This page is part of the FHIR Specification (v0.01: Historical Archive Draft). The current version which supercedes this version is 4.0.1. For a full list of available versions, see the Directory of published versions

# Prescription

Directions provided by a prescribing practitioner for a specific medication to be administered to an individual.

The relative url is /prescriptions

## Content

    <Prescription xmlns="http://www.hl7.org/fhir">
      <id> mand id Master Resource Id, always first in all resources</id>
      <identifier> mand Zero+ HumanId Prescription identification</identifier>
      <status> mand code Status: Active|Completed</status>
      <patient> mand (Patient) Patient receiving medicine</patient>
      <prescriber> mand (Agent) Prescribing doctor</prescriber>
      <prescribed> mand dateTime Date/time prescribed</prescribed>
      <dispense> opt  <!-- Details of included dispense request -->
       <repeats> opt integer Number of repeats</repeats>
       <quantity> mand Quantity Quantity per repeat</quantity>
       <dispenser> opt (Agent|Organization) Person to fullfil the requested dispense</dispenser>
      </dispense>
      <medicine> mand  <!-- Prescribed medicine -->
       <productCode> cond Coding Coded representation of medicine</productCode>
       <description> cond string Textual description of medicine</description>
       <activeIngredient> opt  <!-- Zero+ Active substance -->
        <productCode> mand Coding Coded representation of active ingredient</productCode>
        <quantity> opt Ratio Relative quantity of active ingredient</quantity>
       </activeIngredient>
       <inactiveIngredient> opt  <!-- Zero+ Inactive substance -->
        <productCode> mand Coding Coded representation of inactive ingredient</productCode>
        <quantity> opt Ratio Relative quantity of inactive ingredient</quantity>
       </inactiveIngredient>
      </medicine>
      <administrationRequest> mand  <!-- Instructions for use -->
       <description> opt string Textual instructions for use</description>
       <totalPeriodicDosis> opt Ratio Total periodic dosis</totalPeriodicDosis>
       <start> cond dateTime Startdate for administration</start>
       <end> cond dateTime Enddate for administration</end>
       <duration> cond Quantity Total duration of administration</duration>
       <numberOfAdministrations> cond integer Maximum number of separate administrations</numberOfAdministrations>
       <dosageInstruction> mand  <!-- One+ Dosage instruction -->
        <precondition> opt Zero+ CodeableConcept Precondition for starting administration</precondition>
        <prn> opt code Pro re nate: Yes|No</prn>
        <additionalInstruction> opt Zero+ CodeableConcept Additional instructions</additionalInstruction>
        <route> opt CodeableConcept Route of administration</route>
        <dose[x]> mand Quantity|Interval(Quantity) Dose per administration</dose[x]>
        <rate> opt Quantity Flow-rate for IV</rate>
        <schedule> mand One+ Schedule Schedule for administration</schedule>
       </dosageInstruction>
      </administrationRequest>
      <reason> opt CodeableConcept Reason for prescription</reason>
      <extensions> opt See Extensions   See Extensions </extensions>
      <text> mand Narrative Text summary of the prescription, for human interpretation</text>
    </Prescription>

Schema for Prescription and an example (or formatted for browser)

Terminology Bindings

- Prescription.status is bound to the concept domain PrescriptionStatus: "The status of a prescription". Possible values:

  active | Patient is using the prescribed medicin
  completed | Prescription is no longer current

- Prescription.medicine.productCode, Prescription.medicine.activeIngredient.productCode and Prescription.medicine.inactiveIngredient.productCode are bound to the concept domain MedicationKind: "The kind of medication, vaccine or therapeutic material". The possible values are those specified in G-Standaard (Netherlands), AMT (Australie)
- Prescription.administrationRequest.dosageInstruction.precondition is bound to the concept domain AdministrationPrecondition: "Precondition for administering medication". The possible values are those specified in NHG Table 25b
- Prescription.administrationRequest.dosageInstruction.prn is bound to the concept domain BooleanYesNo: "Either yes or no, true or false". Possible values:

  yes | TRUE
  no | FALSE

- Prescription.administrationRequest.dosageInstruction.additionalInstruction is bound to the concept domain AdministrationInstruction: "Instructions for administering medication". The possible values are those specified in NHG Table 25b
- Prescription.administrationRequest.dosageInstruction.route is bound to the concept domain AdministrationRoute: "Route by which a medication is administered". The possible values are those specified in G-Standaard subtable 0007
- Prescription.reason is bound to the concept domain PrescriptionReason: "Medical reason for prescribing a medicine". The possible values are those specified in ICD-10, ICPC-1

Notes:

- TODO

## RESTful Transactions

TODO

There is no content model for the response, except for an HTTP status code.

## Searching Criteria

The following simple search/filter parameters are defined for prescription:

patient | The identity of a patient to list prescriptions for
prescriber | The identity of a prescriber to list prescriptions from
startdate | Return only prescriptions made starting from this date
enddate | Return only prescriptions made before this date
id | search id in any prescription identifiers

The standard search parameters also apply (see Searching).

## Formal Definitions

The formal definitions for the elements above. Also available as an XML file.

Prescription
Definition | Directions provided by a prescribing practitioner for a specific medication to be administered to an individual
Control | Mandatory, 1..1
Requirements | Used to record details about the prescribed medication, administration schedule, dosage and dispensing.
RIM Mapping | SubstanceAdministration
Prescription.id
Definition | Master Resource Id, always first in all resources
Control | Mandatory, 1..1
Type | id
Prescription.identifier
Definition | A identifier used in an external system and associated with this medication
Control | Mandatory, 0..*
Type | HumanId
Must Understand | true
Requirements | Prescriptions are almost always assigned specific numerical identifiers
RIM Mapping | .id
Prescription.status
Definition | Actual status of the prescription
Control | Mandatory, 1..1
Type | code from PrescriptionStatus
Must Understand | true
RIM Mapping | .statusCode
Prescription.patient
Definition | The patient the prescription is prescribing medicine for
Control | Mandatory, 1..1
Type | Resource(Patient)
Must Understand | true
Prescription.prescriber
Definition | The clinician or doctor prescribing the medication
Control | Mandatory, 1..1
Type | Resource(Agent)
Prescription.prescribed
Definition | Date/time on which the prescription was written
Control | Mandatory, 1..1
Type | dateTime
Prescription.dispense
Definition | Details of the dispense as requested by the prescriber
Control | Optional, 0..1
Prescription.dispense.repeats
Definition | Requested number of repeats
Control | Optional, 0..1
Type | integer
Comments | Default is "1"
Prescription.dispense.quantity
Definition | Requested quantity per repeat
Control | Mandatory, 1..1
Type | Quantity
Prescription.dispense.dispenser
Definition | Person to fullfil the requested dispense
Control | Optional, 0..1
Type | Resource(Agent|Organization)
Prescription.medicine
Definition | The one single medicatine, vaccine or therapeutic good prescribed in this prescription.
Control | Mandatory, 1..1
Prescription.medicine.productCode
Definition | Coded representation of medicine
Control | Conditional, 0..1: Can only be left empty if it cannot be coded
Type | Coding from MedicationKind
Must Understand | true
To Do | Conformance should be "Required", not "Optional"
Prescription.medicine.description
Definition | Textual description of medicine, including strength and ingredients
Control | Conditional, 0..1: Mandatory when medication cannot be coded
Type | string
Prescription.medicine.activeIngredient
Definition | The substance in the medication formulation that is pharmaceutically active and is responsible for the medication's therapeutic effect
Control | Optional, 0..*
Prescription.medicine.activeIngredient.productCode
Definition | Coded representation of active ingredient
Control | Mandatory, 1..1
Type | Coding from MedicationKind
Prescription.medicine.activeIngredient.quantity
Definition | Quantity of active ingredient expressed in relation to the whole of the prepared medicine
Control | Optional, 0..1
Type | Ratio
Prescription.medicine.inactiveIngredient
Definition | Ingredients in the medication that are not active
Control | Optional, 0..*
Prescription.medicine.inactiveIngredient.productCode
Definition | Coded representation of the inactive ingredient
Control | Mandatory, 1..1
Type | Coding from MedicationKind
Prescription.medicine.inactiveIngredient.quantity
Definition | Quantity of inactive ingredient expressed in relation to the whole of the prepared medicine
Control | Optional, 0..1
Type | Ratio
Prescription.administrationRequest
Definition | Instructions for the use of the medication. Includes details about the timing schedule, dosis amounts and additional usage instructions.
Control | Mandatory, 1..1
Prescription.administrationRequest.description
Definition | Textual description of the use of the medication.
Control | Optional, 0..1
Type | string
Comments | Can contain more details than the structured information under this element, but must be in accordance with it. May not contain information about the medicine itself.
Prescription.administrationRequest.totalPeriodicDosis
Definition | Total dose per day/week or other period when more specific information is missing or cannot be expressed using the timing specifications.
Control | Optional, 0..1
Type | Ratio
Requirements | It should be possible, as a last resort, to specify e.g. a daily dosis, even if more specific details are unknown
Prescription.administrationRequest.start
Definition | First moment on which medication should be taken
Control | Conditional, 0..1: Duration is given OR (Start is given AND (Duration OR End is given)) OR (Duration, Start and End are not given)
Type | dateTime
Prescription.administrationRequest.end
Definition | Last moment on which medication should be taken
Control | Conditional, 0..1: Duration is given OR (Start is given AND (Duration OR End is given)) OR (Duration, Start and End are not given)
Type | dateTime
Prescription.administrationRequest.duration
Definition | Total duration of administration
Control | Conditional, 0..1: Duration is given OR (Start is given AND (Duration OR End is given)) OR (Duration, Start and End are not given)
Type | Quantity
Prescription.administrationRequest.numberOfAdministrations
Definition | Maximum number of separate administrations before the instruction ends.
Control | Conditional, 0..1: Can be given instead of Duration, as specified above
Type | integer
Prescription.administrationRequest.dosageInstruction
Definition | Specification of dose and schedule for administration
Control | Mandatory, 1..*
Comments | The can be >1 dosage instruction to support administration of varying doses, resulting in 1 instruction per fixed dose.
Prescription.administrationRequest.dosageInstruction.precondition
Definition | Precondition for starting the administration specified in this instruction
Control | Optional, 0..*
Type | CodeableConcept from AdministrationPrecondition
Prescription.administrationRequest.dosageInstruction.prn
Definition | Pro re nate, "If necessary": Specifies whether administration depens on the state and symptoms of the patient
Control | Optional, 0..1
Type | code from BooleanYesNo
Comments | Default is "false"
Prescription.administrationRequest.dosageInstruction.additionalInstruction
Definition | Additional details to guide administration. Especially relevant for medicine administered by patient
Control | Optional, 0..*
Type | CodeableConcept from AdministrationInstruction
Prescription.administrationRequest.dosageInstruction.route
Definition | Route of administration (oral, nasal, intravenous)
Control | Optional, 0..1
Type | CodeableConcept from AdministrationRoute
Comments | Since the route of administration is generally determined by the choice of medication, it is not necessary to provide a value in route
Prescription.administrationRequest.dosageInstruction.dose[x]
Definition | Dose per administration, expressed in units of the (prepared) product
Control | Mandatory, 1..1
Type | Quantity|Interval(Quantity)
Comments | Dose may be an interval, "2-3 tablets per 4 hours"
Prescription.administrationRequest.dosageInstruction.rate
Definition | Flow-rate for IV
Control | Optional, 0..1
Type | Quantity
Prescription.administrationRequest.dosageInstruction.schedule
Definition | Schedule for administration. If multiple are given, they are considered to be active in parrallel
Control | Mandatory, 1..*
Type | Schedule
Comments | Will submit proposal to change Schedule type.
Prescription.reason
Definition | Diagnosis which is the reason for prescribing this medicine
Control | Optional, 0..1
Type | CodeableConcept from PrescriptionReason
Prescription.extensions
Definition | See Extensions
Control | Optional, 0..1
Prescription.text
Definition | Text summary of the prescription, for human interpretation
Control | Mandatory, 1..1
Type | Narrative

This is an old version of FHIR retained for archive purposes. Do not use for anything else
Implementers are welcome to experiment with the content defined here, but should note that the contents are subject to change without prior notice.
© HL7.org 2011 - 2012. FHIR v0.01 generated on Mon, May 14, 2012 09:48+1000.