This page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). 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 ------------------------------------------------------------------- [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: MedicationRequest</b><a name=\"medrx0301\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest "medrx0301" </p></div><p><b>identifier</b>: id: 12345689 (OFFICIAL)</p><p><b>status</b>: completed</p><p><b>statusReason</b>: Try another treatment first <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-medicationrequest-status-reason.html\">MedicationRequest Status Reason Codes</a>#altchoice)</span></p><p><b>intent</b>: order</p><p><b>category</b>: Inpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-medicationrequest-admin-location.html\">Medication request administration location codes</a>#inpatient)</span></p><h3>Medications</h3><table class=\"grid\"><tr><td>-</td><td><b>Reference</b></td></tr><tr><td>*</td><td><span title=\" Linked to a RESOURCE Medication \"><a name=\"med0310\"> </a></span><blockquote><p/><p><a name=\"med0310\"> </a></p><p><b>code</b>: Oral Form Oxycodone (product) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#430127000)</span></p></blockquote></td></tr></table><p><b>subject</b>: <a href=\"patient-example-a.html\">Patient/pat1: Donald Duck</a> "Donald DUCK"</p><p><b>encounter</b>: <a href=\"encounter-example-f201-20130404.html\">Encounter/f201: encounter who leads to this prescription</a></p><p><b>supportingInformation</b>: <a href=\"procedure-example-biopsy.html\">Procedure/biopsy</a></p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a href=\"practitioner-example-f007-sh.html\">Practitioner/f007: Patrick Pump</a> "Simone HEPS"</p><p><b>performerType</b>: Public Health Nurse <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#26369006)</span></p><p><b>performer</b>: <a href=\"practitioner-example-f204-ce.html\">Practitioner/f204: Carla Espinosa</a> "Carla Espinosa"</p><h3>Reasons</h3><table class=\"grid\"><tr><td>-</td><td><b>Concept</b></td></tr><tr><td>*</td><td>Rib Pain (finding) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#297217002)</span></td></tr></table><p><b>insurance</b>: <a href=\"coverage-example.html\">Coverage/9876B1</a></p><p><b>note</b>: Patient told to take with food</p><blockquote><p><b>dose</b></p><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 1</p><p><b>text</b>: one to two tablets every 4-6 hours as needed for rib pain</p><p><b>additionalInstruction</b>: Warning. May cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#418914006)</span></p><p><b>patientInstruction</b>: Take one to two tablets every four to six hours as needed for rib pain</p><p><b>timing</b>: Do Once per 4-6 hours</p><p><b>asNeededFor</b>: Rib Pain (finding) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#297217002)</span></p><p><b>route</b>: Oral Route <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#26643006)</span></p><p><b>method</b>: Swallow - dosing instruction imperative (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#421521009)</span></p></blockquote></blockquote><blockquote><p><b>dispenseRequest</b></p><p><b>validityPeriod</b>: 2015-01-15 --> 2016-01-15</p><p><b>numberOfRepeatsAllowed</b>: 0</p><p><b>quantity</b>: 30 TAB<span style=\"background: LightGoldenRodYellow\"> (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code TAB = 'Tablet')</span></p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td>*</td><td>10</td><td>days</td><td><a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ucum.html\">Unified Code for Units of Measure (UCUM)</a></td><td>d</td></tr></table><p><b>dispenser</b>: <a href=\"organization-example-good-health-care.html\">Organization/2.16.840.1.113883.19.5</a> "Good Health Clinic"</p></blockquote><h3>Substitutions</h3><table class=\"grid\"><tr><td>-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td>*</td><td>true</td><td>formulary policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ActReason.html\">ActReason</a>#FP)</span></td></tr></table><p><b>eventHistory</b>: <a name=\"signature\"> </a></p><blockquote><p/><p><a name=\"signature\"> </a></p><p><b>target</b>: <a href=\"servicerequest-example2.html\">ServiceRequest/physiotherapy</a></p><p><b>recorded</b>: 02/02/2017 4:23:07 AM</p><h3>Agents</h3><table class=\"grid\"><tr><td>-</td><td><b>Role</b></td><td><b>Who</b></td></tr><tr><td>*</td><td>author (originator) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ParticipationType.html\">ParticipationType</a>#AUT)</span></td><td><a href=\"practitioner-example.html\">Practitioner/example: Dr Adam Careful</a> "Adam CAREFUL"</td></tr></table><h3>Signatures</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>TargetFormat</b></td><td><b>SigFormat</b></td><td><b>Data</b></td></tr><tr><td>*</td><td>Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'Author's Signature')</td><td>02/02/2017 4:23:07 AM</td><td><a href=\"practitioner-example.html\">Practitioner/example: Dr Adam Careful</a> "Adam CAREFUL"</td><td>application/fhir+xml</td><td>application/signature+xml</td><td>dGhpcyBibG9iIGlzIHNuaXBwZWQ=</td></tr></table></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: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: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: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:Reference.reference [ fhir:value "Patient/pat1" ]; fhir:Reference.display [ fhir:value "Donald Duck" ] ]; fhir:MedicationRequest.encounter [ 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:Reference.reference [ fhir:value "Procedure/biopsy" ] ]; fhir:MedicationRequest.authoredOn [ fhir:value "2015-01-15"^^xsd:date]; fhir:MedicationRequest.requester [ fhir:Reference.reference [ fhir:value "Practitioner/f007" ]; fhir:Reference.display [ fhir:value "Patrick Pump" ] ]; 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.performer [ fhir:index 0; fhir:Reference.reference [ fhir:value "Practitioner/f204" ]; fhir:Reference.display [ fhir:value "Carla Espinosa" ] ]; 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: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.dose [ fhir:MedicationRequest.dose.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.asNeededFor [ fhir:index 0; 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: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.eventHistory [ fhir:index 0; fhir:Reference.reference [ fhir:value "#signature" ]; fhir:Reference.display [ fhir:value "Author's Signature" ] ]] . # - ontology header ------------------------------------------------------------ [a owl:Ontology; owl:imports fhir:fhir.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.