Release 5 Preview #3

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

Medicationrequest0301.xml

Pharmacy Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Encounter, Patient, Practitioner

Raw XML (canonical form + also see XML Format Specification)

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Order with as needed (PRN) dosage with pre-condition - Oxycodone - active with reasonCode, note, dispenseRequest and substitution (id = "medrx0301")

<?xml version="1.0" encoding="UTF-8"?>

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="medrx0301"/> 
    <text> <status value="generated"/> <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 --&gt; 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 --&gt; 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> </text> <contained> 
      <Medication> 
          <id value="med0310"/> 
          <code> 
              <coding> 
                  <system value="http://snomed.info/sct"/> 
                  <code value="430127000"/> 
                  <display value="Oral Form Oxycodone (product)"/> 
              </coding> 
          </code> 
      </Medication> 
  </contained> 
    <contained> 
        <Provenance> 
            <id value="signature"/> 
            <target> 
                <reference value="ServiceRequest/physiotherapy"/> 
            </target> 
            <recorded value="2017-02-01T17:23:07Z"/> 
            <agent> 
                <role> 
                    <coding> 
                        <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/> 
                        <code value="AUT"/> 
                    </coding> 
                </role> 
                <who> 
                    <reference value="Practitioner/example"/> 
                    <display value="Dr Adam Careful"/> 
                </who> 
            </agent> 
            <signature> 
                <type> 
                    <system value="urn:iso-astm:E1762-95:2013"/> 
                    <code value="1.2.840.10065.1.12.1.1"/> 
                    <display value="Author's Signature"/> 
                </type> 
                <when value="2017-02-01T17:23:07Z"/> 
        <who> 
                    <reference value="Practitioner/example"/> 
                    <display value="Dr Adam Careful"/> 
        </who> 
                <targetFormat value="application/fhir+xml"/> 
        <sigFormat value="application/signature+xml"/> 
                <data value="dGhpcyBibG9iIGlzIHNuaXBwZWQ="/> 
            </signature> 
        </Provenance> 
    </contained> 
    <identifier> 
        <use value="official"/> 
        <system value="http://www.bmc.nl/portal/prescriptions"/> 
        <value value="12345689"/> 
    </identifier> 
    <status value="completed"/> 
    <statusReason> 
        <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-status-reason"/> 
            <code value="altchoice"/> 
            <display value="Try another treatment first"/> 
        </coding> 
    </statusReason> 
    <intent value="order"/> 
    <category> 
        <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-admin-location"/> 
            <code value="inpatient"/> 
            <display value="Inpatient"/> 
        </coding> 
    </category> 
    <medication>  <!--    Linked to a RESOURCE Medication    -->
        <reference> 
           <reference value="#med0310"/> 
        </reference> 
    </medication>  
    <subject>  <!--    Linked to the resource patient who needs the medication    -->
        <reference value="Patient/pat1"/> 
        <display value="Donald Duck"/>            
    </subject> 
    <encounter>  <!--    Linked to a resource Encounter between patient and practitioner   -->
        <reference value="Encounter/f201"/> 
        <display value="encounter who leads to this prescription"/> 
    </encounter> 
    <supportingInformation> 
        <reference value="Procedure/biopsy"/> 
    </supportingInformation> 
    <authoredOn value="2015-01-15"/> 
    <requester> 
        <reference value="Practitioner/f007"/> 
        <display value="Patrick Pump"/> 
    </requester> 
    <performer> 
        <reference value="Practitioner/f204"/> 
        <display value="Carla Espinosa"/> 
    </performer> 
    <performerType> 
        <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="26369006"/> 
            <display value="Public Health Nurse"/> 
        </coding> 
    </performerType> 
    <reason> 
      <concept> 
        <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="297217002"/> 
            <display value="Rib Pain (finding)"/> 
        </coding> 
      </concept> 
    </reason> 
    <insurance> 
        <reference value="Coverage/9876B1"/> 
    </insurance> 
    <note> 
        <text value="Patient told to take with food"/> 
    </note> 
    <dosageInstruction> 
        <sequence value="1"/> 
        <text value="one to two tablets every 4-6 hours as needed for rib pain"/> 
        <additionalInstruction> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="418914006"/> 
                <display value="Warning. May cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic
         drink (qualifier value)"/> 
            </coding> 
        </additionalInstruction> 
        <patientInstruction value="Take one to two tablets every four to six hours as needed for rib pain"/> 
        <timing> 
            <repeat> 
                <frequency value="1"/> 
                <period value="4"/> 
                <periodMax value="6"/> 
                <periodUnit value="h"/> 
            </repeat> 
        </timing> 
        <asNeededCodeableConcept> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="297217002"/> 
                <display value="Rib Pain (finding)"/> 
            </coding> 
        </asNeededCodeableConcept> 
        <route> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="26643006"/> 
                <display value="Oral Route"/> 
            </coding> 
        </route> 
        <method> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="421521009"/> 
                <display value="Swallow - dosing instruction imperative (qualifier value)"/> 
            </coding> 
        </method> 
        <doseAndRate> 
            <type> 
                <coding> 
                    <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/> 
                    <code value="ordered"/> 
                    <display value="Ordered"/> 
                </coding> 
            </type> 
            <doseRange> 
                <low> 
                    <value value="1"/> 
                    <unit value="TAB"/> 
                    <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
                    <code value="TAB"/>  
                </low> 
                <high> 
                    <value value="2"/> 
                    <unit value="TAB"/> 
                    <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
                    <code value="TAB"/>  
                </high> 
            </doseRange> 
        </doseAndRate> 
        
    </dosageInstruction> 
    <dispenseRequest> 
        <validityPeriod> 
            <start value="2015-01-15"/> 
            <end value="2016-01-15"/> 
        </validityPeriod> 
        <numberOfRepeatsAllowed value="0"/> 
        <quantity> 
            <value value="30"/> 
            <unit value="TAB"/> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
            <code value="TAB"/>  
        </quantity> 
        <expectedSupplyDuration> 
            <value value="10"/> 
            <unit value="days"/> 
            <system value="http://unitsofmeasure.org"/> 
            <code value="d"/>  
        </expectedSupplyDuration> 
        <dispenser> 
            <reference value="Organization/2.16.840.1.113883.19.5"/> 
        </dispenser> 
    </dispenseRequest>    
    <substitution> 
        <allowedBoolean value="true"/> 
        <reason> 
            <coding> 
                <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/> 
                <code value="FP"/> 
                <display value="formulary policy"/>              
            </coding> 
        </reason> 
    </substitution> 
    <detectedIssue> 
        <reference value="DetectedIssue/allergy"/> 
    </detectedIssue> 
    <eventHistory> 
        <reference value="#signature"/> 
        <display value="Author's Signature"/> 
    </eventHistory> 
</MedicationRequest> 

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.