StructureDefinition: GAO Medication Order - XML

GAO Medication Order

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="gao-medicationorder"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">

      <h2>GAO Medication Order</h2>

      <p>Profiles the medication order to ensure that the services ordered can be identified and
         evaluated for appropraiteness</p>

      <h3>Requirements</h3>

      <p>The medication order resource is required to identify the medications ordered, and to
         provide additional details that may be necessary to evaluate the order for appropriateness.</p>

    </div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/gao-medicationorder"/>
  <name value="GAO Medication Order"/>
  <status value="draft"/>
  <date value="2015-09-22T20:02:49+10:00"/>
  <description value="Profiles the medication order to ensure that the services ordered can be identified and
   evaluated for appropraiteness"/>
  <requirements value="The medication order resource is required to identify the medications ordered, and to
   provide additional details that may be necessary to evaluate the order for appropriateness."/>
  <fhirVersion value="1.1.0"/>
  <kind value="resource"/>
  <constrainedType value="MedicationOrder"/>
  <abstract value="false"/>
  <base value="http://hl7.org/fhir/StructureDefinition/MedicationOrder"/>
  <snapshot>
    <element>
      <path value="MedicationOrder"/>
      <short value="Prescription of medication to for patient"/>
      <definition value="An order for both supply of the medication and the instructions for administration of
       the medication to a patient. The resource is called &quot;MedicationOrder&quot; rather
       than &quot;MedicationPrescription&quot; to generalize the use across inpatient and outpatient
       settings as well as for care plans, etc."/>
      <alias value="Prescription"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="MedicationOrder"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="CombinedMedicationRequest"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.medication"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="A human language."/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="MedicationOrder.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/>
      <comments value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order 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 is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order 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 is allowed to 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.identifier"/>
      <short value="External identifier"/>
      <definition value="External identifier - one that would be used by another non-FHIR system - for example
       a re-imbursement system might issue its own id for each prescription that is created.
        This is particularly important where FHIR only provides part of an entire workflow process
       where records have to be tracked through an entire system."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-2-Placer Order Number / ORC-3-Filler Order Number"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dateWritten"/>
      <short value="When prescription was authorized"/>
      <definition value="The date (and perhaps time) when the prescription was written."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dateWritten"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="author.time"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.status"/>
      <short value="active | on-hold | completed | entered-in-error | stopped | draft"/>
      <definition value="A code specifying the state of the order.  Generally this will be active or completed
       state."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="A code specifying the state of the prescribing event. Describes the lifecycle of the prescription."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/medication-order-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="statusCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dateEnded"/>
      <short value="When prescription was stopped"/>
      <definition value="The date (and perhaps time) when the prescription was stopped."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dateEnded"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.reasonEnded"/>
      <short value="Why prescription was stopped"/>
      <definition value="The reason why the prescription was stopped, if it was."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.reasonEnded"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes indicating why the medication was terminated; e.g. Adverse reaction, medication
         change, issue resolved, etc."/>
      </binding>
    </element>
    <element>
      <path value="MedicationOrder.patient"/>
      <short value="Who prescription is for"/>
      <definition value="A link to a resource representing the person to whom the medication will be given."/>
      <comments value="SubstanceAdministration-&gt;subject-&gt;Patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.patient"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3-Patient ID List"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="subject.role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.prescriber"/>
      <short value="Who ordered the medication(s)"/>
      <definition value="The healthcare professional responsible for authorizing the prescription."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.prescriber"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Tr
        eatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering
         Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="author.role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.encounter"/>
      <short value="Created during encounter/admission/stay"/>
      <definition value="A link to a resource that identifies the particular occurrence of contact between patient
       and health care provider."/>
      <comments value="SubstanceAdministration-&gt;component-&gt;EncounterEvent."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19-Visit Number"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="componentOf.patientEncounter"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.reasonCodeableConcept"/>
      <short value="Reason or indication for writing the prescription"/>
      <definition value="Can be the reason or the indication for writing the prescription."/>
      <requirements value="The reason for the prescription SHALL be provided."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.reason[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes indicating why the medication was ordered."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication
         / RXG-22-Indication / RXA-19-Indication"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="reason.observation or reason.observation[code=ASSERTION].value"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.note"/>
      <short value="Information about the prescription"/>
      <definition value="Extra information about the prescription that could not be conveyed by the other attributes."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.note"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.medication[x]"/>
      <short value="Medication to be taken"/>
      <definition value="Identifies the medication being administered. This is a link to a resource that represents
       the medication which may be the details of the medication or simply an attribute carrying
       a code that identifies the medication from a known list of medications."/>
      <comments value="If only a code is specified, then it needs to be a code for a specific product.  If more
       information is required, then the use of the medication resource is recommended.  Note:
       do not use Medication.name to describe the prescribed medication. When the only available
       information is a text description of the medication, Medication.code.text should be used."/>
      <requirements value="The medication being prescribed SHALL be described.  The medication being prescribe is
       necessary to determine whether it is appropriate."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.medication[x]"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="consumable.administrableMedication"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction"/>
      <short value="How medication should be taken"/>
      <definition value="Indicates how the medication is to be used by the patient."/>
      <comments value="When the dose or rate is intended to change over the entire administration period, e.g.
       Tapering dose prescriptions, multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates. Another common example in institutional
       settings is 'titration' of an IV medication dose to maintain a specific stated hemodynamic
       value or range e.g. drug x to be administered to maintain AM (arterial mean) greater than
       65."/>
      <requirements value="At least one dosage instruction SHALL be provided.  This will enable the dosage to be
       evaluated for appropriateness."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.dosageInstruction"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="component.substanceAdministrationRequest"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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 is allowed to 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.text"/>
      <short value="Dosage instructions expressed as text"/>
      <definition value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-7.2-Provider's Administration Instructions.text / RXO-7.2-Provider's Administration
         Instructions.text / TQ1-10-Condition Text / TQ1-11-Text Instruction"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="text"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.additionalInstructions"/>
      <short value="Supplemental instructions - e.g. &quot;with meals&quot;"/>
      <definition value="Additional instructions such as &quot;Swallow with plenty of water&quot; which may or
       may not be coded."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.additionalInstructions"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes identifying additional instructions such as &quot;take with water&quot; or &quot;avoid
         operating heavy machinery&quot;."/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-7.2-Provider's Administration Instructions.text / RXO-7.2-Provider's Administration
         Instructions.text / TQ1-10-Condition Text / TQ1-11-Text Instruction"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="component.substanceAdministrationRequest.text"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.timing"/>
      <short value="When medication should be administered"/>
      <definition value="The timing schedule for giving the medication to the patient. The Schedule data type allows
       many different expressions. For example: &quot;Every 8 hours&quot;; &quot;Three times
       a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;; &quot;15
       Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;."/>
      <comments value="This attribute may not always be populated while the DosageInstruction.text is expected
       to be populated.  If both are populated, then the DosageInstruction.text should reflect
       the content of the Dosage.timing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.timing"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Timing"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="TQ1-X / ORC Quantity/timing"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.asNeeded[x]"/>
      <short value="Take &quot;as needed&quot; (for x)"/>
      <definition value="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)."/>
      <comments value="Specifically if 'boolean' datatype is selected, then the following logic applies:  If
       set to True, this indicates that the medication is only taken when needed, within the
       specified schedule."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.asNeeded[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept identifying the precondition that should be met or evaluated prior to
         consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30
         minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc."/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false
          CodeableConcept: precondition.observationEventCriterion[code=&quot;Assertion&quot;].value"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.site[x]"/>
      <short value="Body site to administer to"/>
      <definition value="A coded specification of the anatomic site where the medication first enters the body."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.site[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/BodySite"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing the site location the medicine enters into or onto the body."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/approach-site-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-2-Administration Site"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="approachSiteCode"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.route"/>
      <short value="How drug should enter body"/>
      <definition value="A code specifying the route or physiological path of administration of a therapeutic agent
       into or onto a patient's body."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.route"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing the route or physiological path of administration of a therapeutic
         agent into or onto the body of a subject."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/route-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-1-Route"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="routeCode"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.method"/>
      <short value="Technique for administering medication"/>
      <definition value="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."/>
      <comments value="Terminologies used often pre-coordinate this term with the route and or form of administration."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.method"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing the technique by which the medicine is administered."/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXR-4-Administration Method"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="methodCode"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.dose[x]"/>
      <short value="Amount of medication per dose"/>
      <definition value="The amount of therapeutic or other substance given at one administration event."/>
      <comments value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.dose[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name
         of coding system"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="doseQuantity"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.rate[x]"/>
      <short value="Amount of medication per unit of time"/>
      <definition value="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.   Currently we do not specify a default
       of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or
       200 mcg/1 minute; 1 liter/8 hours."/>
      <comments value="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 MedicationOrder with an updated rate, or captured with a new MedicationOrder
       with the new rate."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.rate[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-22-Give Per (Time Unit)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="rateQuantity"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction.maxDosePerPeriod"/>
      <short value="Upper limit on medication per unit of time"/>
      <definition value="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."/>
      <comments value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For
       example &quot;2 tablets every 4 hours to a maximum of 8/day&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dosageInstruction.maxDosePerPeriod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Ratio"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-4-Give Amount - Maximum / RXE-5-Give Units"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="maxDoseQuantity"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest"/>
      <short value="Medication supply authorization"/>
      <definition value="Indicates the specific details for the dispense or medication supply part of a medication
       order (also known as a Medication Prescription).  Note that this information is NOT always
       sent with the order.  There may be in some settings (e.g. hospitals) institutional or
       system support for completing the dispense details in the pharmacy department."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="component.supplyEvent"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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 is allowed to 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.medication[x]"/>
      <short value="Product to be supplied"/>
      <definition value="Identifies the medication being administered. This is a link to a resource that represents
       the medication which may be the details of the medication or simply an attribute carrying
       a code that identifies the medication from a known list of medications."/>
      <comments value="If only a code is specified, then it needs to be a code for a specific product.  If more
       information is required, then the use of the medication resource is recommended."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.medication[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-2-Give Code / RXO-1-Requested Give Code / RXD-2-Dispense/Give Code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="consumable.role"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.validityPeriod"/>
      <short value="Time period supply is authorized for"/>
      <definition value="This indicates the validity period of a prescription (stale dating the Prescription)."/>
      <comments value="It reflects the prescriber perspective for the validity of the prescription. Dispenses
       must not be made against the prescription outside of this period. The lower-bound of the
       Dispensing Window signifies the earliest date that the prescription can be filled for
       the first time. If an upper-bound is not specified then the Prescription is open-ended
       or will default to a stale-date based on regulations."/>
      <requirements value="Indicates when the Prescription becomes valid, and when it ceases to be a dispensable
       Prescription."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.validityPeriod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.numberOfRepeatsAllowed"/>
      <short value="Number of refills authorized"/>
      <definition value="An integer indicating the number of additional times (aka refills or repeats) the patient
       can receive the prescribed medication.   Usage Notes: This integer does NOT include the
       original order dispense.   This means that if an order indicates dispense 30 tablets plus
        &quot;3 repeats&quot;, then the order can be dispensed a total of 4 times and the patient
       can receive a total of 120 tablets."/>
      <comments value="If displaying &quot;number of authorized refills&quot;, subtract 1 from this number."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.numberOfRepeatsAllowed"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-12-Number of Refills"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="repeatNumber"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.quantity"/>
      <short value="Amount of medication to supply per dispense"/>
      <definition value="The amount that is to be dispensed for one fill."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.quantity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="quantity"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.dispenseRequest.expectedSupplyDuration"/>
      <short value="Number of days supply per dispense"/>
      <definition value="Identifies the period time over which the supplied product is expected to be used, or
       the length of time the dispense is expected to last."/>
      <comments value="In some situations, this attribute may be used instead of quantity to identify the amount
       supplied by how long it is expected to last, rather than the physical quantity issued,
       e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always
       better to specify quantity, as this tends to be more precise. expectedSupplyDuration will
       always be an estimate that can be influenced by external factors."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.dispenseRequest.expectedSupplyDuration"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Duration"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="expectedUseTime"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.substitution"/>
      <short value="Any restrictions on medication substitution"/>
      <definition value="Indicates whether or not substitution can or should be part of the dispense. In some cases
       substitution must happen, in other cases substitution must not happen, and in others it
       does not matter. This block explains the prescriber's intent. If nothing is specified
       substitution may be done."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.substitution"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="subjectOf.substitutionPersmission"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.substitution.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.substitution.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.substitution.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.substitution.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.substitution.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="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 that contains it. Usually
       modifier elements provide negation or qualification. In order 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 is allowed to 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."/>
      <comments value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationOrder.substitution.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.substitution.type"/>
      <short value="generic | formulary +"/>
      <definition value="A code signifying whether a different drug should be dispensed from what was prescribed."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.substitution.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing whether a different medicinal product may be dispensed other
         than the product as specified exactly in the prescription."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.substitution.reason"/>
      <short value="Why should (not) substitution be made"/>
      <definition value="Indicates the reason for the substitution, or why substitution must or must not be performed."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.substitution.reason"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="A coded concept describing the reason that a different medication should (or should not)
         be substituted from what was prescribed."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXE-9 Substition status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="reasonCode"/>
      </mapping>
    </element>
    <element>
      <path value="MedicationOrder.priorPrescription"/>
      <short value="An order/prescription that this supersedes"/>
      <definition value="A link to a resource representing an earlier order or prescription that this order supersedes."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationOrder.priorPrescription"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/MedicationOrder"/>
      </type>
      <isSummary value="true"/>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="MedicationOrder"/>
      <short value="Prescription of medication to for patient"/>
      <definition value="An order for both supply of the medication and the instructions for administration of
       the medication to a patient. The resource is called &quot;MedicationOrder&quot; rather
       than &quot;MedicationPrescription&quot; to generalize the use across inpatient and outpatient
       settings as well as for care plans, etc."/>
      <alias value="Prescription"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="MedicationOrder"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.reason[x]"/>
      <short value="Reason or indication for writing the prescription"/>
      <definition value="Can be the reason or the indication for writing the prescription."/>
      <requirements value="The reason for the prescription SHALL be provided."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes indicating why the medication was ordered."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="MedicationOrder.medication[x]"/>
      <short value="Medication to be taken"/>
      <definition value="Identifies the medication being administered. This is a link to a resource that represents
       the medication which may be the details of the medication or simply an attribute carrying
       a code that identifies the medication from a known list of medications."/>
      <comments value="If only a code is specified, then it needs to be a code for a specific product.  If more
       information is required, then the use of the medication resource is recommended.  Note:
       do not use Medication.name to describe the prescribed medication. When the only available
       information is a text description of the medication, Medication.code.text should be used."/>
      <requirements value="The medication being prescribed SHALL be described.  The medication being prescribe is
       necessary to determine whether it is appropriate."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="MedicationOrder.dosageInstruction"/>
      <short value="How medication should be taken"/>
      <definition value="Indicates how the medication is to be used by the patient."/>
      <comments value="When the dose or rate is intended to change over the entire administration period, e.g.
       Tapering dose prescriptions, multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates. Another common example in institutional
       settings is 'titration' of an IV medication dose to maintain a specific stated hemodynamic
       value or range e.g. drug x to be administered to maintain AM (arterial mean) greater than
       65."/>
      <requirements value="At least one dosage instruction SHALL be provided.  This will enable the dosage to be
       evaluated for appropriateness."/>
      <min value="1"/>
      <max value="*"/>
      <isSummary value="true"/>
    </element>
  </differential>
</StructureDefinition>