This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
StructureDefinition for medicationorder
{ "resourceType": "StructureDefinition", "id": "MedicationOrder", "meta": { "lastUpdated": "2016-08-11T17:02:54.322+10:00" }, "text": { "status": "generated", "div": "<div>!-- Snipped for Brevity --></div>" }, "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger": 1 } ], "url": "http://hl7.org/fhir/StructureDefinition/MedicationOrder", "name": "MedicationOrder", "status": "draft", "publisher": "Health Level Seven International (Pharmacy)", "contact": [ { "telecom": [ { "system": "other", "value": "http://hl7.org/fhir" } ] }, { "telecom": [ { "system": "other", "value": "http://www.hl7.org/Special/committees/medication/index.cfm" } ] } ], "date": "2016-08-11T17:02:54+10:00", "description": "Base StructureDefinition for MedicationOrder Resource", "fhirVersion": "1.6.0", "mapping": [ { "identity": "script10.6", "uri": "http://ncpdp.org/SCRIPT10_6", "name": "Mapping to NCPDP SCRIPT 10.6" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/w5", "name": "W5 Mapping" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" } ], "kind": "resource", "abstract": false, "type": "MedicationOrder", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource", "derivation": "specialization", "snapshot": { "element": [ { "id": "MedicationOrder", "path": "MedicationOrder", "short": "Prescription of medication to for patient", "definition": "An order for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called \"MedicationOrder\" rather than \"MedicationPrescription\" to generalize the use across inpatient and outpatient settings as well as for care plans, etc.", "comments": "The WG will be updating the MedicationOrder resource to adjust each affected resource to align with the workflow pattern (see workflow.html). MedicationOrder will be renamed to MedicationRequest as part of these changes.", "alias": [ "Prescription" ], "min": 0, "max": "*", "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)" }, { "key": "dom-1", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative", "expression": "contained.text.empty()", "xpath": "not(parent::f:contained and f:text)" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" }, { "key": "dom-3", "severity": "error", "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource", "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()", "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "script10.6", "map": "Message/Body/NewRx" }, { "identity": "rim", "map": "CombinedMedicationRequest" }, { "identity": "w5", "map": "clinical.medication" } ] }, { "id": "MedicationOrder.id", "path": "MedicationOrder.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "*" }, "type": [ { "code": "id" } ], "isSummary": true }, { "id": "MedicationOrder.meta", "path": "MedicationOrder.meta", "short": "Metadata about the resource", "definition": "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": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "*" }, "type": [ { "code": "Meta" } ], "isSummary": true }, { "id": "MedicationOrder.implicitRules", "path": "MedicationOrder.implicitRules", "short": "A set of rules under which this content was created", "definition": "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": "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": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "*" }, "type": [ { "code": "uri" } ], "isModifier": true, "isSummary": true }, { "id": "MedicationOrder.language", "path": "MedicationOrder.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comments": "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": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "*" }, "type": [ { "code": "code" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueReference": { "reference": "http://hl7.org/fhir/ValueSet/all-languages" } } ], "strength": "extensible", "description": "A human language.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/languages" } } }, { "id": "MedicationOrder.text", "path": "MedicationOrder.text", "short": "Text summary of the resource, for human interpretation", "definition": "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 \"clinically safe\" 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": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "*" }, "type": [ { "code": "Narrative" } ], "condition": [ "dom-1" ], "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "MedicationOrder.contained", "path": "MedicationOrder.contained", "short": "Contained, inline Resources", "definition": "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": "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": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.extension", "path": "MedicationOrder.extension", "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the 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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.modifierExtension", "path": "MedicationOrder.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.identifier", "path": "MedicationOrder.identifier", "short": "External identifier", "definition": "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": 0, "max": "*", "type": [ { "code": "Identifier" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Header/PrescriberOrderNumber" }, { "identity": "v2", "map": "ORC-2-Placer Order Number / ORC-3-Filler Order Number" }, { "identity": "rim", "map": "id" }, { "identity": "w5", "map": "id" } ] }, { "id": "MedicationOrder.status", "path": "MedicationOrder.status", "short": "active | on-hold | completed | entered-in-error | stopped | draft", "definition": "A code specifying the state of the order. Generally this will be active or completed state.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "isModifier": true, "isSummary": true, "binding": { "strength": "required", "description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-order-status" } }, "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "rim", "map": "statusCode" }, { "identity": "w5", "map": "status" } ] }, { "id": "MedicationOrder.medication[x]", "path": "MedicationOrder.medication[x]", "short": "Medication to be taken", "definition": "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": "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.", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Medication" } ], "isSummary": true, "binding": { "strength": "example", "description": "A coded concept identifying substance or product that can be ordered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-codes" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed\n\nMedication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode\n\nMedication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier\n\nMedication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription" }, { "identity": "v2", "map": "RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code" }, { "identity": "rim", "map": "consumable.administrableMedication" }, { "identity": "w5", "map": "what" } ] }, { "id": "MedicationOrder.patient", "path": "MedicationOrder.patient", "short": "Who prescription is for", "definition": "A link to a resource representing the person to whom the medication will be given.", "comments": "SubstanceAdministration->subject->Patient.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Patient" } ], "isSummary": true, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/Patient\n\n(need detail to link to specific patient … Patient.Identification in SCRIPT)" }, { "identity": "v2", "map": "PID-3-Patient ID List" }, { "identity": "rim", "map": "subject.role" }, { "identity": "w5", "map": "who.focus" } ] }, { "id": "MedicationOrder.encounter", "path": "MedicationOrder.encounter", "short": "Created during encounter/admission/stay", "definition": "A link to a resource that identifies the particular occurrence of contact between patient and health care provider.", "comments": "SubstanceAdministration->component->EncounterEvent.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Encounter" } ], "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "v2", "map": "PV1-19-Visit Number" }, { "identity": "rim", "map": "componentOf.patientEncounter" }, { "identity": "w5", "map": "context" } ] }, { "id": "MedicationOrder.dateWritten", "path": "MedicationOrder.dateWritten", "short": "When prescription was initially authorized", "definition": "The date (and perhaps time) when the prescription was initially written.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/WrittenDate" }, { "identity": "v2", "map": "RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction" }, { "identity": "rim", "map": "author.time" }, { "identity": "w5", "map": "when.recorded" } ] }, { "id": "MedicationOrder.prescriber", "path": "MedicationOrder.prescriber", "short": "Who ordered the initial medication(s)", "definition": "The healthcare professional responsible for authorizing the initial prescription.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "isSummary": true, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/Prescriber\n\n(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)" }, { "identity": "v2", "map": "RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment 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)" }, { "identity": "rim", "map": "author.role" }, { "identity": "w5", "map": "who.actor" } ] }, { "id": "MedicationOrder.reasonCode", "path": "MedicationOrder.reasonCode", "short": "Reason or indication for writing the prescription", "definition": "Can be the reason or the indication for writing the prescription.", "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept indicating why the medication was ordered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/condition-code" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value" }, { "identity": "v2", "map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication" }, { "identity": "rim", "map": "reason.observation.reasonCode" }, { "identity": "w5", "map": "why" } ] }, { "id": "MedicationOrder.reasonReference", "path": "MedicationOrder.reasonReference", "short": "Condition that supports why the prescription is being written", "definition": "Condition that supports why the prescription is being written.", "comments": "This is a reference to a condition that is the reason for the medication order. If only a code exists, use reasonCode.", "min": 0, "max": "*", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Condition" } ], "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "rim", "map": "reason.observation[code=ASSERTION].value" }, { "identity": "w5", "map": "why" } ] }, { "id": "MedicationOrder.note", "path": "MedicationOrder.note", "short": "Information about the prescription", "definition": "Extra information about the prescription that could not be conveyed by the other attributes.", "min": 0, "max": "*", "type": [ { "code": "Annotation" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Note" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value" } ] }, { "id": "MedicationOrder.category", "path": "MedicationOrder.category", "short": "Type of medication usage", "definition": "Indicates where type of medication order and where the medication is expected to be consumed or administered.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "binding": { "strength": "example", "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-order-category" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Directions\n\nor \n\nMessage/Body/NewRx/MedicationPrescribed/StructuredSIG" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.dosageInstruction", "path": "MedicationOrder.dosageInstruction", "short": "How medication should be taken", "definition": "Indicates how the medication is to be used by the patient.", "comments": "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.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Directions\n\nor \n\n//element(*,SIGType)/FreeText" }, { "identity": "rim", "map": "component.substanceAdministrationRequest" } ] }, { "id": "MedicationOrder.dosageInstruction.id", "path": "MedicationOrder.dosageInstruction.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "*" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.dosageInstruction.extension", "path": "MedicationOrder.dosageInstruction.extension", "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. 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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.dosageInstruction.modifierExtension", "path": "MedicationOrder.dosageInstruction.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "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": "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": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.dosageInstruction.text", "path": "MedicationOrder.dosageInstruction.text", "short": "Free text dosage instructions e.g. SIG", "definition": "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": 0, "max": "1", "type": [ { "code": "string" } ], "mapping": [ { "identity": "v2", "map": "RXE-7.2-Provider's Administration Instructions.text / RXO-7.2-Provider's Administration Instructions.text / TQ1-10-Condition Text / TQ1-11-Text Instruction" }, { "identity": "rim", "map": "text" } ] }, { "id": "MedicationOrder.dosageInstruction.additionalInstructions", "path": "MedicationOrder.dosageInstruction.additionalInstructions", "short": "Supplemental instructions - e.g. \"with meals\"", "definition": "Additional instructions such as \"Swallow with plenty of water\" which may or may not be coded.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\".", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/Timing" }, { "identity": "v2", "map": "RXE-7.2-Provider's Administration Instructions.text / RXO-7.2-Provider's Administration Instructions.text / TQ1-10-Condition Text / TQ1-11-Text Instruction" }, { "identity": "rim", "map": "component.substanceAdministrationRequest.text" } ] }, { "id": "MedicationOrder.dosageInstruction.timing", "path": "MedicationOrder.dosageInstruction.timing", "short": "When medication should be administered", "definition": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "comments": "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": 0, "max": "1", "type": [ { "code": "Timing" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/SiteofAdministration" }, { "identity": "v2", "map": "TQ1-X / ORC Quantity/timing" }, { "identity": "rim", "map": "effectiveTime" } ] }, { "id": "MedicationOrder.dosageInstruction.asNeeded[x]", "path": "MedicationOrder.dosageInstruction.asNeeded[x]", "short": "Take \"as needed\" (for x)", "definition": "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": "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": 0, "max": "1", "type": [ { "code": "boolean" }, { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/StructuredSIG/SiteofAdministration" }, { "identity": "rim", "map": "boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code=\"Assertion\"].value" } ] }, { "id": "MedicationOrder.dosageInstruction.site[x]", "path": "MedicationOrder.dosageInstruction.site[x]", "short": "Body site to administer to", "definition": "A coded specification of the anatomic site where the medication first enters the body.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/BodySite" } ], "binding": { "strength": "example", "description": "A coded concept describing the site location the medicine enters into or onto the body.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/approach-site-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/RouteofAdministration" }, { "identity": "v2", "map": "RXR-2-Administration Site" }, { "identity": "rim", "map": "approachSiteCode" } ] }, { "id": "MedicationOrder.dosageInstruction.route", "path": "MedicationOrder.dosageInstruction.route", "short": "How drug should enter body", "definition": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "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": "http://hl7.org/fhir/ValueSet/route-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/Dose/DoseDeliveryMethodCode" }, { "identity": "v2", "map": "RXR-1-Route" }, { "identity": "rim", "map": "routeCode" } ] }, { "id": "MedicationOrder.dosageInstruction.method", "path": "MedicationOrder.dosageInstruction.method", "short": "Technique for administering medication", "definition": "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": "Terminologies used often pre-coordinate this term with the route and or form of administration.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing the technique by which the medicine is administered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/Dose" }, { "identity": "v2", "map": "RXR-4-Administration Method" }, { "identity": "rim", "map": "methodCode" } ] }, { "id": "MedicationOrder.dosageInstruction.dose[x]", "path": "MedicationOrder.dosageInstruction.dose[x]", "short": "Amount of medication per dose", "definition": "The amount of therapeutic or other substance given at one administration event.", "comments": "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": 0, "max": "1", "type": [ { "code": "Range" }, { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/MaximumDoseRestriction" }, { "identity": "v2", "map": "RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name of coding system" }, { "identity": "rim", "map": "doseQuantity" } ] }, { "id": "MedicationOrder.dosageInstruction.maxDosePerPeriod", "path": "MedicationOrder.dosageInstruction.maxDosePerPeriod", "short": "Upper limit on medication per unit of time", "definition": "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": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example \"2 tablets every 4 hours to a maximum of 8/day\".", "min": 0, "max": "1", "type": [ { "code": "Ratio" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/MaximumDoseRestriction" }, { "identity": "v2", "map": "RXE-4-Give Amount - Maximum / RXE-5-Give Units" }, { "identity": "rim", "map": "maxDoseQuantity" } ] }, { "id": "MedicationOrder.dosageInstruction.maxDosePerAdministration", "path": "MedicationOrder.dosageInstruction.maxDosePerAdministration", "short": "Upper limit on medication per administration", "definition": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.", "comments": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/MaximumDoseRestriction" }, { "identity": "rim", "map": "no mapping" } ] }, { "id": "MedicationOrder.dosageInstruction.maxDosePerLifetime", "path": "MedicationOrder.dosageInstruction.maxDosePerLifetime", "short": "Upper limit on medication per lifetime of the patient", "definition": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "rim", "map": "no mapping" } ] }, { "id": "MedicationOrder.dosageInstruction.rate[x]", "path": "MedicationOrder.dosageInstruction.rate[x]", "short": "Amount of medication per unit of time", "definition": "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. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "comments": "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": 0, "max": "1", "type": [ { "code": "Ratio" }, { "code": "Range" }, { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "v2", "map": "RXE-22-Give Per (Time Unit)" }, { "identity": "rim", "map": "rateQuantity" } ] }, { "id": "MedicationOrder.dispenseRequest", "path": "MedicationOrder.dispenseRequest", "short": "Medication supply authorization", "definition": "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": 0, "max": "1", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/ExpirationDate" }, { "identity": "rim", "map": "component.supplyEvent" } ] }, { "id": "MedicationOrder.dispenseRequest.id", "path": "MedicationOrder.dispenseRequest.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "*" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.dispenseRequest.extension", "path": "MedicationOrder.dispenseRequest.extension", "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. 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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.dispenseRequest.modifierExtension", "path": "MedicationOrder.dispenseRequest.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "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": "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": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.dispenseRequest.validityPeriod", "path": "MedicationOrder.dispenseRequest.validityPeriod", "short": "Time period supply is authorized for", "definition": "This indicates the validity period of a prescription (stale dating the Prescription).", "comments": "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": "Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.", "min": 0, "max": "1", "type": [ { "code": "Period" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Refills" }, { "identity": "rim", "map": "effectiveTime" } ] }, { "id": "MedicationOrder.dispenseRequest.numberOfRepeatsAllowed", "path": "MedicationOrder.dispenseRequest.numberOfRepeatsAllowed", "short": "Number of refills authorized", "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that 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 \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.", "comments": "If displaying \"number of authorized fills\", add 1 to this number.", "min": 0, "max": "1", "type": [ { "code": "positiveInt" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Quantity" }, { "identity": "v2", "map": "RXE-12-Number of Refills" }, { "identity": "rim", "map": "repeatNumber" } ] }, { "id": "MedicationOrder.dispenseRequest.quantity", "path": "MedicationOrder.dispenseRequest.quantity", "short": "Amount of medication to supply per dispense", "definition": "The amount that is to be dispensed for one fill.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/DaysSupply" }, { "identity": "v2", "map": "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system" }, { "identity": "rim", "map": "quantity" } ] }, { "id": "MedicationOrder.dispenseRequest.expectedSupplyDuration", "path": "MedicationOrder.dispenseRequest.expectedSupplyDuration", "short": "Number of days supply per dispense", "definition": "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": "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": 0, "max": "1", "type": [ { "code": "Duration" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Substitutions" }, { "identity": "rim", "map": "expectedUseTime" } ] }, { "id": "MedicationOrder.substitution", "path": "MedicationOrder.substitution", "short": "Any restrictions on medication substitution", "definition": "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": 0, "max": "1", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions" }, { "identity": "rim", "map": "subjectOf.substitutionPersmission" } ] }, { "id": "MedicationOrder.substitution.id", "path": "MedicationOrder.substitution.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "*" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.substitution.extension", "path": "MedicationOrder.substitution.extension", "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. 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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.substitution.modifierExtension", "path": "MedicationOrder.substitution.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "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": "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": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.substitution.allowed", "path": "MedicationOrder.substitution.allowed", "short": "Whether substitution is allowed or not", "definition": "True if the prescriber allows a different drug to be dispensed from what was prescribed.", "min": 1, "max": "1", "type": [ { "code": "boolean" } ], "mapping": [ { "identity": "script10.6", "map": "specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions" }, { "identity": "v2", "map": "RXO-9-Allow Substitutions / RXE-9-Substitution Status" }, { "identity": "rim", "map": "code" } ] }, { "id": "MedicationOrder.substitution.reason", "path": "MedicationOrder.substitution.reason", "short": "Why should (not) substitution be made", "definition": "Indicates the reason for the substitution, or why substitution must or must not be performed.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason" } }, "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "v2", "map": "RXE-9 Substition status" }, { "identity": "rim", "map": "reasonCode" } ] }, { "id": "MedicationOrder.priorPrescription", "path": "MedicationOrder.priorPrescription", "short": "An order/prescription that this supersedes", "definition": "A link to a resource representing an earlier order related order or prescription.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/MedicationOrder" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]" } ] }, { "id": "MedicationOrder.eventHistory", "path": "MedicationOrder.eventHistory", "short": "A list of events of interest in the lifecycle", "definition": "A summary of the events of interest that have occurred as the request is processed; e.g. when the order was verified or when it was completed.", "comments": "This is not the same as an audit trail. It is a view of the important things that happened in the past. Typically, there would only be one entry for any given status, and systems may not record all the status events.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.id", "path": "MedicationOrder.eventHistory.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "*" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.eventHistory.extension", "path": "MedicationOrder.eventHistory.extension", "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. 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": "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": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationOrder.eventHistory.modifierExtension", "path": "MedicationOrder.eventHistory.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "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": "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": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationOrder.eventHistory.status", "path": "MedicationOrder.eventHistory.status", "short": "active | on-hold | completed | entered-in-error | stopped | draft", "definition": "The status for the event.", "min": 1, "max": "1", "type": [ { "code": "code" } ], "binding": { "strength": "required", "description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-order-status" } }, "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.action", "path": "MedicationOrder.eventHistory.action", "short": "Action taken (e.g. verify, discontinue)", "definition": "The action that was taken (e.g. verify, discontinue).", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing an action taken on a medication order." }, "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.dateTime", "path": "MedicationOrder.eventHistory.dateTime", "short": "The date at which the event happened", "definition": "The date/time at which the event occurred.", "min": 1, "max": "1", "type": [ { "code": "dateTime" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.actor", "path": "MedicationOrder.eventHistory.actor", "short": "Who took the action", "definition": "The person responsible for taking the action.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.reason", "path": "MedicationOrder.eventHistory.reason", "short": "Reason the action was taken", "definition": "The reason why the action was taken.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing the reason for an action taken on a medication order." }, "mapping": [ { "identity": "rim", "map": "not mapped" } ] } ] }, "differential": { "element": [ { "id": "MedicationOrder", "path": "MedicationOrder", "short": "Prescription of medication to for patient", "definition": "An order for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called \"MedicationOrder\" rather than \"MedicationPrescription\" to generalize the use across inpatient and outpatient settings as well as for care plans, etc.", "comments": "The WG will be updating the MedicationOrder resource to adjust each affected resource to align with the workflow pattern (see workflow.html). MedicationOrder will be renamed to MedicationRequest as part of these changes.", "alias": [ "Prescription" ], "min": 0, "max": "*", "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx" }, { "identity": "rim", "map": "CombinedMedicationRequest" }, { "identity": "w5", "map": "clinical.medication" } ] }, { "id": "MedicationOrder.identifier", "path": "MedicationOrder.identifier", "short": "External identifier", "definition": "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": 0, "max": "*", "type": [ { "code": "Identifier" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Header/PrescriberOrderNumber" }, { "identity": "v2", "map": "ORC-2-Placer Order Number / ORC-3-Filler Order Number" }, { "identity": "rim", "map": "id" }, { "identity": "w5", "map": "id" } ] }, { "id": "MedicationOrder.status", "path": "MedicationOrder.status", "short": "active | on-hold | completed | entered-in-error | stopped | draft", "definition": "A code specifying the state of the order. Generally this will be active or completed state.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "isModifier": true, "isSummary": true, "binding": { "strength": "required", "description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-order-status" } }, "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "rim", "map": "statusCode" }, { "identity": "w5", "map": "status" } ] }, { "id": "MedicationOrder.medication[x]", "path": "MedicationOrder.medication[x]", "short": "Medication to be taken", "definition": "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": "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.", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Medication" } ], "isSummary": true, "binding": { "strength": "example", "description": "A coded concept identifying substance or product that can be ordered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-codes" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed\n\nMedication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode\n\nMedication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier\n\nMedication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription" }, { "identity": "v2", "map": "RXE-2-Give Code / RXO-1-Requested Give Code / RXC-2-Component Code" }, { "identity": "rim", "map": "consumable.administrableMedication" }, { "identity": "w5", "map": "what" } ] }, { "id": "MedicationOrder.patient", "path": "MedicationOrder.patient", "short": "Who prescription is for", "definition": "A link to a resource representing the person to whom the medication will be given.", "comments": "SubstanceAdministration->subject->Patient.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Patient" } ], "isSummary": true, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/Patient\n\n(need detail to link to specific patient … Patient.Identification in SCRIPT)" }, { "identity": "v2", "map": "PID-3-Patient ID List" }, { "identity": "rim", "map": "subject.role" }, { "identity": "w5", "map": "who.focus" } ] }, { "id": "MedicationOrder.encounter", "path": "MedicationOrder.encounter", "short": "Created during encounter/admission/stay", "definition": "A link to a resource that identifies the particular occurrence of contact between patient and health care provider.", "comments": "SubstanceAdministration->component->EncounterEvent.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Encounter" } ], "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "v2", "map": "PV1-19-Visit Number" }, { "identity": "rim", "map": "componentOf.patientEncounter" }, { "identity": "w5", "map": "context" } ] }, { "id": "MedicationOrder.dateWritten", "path": "MedicationOrder.dateWritten", "short": "When prescription was initially authorized", "definition": "The date (and perhaps time) when the prescription was initially written.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/WrittenDate" }, { "identity": "v2", "map": "RXE-32-Original Order Date/Time / ORC-9-Date/Time of Transaction" }, { "identity": "rim", "map": "author.time" }, { "identity": "w5", "map": "when.recorded" } ] }, { "id": "MedicationOrder.prescriber", "path": "MedicationOrder.prescriber", "short": "Who ordered the initial medication(s)", "definition": "The healthcare professional responsible for authorizing the initial prescription.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "isSummary": true, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/Prescriber\n\n(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)" }, { "identity": "v2", "map": "RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment 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)" }, { "identity": "rim", "map": "author.role" }, { "identity": "w5", "map": "who.actor" } ] }, { "id": "MedicationOrder.reasonCode", "path": "MedicationOrder.reasonCode", "short": "Reason or indication for writing the prescription", "definition": "Can be the reason or the indication for writing the prescription.", "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept indicating why the medication was ordered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/condition-code" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value" }, { "identity": "v2", "map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication" }, { "identity": "rim", "map": "reason.observation.reasonCode" }, { "identity": "w5", "map": "why" } ] }, { "id": "MedicationOrder.reasonReference", "path": "MedicationOrder.reasonReference", "short": "Condition that supports why the prescription is being written", "definition": "Condition that supports why the prescription is being written.", "comments": "This is a reference to a condition that is the reason for the medication order. If only a code exists, use reasonCode.", "min": 0, "max": "*", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Condition" } ], "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "rim", "map": "reason.observation[code=ASSERTION].value" }, { "identity": "w5", "map": "why" } ] }, { "id": "MedicationOrder.note", "path": "MedicationOrder.note", "short": "Information about the prescription", "definition": "Extra information about the prescription that could not be conveyed by the other attributes.", "min": 0, "max": "*", "type": [ { "code": "Annotation" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Note" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value" } ] }, { "id": "MedicationOrder.category", "path": "MedicationOrder.category", "short": "Type of medication usage", "definition": "Indicates where type of medication order and where the medication is expected to be consumed or administered.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "binding": { "strength": "example", "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-order-category" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Directions\n\nor \n\nMessage/Body/NewRx/MedicationPrescribed/StructuredSIG" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.dosageInstruction", "path": "MedicationOrder.dosageInstruction", "short": "How medication should be taken", "definition": "Indicates how the medication is to be used by the patient.", "comments": "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.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Directions\n\nor \n\n//element(*,SIGType)/FreeText" }, { "identity": "rim", "map": "component.substanceAdministrationRequest" } ] }, { "id": "MedicationOrder.dosageInstruction.text", "path": "MedicationOrder.dosageInstruction.text", "short": "Free text dosage instructions e.g. SIG", "definition": "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": 0, "max": "1", "type": [ { "code": "string" } ], "mapping": [ { "identity": "v2", "map": "RXE-7.2-Provider's Administration Instructions.text / RXO-7.2-Provider's Administration Instructions.text / TQ1-10-Condition Text / TQ1-11-Text Instruction" }, { "identity": "rim", "map": "text" } ] }, { "id": "MedicationOrder.dosageInstruction.additionalInstructions", "path": "MedicationOrder.dosageInstruction.additionalInstructions", "short": "Supplemental instructions - e.g. \"with meals\"", "definition": "Additional instructions such as \"Swallow with plenty of water\" which may or may not be coded.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\".", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/Timing" }, { "identity": "v2", "map": "RXE-7.2-Provider's Administration Instructions.text / RXO-7.2-Provider's Administration Instructions.text / TQ1-10-Condition Text / TQ1-11-Text Instruction" }, { "identity": "rim", "map": "component.substanceAdministrationRequest.text" } ] }, { "id": "MedicationOrder.dosageInstruction.timing", "path": "MedicationOrder.dosageInstruction.timing", "short": "When medication should be administered", "definition": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "comments": "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": 0, "max": "1", "type": [ { "code": "Timing" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/SiteofAdministration" }, { "identity": "v2", "map": "TQ1-X / ORC Quantity/timing" }, { "identity": "rim", "map": "effectiveTime" } ] }, { "id": "MedicationOrder.dosageInstruction.asNeeded[x]", "path": "MedicationOrder.dosageInstruction.asNeeded[x]", "short": "Take \"as needed\" (for x)", "definition": "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": "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": 0, "max": "1", "type": [ { "code": "boolean" }, { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason" } }, "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/StructuredSIG/SiteofAdministration" }, { "identity": "rim", "map": "boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code=\"Assertion\"].value" } ] }, { "id": "MedicationOrder.dosageInstruction.site[x]", "path": "MedicationOrder.dosageInstruction.site[x]", "short": "Body site to administer to", "definition": "A coded specification of the anatomic site where the medication first enters the body.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/BodySite" } ], "binding": { "strength": "example", "description": "A coded concept describing the site location the medicine enters into or onto the body.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/approach-site-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/RouteofAdministration" }, { "identity": "v2", "map": "RXR-2-Administration Site" }, { "identity": "rim", "map": "approachSiteCode" } ] }, { "id": "MedicationOrder.dosageInstruction.route", "path": "MedicationOrder.dosageInstruction.route", "short": "How drug should enter body", "definition": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "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": "http://hl7.org/fhir/ValueSet/route-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/Dose/DoseDeliveryMethodCode" }, { "identity": "v2", "map": "RXR-1-Route" }, { "identity": "rim", "map": "routeCode" } ] }, { "id": "MedicationOrder.dosageInstruction.method", "path": "MedicationOrder.dosageInstruction.method", "short": "Technique for administering medication", "definition": "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": "Terminologies used often pre-coordinate this term with the route and or form of administration.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing the technique by which the medicine is administered.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes" } }, "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/Dose" }, { "identity": "v2", "map": "RXR-4-Administration Method" }, { "identity": "rim", "map": "methodCode" } ] }, { "id": "MedicationOrder.dosageInstruction.dose[x]", "path": "MedicationOrder.dosageInstruction.dose[x]", "short": "Amount of medication per dose", "definition": "The amount of therapeutic or other substance given at one administration event.", "comments": "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": 0, "max": "1", "type": [ { "code": "Range" }, { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/MaximumDoseRestriction" }, { "identity": "v2", "map": "RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name of coding system" }, { "identity": "rim", "map": "doseQuantity" } ] }, { "id": "MedicationOrder.dosageInstruction.maxDosePerPeriod", "path": "MedicationOrder.dosageInstruction.maxDosePerPeriod", "short": "Upper limit on medication per unit of time", "definition": "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": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example \"2 tablets every 4 hours to a maximum of 8/day\".", "min": 0, "max": "1", "type": [ { "code": "Ratio" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/MaximumDoseRestriction" }, { "identity": "v2", "map": "RXE-4-Give Amount - Maximum / RXE-5-Give Units" }, { "identity": "rim", "map": "maxDoseQuantity" } ] }, { "id": "MedicationOrder.dosageInstruction.maxDosePerAdministration", "path": "MedicationOrder.dosageInstruction.maxDosePerAdministration", "short": "Upper limit on medication per administration", "definition": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.", "comments": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "//element(*,SIGType)/MaximumDoseRestriction" }, { "identity": "rim", "map": "no mapping" } ] }, { "id": "MedicationOrder.dosageInstruction.maxDosePerLifetime", "path": "MedicationOrder.dosageInstruction.maxDosePerLifetime", "short": "Upper limit on medication per lifetime of the patient", "definition": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "rim", "map": "no mapping" } ] }, { "id": "MedicationOrder.dosageInstruction.rate[x]", "path": "MedicationOrder.dosageInstruction.rate[x]", "short": "Amount of medication per unit of time", "definition": "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. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.", "comments": "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": 0, "max": "1", "type": [ { "code": "Ratio" }, { "code": "Range" }, { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "no mapping" }, { "identity": "v2", "map": "RXE-22-Give Per (Time Unit)" }, { "identity": "rim", "map": "rateQuantity" } ] }, { "id": "MedicationOrder.dispenseRequest", "path": "MedicationOrder.dispenseRequest", "short": "Medication supply authorization", "definition": "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": 0, "max": "1", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/ExpirationDate" }, { "identity": "rim", "map": "component.supplyEvent" } ] }, { "id": "MedicationOrder.dispenseRequest.validityPeriod", "path": "MedicationOrder.dispenseRequest.validityPeriod", "short": "Time period supply is authorized for", "definition": "This indicates the validity period of a prescription (stale dating the Prescription).", "comments": "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": "Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.", "min": 0, "max": "1", "type": [ { "code": "Period" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Refills" }, { "identity": "rim", "map": "effectiveTime" } ] }, { "id": "MedicationOrder.dispenseRequest.numberOfRepeatsAllowed", "path": "MedicationOrder.dispenseRequest.numberOfRepeatsAllowed", "short": "Number of refills authorized", "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that 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 \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.", "comments": "If displaying \"number of authorized fills\", add 1 to this number.", "min": 0, "max": "1", "type": [ { "code": "positiveInt" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Quantity" }, { "identity": "v2", "map": "RXE-12-Number of Refills" }, { "identity": "rim", "map": "repeatNumber" } ] }, { "id": "MedicationOrder.dispenseRequest.quantity", "path": "MedicationOrder.dispenseRequest.quantity", "short": "Amount of medication to supply per dispense", "definition": "The amount that is to be dispensed for one fill.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/DaysSupply" }, { "identity": "v2", "map": "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system" }, { "identity": "rim", "map": "quantity" } ] }, { "id": "MedicationOrder.dispenseRequest.expectedSupplyDuration", "path": "MedicationOrder.dispenseRequest.expectedSupplyDuration", "short": "Number of days supply per dispense", "definition": "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": "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": 0, "max": "1", "type": [ { "code": "Duration" } ], "mapping": [ { "identity": "script10.6", "map": "Message/Body/NewRx/MedicationPrescribed/Substitutions" }, { "identity": "rim", "map": "expectedUseTime" } ] }, { "id": "MedicationOrder.substitution", "path": "MedicationOrder.substitution", "short": "Any restrictions on medication substitution", "definition": "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": 0, "max": "1", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions" }, { "identity": "rim", "map": "subjectOf.substitutionPersmission" } ] }, { "id": "MedicationOrder.substitution.allowed", "path": "MedicationOrder.substitution.allowed", "short": "Whether substitution is allowed or not", "definition": "True if the prescriber allows a different drug to be dispensed from what was prescribed.", "min": 1, "max": "1", "type": [ { "code": "boolean" } ], "mapping": [ { "identity": "script10.6", "map": "specific values within Message/Body/NewRx/MedicationPrescribed/Substitutions" }, { "identity": "v2", "map": "RXO-9-Allow Substitutions / RXE-9-Substitution Status" }, { "identity": "rim", "map": "code" } ] }, { "id": "MedicationOrder.substitution.reason", "path": "MedicationOrder.substitution.reason", "short": "Why should (not) substitution be made", "definition": "Indicates the reason for the substitution, or why substitution must or must not be performed.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason" } }, "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "v2", "map": "RXE-9 Substition status" }, { "identity": "rim", "map": "reasonCode" } ] }, { "id": "MedicationOrder.priorPrescription", "path": "MedicationOrder.priorPrescription", "short": "An order/prescription that this supersedes", "definition": "A link to a resource representing an earlier order related order or prescription.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/MedicationOrder" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=?RPLC or ?SUCC]/target[classCode=SBADM,moodCode=RQO]" } ] }, { "id": "MedicationOrder.eventHistory", "path": "MedicationOrder.eventHistory", "short": "A list of events of interest in the lifecycle", "definition": "A summary of the events of interest that have occurred as the request is processed; e.g. when the order was verified or when it was completed.", "comments": "This is not the same as an audit trail. It is a view of the important things that happened in the past. Typically, there would only be one entry for any given status, and systems may not record all the status events.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.status", "path": "MedicationOrder.eventHistory.status", "short": "active | on-hold | completed | entered-in-error | stopped | draft", "definition": "The status for the event.", "min": 1, "max": "1", "type": [ { "code": "code" } ], "binding": { "strength": "required", "description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-order-status" } }, "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.action", "path": "MedicationOrder.eventHistory.action", "short": "Action taken (e.g. verify, discontinue)", "definition": "The action that was taken (e.g. verify, discontinue).", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing an action taken on a medication order." }, "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.dateTime", "path": "MedicationOrder.eventHistory.dateTime", "short": "The date at which the event happened", "definition": "The date/time at which the event occurred.", "min": 1, "max": "1", "type": [ { "code": "dateTime" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.actor", "path": "MedicationOrder.eventHistory.actor", "short": "Who took the action", "definition": "The person responsible for taking the action.", "min": 0, "max": "1", "type": [ { "code": "Reference", "profile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "mapping": [ { "identity": "script10.6", "map": "not mapped" }, { "identity": "rim", "map": "not mapped" } ] }, { "id": "MedicationOrder.eventHistory.reason", "path": "MedicationOrder.eventHistory.reason", "short": "Reason the action was taken", "definition": "The reason why the action was taken.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "A coded concept describing the reason for an action taken on a medication order." }, "mapping": [ { "identity": "rim", "map": "not mapped" } ] } ] } }
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.