card/1

Provenance

world-models research · reviewable-draft

Built from: models/wm-act-048-medication-order-administration/spec.yaml, ver-cy/world-models/card-supplements/wm-act-048-medication-order-administration.json