This page is part of the FHIR Specification (v4.5.0: R5 Preview #3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3
Pharmacy Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Encounter, Patient, Practitioner |
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Order with as needed (PRN) dosage with pre-condition - Oxycodone - active with reasonCode, note, dispenseRequest and substitution
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix sct: <http://snomed.info/id/> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/MedicationRequest/medrx0301> a fhir:MedicationRequest; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "medrx0301"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ]; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: medrx0301</p><p><b>identifier</b>: id: 12345689 (OFFICIAL)</p><p><b>status</b>: completed</p><p><b>statusReason</b>: <span>Try another treatment first</span></p><p><b>intent</b>: order</p><p><b>category</b>: <span>Inpatient</span></p><p><b>medication</b>: </p><p><b>subject</b>: <a>Donald Duck. Generated Summary: id: pat1; Medical record number: 654321 (USUAL); active; Duck Donald (OFFICIAL); gender: male; </a></p><p><b>encounter</b>: <a>encounter who leads to this prescription. Generated Summary: id: f201; id: Encounter_Roel_20130404 (TEMP); status: completed; <span>ambulatory</span>; <span>Consultation</span>; <span>Normal</span>; <span>The patient had fever peaks over the last couple of days. He is worried about these peaks.</span></a></p><p><b>supportingInformation</b>: <a>Generated Summary: id: biopsy; status: completed; <span>Diagnostic procedure</span>; <span>Biopsy of suspected melanoma L) arm</span>; occurrence: 2014-02-03; recorded: 2014-02-03; <span>Dark lesion l) forearm. getting darker last 3 months.</span>; <span>Left forearm</span>; <span>Ineffective airway clearance</span>; <span>Review in clinic</span>; Standard Biopsy; <span>30-guage needle</span></a></p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a>Patrick Pump. Generated Summary: id: f007; id: 874635264 (OFFICIAL), id: 567IUI51C154 (USUAL); Simone Heps (OFFICIAL); ph: 020556936(WORK), S.M.Heps@bmc.nl(WORK), fax: 0205669283(WORK); gender: female; birthDate: 1971-11-07</a></p><p><b>performer</b>: <a>Carla Espinosa. Generated Summary: id: f204; UZI-nummer: 12345678904 (OFFICIAL); Carla Espinosa; ph: +31715262169(WORK); gender: female; birthDate: 1967-11-05</a></p><p><b>performerType</b>: <span>Public Health Nurse</span></p><p><b>reason</b>: </p><p><b>insurance</b>: <a>Generated Summary: id: 9876B1; id: 12345; status: active; <span>extended healthcare</span>; dependent: 0; <span>self</span>; period: 2011-05-23 --> 2012-05-23</a></p><p><b>note</b>: Patient told to take with food</p><p><b>dosageInstruction</b>: </p><h3>DispenseRequests</h3><table><tr><td>-</td><td><b>ValidityPeriod</b></td><td><b>NumberOfRepeatsAllowed</b></td><td><b>Quantity</b></td><td><b>ExpectedSupplyDuration</b></td><td><b>Dispenser</b></td></tr><tr><td>*</td><td>2015-01-15 --> 2016-01-15</td><td>0</td><td>30 TAB</td><td>10 days</td><td><a>Generated Summary: id: 2.16.840.1.113883.19.5; id: urn:oid:2.16.840.1.113883.19.5; name: Good Health Clinic</a></td></tr></table><h3>Substitutions</h3><table><tr><td>-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td>*</td><td>true</td><td><span>formulary policy</span></td></tr></table><p><b>detectedIssue</b>: <a>Generated Summary: id: allergy; status: final</a></p><p><b>eventHistory</b>: <a> </a></p><blockquote><p><b>id</b>: signature</p><p><b>target</b>: <a>Generated Summary: id: physiotherapy; Placer: 20170201-0001; status: completed; intent: order; <span>Physiotherapy of chest (regime/therapy)</span>; Duration 15days, Do 1-1 per 1 days; <span>as needed to clear mucus</span>; authoredOn: 02/02/2017 4:23:07 AM; <span>#cystic-fibrosis</span></a></p><p><b>recorded</b>: 02/02/2017 4:23:07 AM</p><h3>Agents</h3><table><tr><td>-</td><td><b>Role</b></td><td><b>Who</b></td></tr><tr><td>*</td><td><span>author (originator)</span></td><td><a>Dr Adam Careful. Generated Summary: id: example; id: 23; active; Adam Careful </a></td></tr></table><p><b>signature</b>: </p></blockquote></div>" ]; fhir:DomainResource.contained [ a fhir:Medication; fhir:index 0; fhir:Resource.id [ fhir:value "med0310" ]; fhir:Medication.code [ fhir:CodeableConcept.coding [ fhir:index 0; a sct:430127000; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "430127000" ]; fhir:Coding.display [ fhir:value "Oral Form Oxycodone (product)" ] ] ] ], [ a fhir:Provenance; fhir:index 1; fhir:Resource.id [ fhir:value "signature" ]; fhir:Provenance.target [ fhir:index 0; fhir:link <http://hl7.org/fhir/ServiceRequest/physiotherapy>; fhir:Reference.reference [ fhir:value "ServiceRequest/physiotherapy" ] ]; fhir:Provenance.recorded [ fhir:value "2017-02-01T17:23:07Z"^^xsd:dateTime ]; fhir:Provenance.agent [ fhir:index 0; fhir:Provenance.agent.role [ fhir:index 0; fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ParticipationType" ]; fhir:Coding.code [ fhir:value "AUT" ] ] ]; fhir:Provenance.agent.who [ fhir:link <http://hl7.org/fhir/Practitioner/example>; fhir:Reference.reference [ fhir:value "Practitioner/example" ]; fhir:Reference.display [ fhir:value "Dr Adam Careful" ] ] ]; fhir:Provenance.signature [ fhir:index 0; fhir:Signature.type [ fhir:index 0; fhir:Coding.system [ fhir:value "urn:iso-astm:E1762-95:2013" ]; fhir:Coding.code [ fhir:value "1.2.840.10065.1.12.1.1" ]; fhir:Coding.display [ fhir:value "Author's Signature" ] ]; fhir:Signature.when [ fhir:value "2017-02-01T17:23:07Z"^^xsd:dateTime ]; fhir:Signature.who [ fhir:link <http://hl7.org/fhir/Practitioner/example>; fhir:Reference.reference [ fhir:value "Practitioner/example" ]; fhir:Reference.display [ fhir:value "Dr Adam Careful" ] ]; fhir:Signature.targetFormat [ fhir:value "application/fhir+xml" ]; fhir:Signature.sigFormat [ fhir:value "application/signature+xml" ]; fhir:Signature.data [ fhir:value "dGhpcyBibG9iIGlzIHNuaXBwZWQ="^^xsd:base64Binary ] ] ]; fhir:MedicationRequest.identifier [ fhir:index 0; fhir:Identifier.use [ fhir:value "official" ]; fhir:Identifier.system [ fhir:value "http://www.bmc.nl/portal/prescriptions" ]; fhir:Identifier.value [ fhir:value "12345689" ] ]; fhir:MedicationRequest.status [ fhir:value "completed"]; fhir:MedicationRequest.statusReason [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/medicationrequest-status-reason" ]; fhir:Coding.code [ fhir:value "altchoice" ]; fhir:Coding.display [ fhir:value "Try another treatment first" ] ] ]; fhir:MedicationRequest.intent [ fhir:value "order"]; fhir:MedicationRequest.category [ fhir:index 0; fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/medicationrequest-admin-location" ]; fhir:Coding.code [ fhir:value "inpatient" ]; fhir:Coding.display [ fhir:value "Inpatient" ] ] ]; fhir:MedicationRequest.medication [ fhir:CodeableReference.reference [ fhir:Reference.reference [ fhir:value "#med0310" ] ] ]; fhir:MedicationRequest.subject [ fhir:link <http://hl7.org/fhir/Patient/pat1>; fhir:Reference.reference [ fhir:value "Patient/pat1" ]; fhir:Reference.display [ fhir:value "Donald Duck" ] ]; fhir:MedicationRequest.encounter [ fhir:link <http://hl7.org/fhir/Encounter/f201>; fhir:Reference.reference [ fhir:value "Encounter/f201" ]; fhir:Reference.display [ fhir:value "encounter who leads to this prescription" ] ]; fhir:MedicationRequest.supportingInformation [ fhir:index 0; fhir:link <http://hl7.org/fhir/Procedure/biopsy>; fhir:Reference.reference [ fhir:value "Procedure/biopsy" ] ]; fhir:MedicationRequest.authoredOn [ fhir:value "2015-01-15"^^xsd:date]; fhir:MedicationRequest.requester [ fhir:link <http://hl7.org/fhir/Practitioner/f007>; fhir:Reference.reference [ fhir:value "Practitioner/f007" ]; fhir:Reference.display [ fhir:value "Patrick Pump" ] ]; fhir:MedicationRequest.performer [ fhir:link <http://hl7.org/fhir/Practitioner/f204>; fhir:Reference.reference [ fhir:value "Practitioner/f204" ]; fhir:Reference.display [ fhir:value "Carla Espinosa" ] ]; fhir:MedicationRequest.performerType [ fhir:CodeableConcept.coding [ fhir:index 0; a sct:26369006; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "26369006" ]; fhir:Coding.display [ fhir:value "Public Health Nurse" ] ] ]; fhir:MedicationRequest.reason [ fhir:index 0; fhir:CodeableReference.concept [ fhir:CodeableConcept.coding [ fhir:index 0; a sct:297217002; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "297217002" ]; fhir:Coding.display [ fhir:value "Rib Pain (finding)" ] ] ] ]; fhir:MedicationRequest.insurance [ fhir:index 0; fhir:link <http://hl7.org/fhir/Coverage/9876B1>; fhir:Reference.reference [ fhir:value "Coverage/9876B1" ] ]; fhir:MedicationRequest.note [ fhir:index 0; fhir:Annotation.text [ fhir:value "Patient told to take with food" ] ]; fhir:MedicationRequest.dosageInstruction [ fhir:index 0; fhir:Dosage.sequence [ fhir:value "1"^^xsd:integer ]; fhir:Dosage.text [ fhir:value "one to two tablets every 4-6 hours as needed for rib pain" ]; fhir:Dosage.additionalInstruction [ fhir:index 0; fhir:CodeableConcept.coding [ fhir:index 0; a sct:418914006; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "418914006" ]; fhir:Coding.display [ fhir:value "Warning. May cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink (qualifier value)" ] ] ]; fhir:Dosage.patientInstruction [ fhir:value "Take one to two tablets every four to six hours as needed for rib pain" ]; fhir:Dosage.timing [ fhir:Timing.repeat [ fhir:Timing.repeat.frequency [ fhir:value "1"^^xsd:positiveInteger ]; fhir:Timing.repeat.period [ fhir:value "4"^^xsd:decimal ]; fhir:Timing.repeat.periodMax [ fhir:value "6"^^xsd:decimal ]; fhir:Timing.repeat.periodUnit [ fhir:value "h" ] ] ]; fhir:Dosage.asNeededCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index 0; a sct:297217002; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "297217002" ]; fhir:Coding.display [ fhir:value "Rib Pain (finding)" ] ] ]; fhir:Dosage.route [ fhir:CodeableConcept.coding [ fhir:index 0; a sct:26643006; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "26643006" ]; fhir:Coding.display [ fhir:value "Oral Route" ] ] ]; fhir:Dosage.method [ fhir:CodeableConcept.coding [ fhir:index 0; a sct:421521009; fhir:Coding.system [ fhir:value "http://snomed.info/sct" ]; fhir:Coding.code [ fhir:value "421521009" ]; fhir:Coding.display [ fhir:value "Swallow - dosing instruction imperative (qualifier value)" ] ] ]; fhir:Dosage.doseAndRate [ fhir:index 0; fhir:Dosage.doseAndRate.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/dose-rate-type" ]; fhir:Coding.code [ fhir:value "ordered" ]; fhir:Coding.display [ fhir:value "Ordered" ] ] ]; fhir:Dosage.doseAndRate.doseRange [ fhir:Range.low [ fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "TAB" ]; fhir:Quantity.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm" ]; fhir:Quantity.code [ fhir:value "TAB" ] ]; fhir:Range.high [ fhir:Quantity.value [ fhir:value "2"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "TAB" ]; fhir:Quantity.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm" ]; fhir:Quantity.code [ fhir:value "TAB" ] ] ] ] ]; fhir:MedicationRequest.dispenseRequest [ fhir:MedicationRequest.dispenseRequest.validityPeriod [ fhir:Period.start [ fhir:value "2015-01-15"^^xsd:date ]; fhir:Period.end [ fhir:value "2016-01-15"^^xsd:date ] ]; fhir:MedicationRequest.dispenseRequest.numberOfRepeatsAllowed [ fhir:value "0"^^xsd:nonNegativeInteger ]; fhir:MedicationRequest.dispenseRequest.quantity [ fhir:Quantity.value [ fhir:value "30"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "TAB" ]; fhir:Quantity.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm" ]; fhir:Quantity.code [ fhir:value "TAB" ] ]; fhir:MedicationRequest.dispenseRequest.expectedSupplyDuration [ fhir:Quantity.value [ fhir:value "10"^^xsd:decimal ]; fhir:Quantity.unit [ fhir:value "days" ]; fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ]; fhir:Quantity.code [ fhir:value "d" ] ]; fhir:MedicationRequest.dispenseRequest.dispenser [ fhir:link <http://hl7.org/fhir/Organization/2.16.840.1.113883.19.5>; fhir:Reference.reference [ fhir:value "Organization/2.16.840.1.113883.19.5" ] ] ]; fhir:MedicationRequest.substitution [ fhir:MedicationRequest.substitution.allowedBoolean [ fhir:value "true"^^xsd:boolean ]; fhir:MedicationRequest.substitution.reason [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActReason" ]; fhir:Coding.code [ fhir:value "FP" ]; fhir:Coding.display [ fhir:value "formulary policy" ] ] ] ]; fhir:MedicationRequest.detectedIssue [ fhir:index 0; fhir:link <http://hl7.org/fhir/DetectedIssue/allergy>; fhir:Reference.reference [ fhir:value "DetectedIssue/allergy" ] ]; fhir:MedicationRequest.eventHistory [ fhir:index 0; fhir:Reference.reference [ fhir:value "#signature" ]; fhir:Reference.display [ fhir:value "Author's Signature" ] ] . <http://hl7.org/fhir/ServiceRequest/physiotherapy> a fhir:ServiceRequest . <http://hl7.org/fhir/Practitioner/example> a fhir:Practitioner . <http://hl7.org/fhir/Patient/pat1> a fhir:Patient . <http://hl7.org/fhir/Encounter/f201> a fhir:Encounter . <http://hl7.org/fhir/Procedure/biopsy> a fhir:Procedure . <http://hl7.org/fhir/Practitioner/f007> a fhir:Practitioner . <http://hl7.org/fhir/Practitioner/f204> a fhir:Practitioner . <http://hl7.org/fhir/Coverage/9876B1> a fhir:Coverage . <http://hl7.org/fhir/Organization/2.16.840.1.113883.19.5> a fhir:Organization . <http://hl7.org/fhir/DetectedIssue/allergy> a fhir:DetectedIssue . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/MedicationRequest/medrx0301.ttl> a owl:Ontology; owl:imports fhir:fhir.ttl; owl:versionIRI <http://build.fhir.org/MedicationRequest/medrx0301.ttl> . # -------------------------------------------------------------------------------------
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.