Snapshot 3: Connectathon 32 Base

This is Snapshot #3 for FHIR R5, released to support Connectathon 32. For a full list of available versions, see the Directory of published versions.

Example MedicationRequest/medrx0301 (JSON)

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

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

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

{
  "resourceType" : "MedicationRequest",
  "id" : "medrx0301",
  "text" : {
    "status" : "generated",
    "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 &quot;medrx0301&quot; </p></div><p><b>identifier</b>: id: 12345689 (use: 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/4.0.0/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/4.0.0/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> &quot;Donald DUCK&quot;</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> &quot;Simone HEPS&quot;</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> &quot;Carla Espinosa&quot;</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>: 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 --&gt; 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/4.0.0/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> &quot;Good Health Clinic&quot;</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/4.0.0/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>: 2 Feb 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/4.0.0/CodeSystem-v3-ParticipationType.html\">ParticipationType</a>#AUT)</span></td><td><a href=\"practitioner-example.html\">Practitioner/example: Dr Adam Careful</a> &quot;Adam CAREFUL&quot;</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>2 Feb 2017, 4:23:07 am</td><td><a href=\"practitioner-example.html\">Practitioner/example: Dr Adam Careful</a> &quot;Adam CAREFUL&quot;</td><td>application/fhir+xml</td><td>application/signature+xml</td><td>dGhpcyBibG9iIGlzIHNuaXBwZWQ=</td></tr></table></blockquote></div>"
  },
  "contained" : [{
    "resourceType" : "Medication",
    "id" : "med0310",
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "430127000",
        "display" : "Oral Form Oxycodone (product)"
      }]
    }
  },
  {
    "resourceType" : "Provenance",
    "id" : "signature",
    "target" : [{
      "reference" : "ServiceRequest/physiotherapy"
    }],
    "recorded" : "2017-02-01T17:23:07Z",
    "agent" : [{
      "role" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
          "code" : "AUT"
        }]
      }],
      "who" : {
        "reference" : "Practitioner/example",
        "display" : "Dr Adam Careful"
      }
    }],
    "signature" : [{
      "type" : [{
        "system" : "urn:iso-astm:E1762-95:2013",
        "code" : "1.2.840.10065.1.12.1.1",
        "display" : "Author's Signature"
      }],
      "when" : "2017-02-01T17:23:07Z",
      "who" : {
        "reference" : "Practitioner/example",
        "display" : "Dr Adam Careful"
      },
      "targetFormat" : "application/fhir+xml",
      "sigFormat" : "application/signature+xml",
      "data" : "dGhpcyBibG9iIGlzIHNuaXBwZWQ="
    }]
  }],
  "identifier" : [{
    "use" : "official",
    "system" : "http://www.bmc.nl/portal/prescriptions",
    "value" : "12345689"
  }],
  "status" : "completed",
  "statusReason" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-status-reason",
      "code" : "altchoice",
      "display" : "Try another treatment first"
    }]
  },
  "intent" : "order",
  "category" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-admin-location",
      "code" : "inpatient",
      "display" : "Inpatient"
    }]
  }],
  "medication" : {
    "reference" : {
      "reference" : "#med0310"
    }
  },
  "subject" : {
    "reference" : "Patient/pat1",
    "display" : "Donald Duck"
  },
  "encounter" : {
    "reference" : "Encounter/f201",
    "display" : "encounter who leads to this prescription"
  },
  "supportingInformation" : [{
    "reference" : "Procedure/biopsy"
  }],
  "authoredOn" : "2015-01-15",
  "requester" : {
    "reference" : "Practitioner/f007",
    "display" : "Patrick Pump"
  },
  "performerType" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "26369006",
      "display" : "Public Health Nurse"
    }]
  },
  "performer" : [{
    "reference" : "Practitioner/f204",
    "display" : "Carla Espinosa"
  }],
  "reason" : [{
    "concept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "297217002",
        "display" : "Rib Pain (finding)"
      }]
    }
  }],
  "insurance" : [{
    "reference" : "Coverage/9876B1"
  }],
  "note" : [{
    "text" : "Patient told to take with food"
  }],
  "dose" : {
    "dosageInstruction" : [{
      "sequence" : 1,
      "text" : "one to two tablets every 4-6 hours as needed for rib pain",
      "additionalInstruction" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "418914006",
          "display" : "Warning. May cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink (qualifier value)"
        }]
      }],
      "patientInstruction" : "Take one to two tablets every four to six hours as needed for rib pain",
      "timing" : {
        "repeat" : {
          "frequency" : 1,
          "period" : 4,
          "periodMax" : 6,
          "periodUnit" : "h"
        }
      },
      "asNeededFor" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "297217002",
          "display" : "Rib Pain (finding)"
        }]
      }],
      "route" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "26643006",
          "display" : "Oral Route"
        }]
      },
      "method" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "421521009",
          "display" : "Swallow - dosing instruction imperative (qualifier value)"
        }]
      },
      "doseAndRate" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
            "code" : "ordered",
            "display" : "Ordered"
          }]
        },
        "doseRange" : {
          "low" : {
            "value" : 1,
            "unit" : "TAB",
            "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
            "code" : "TAB"
          },
          "high" : {
            "value" : 2,
            "unit" : "TAB",
            "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
            "code" : "TAB"
          }
        }
      }]
    }]
  },
  "dispenseRequest" : {
    "validityPeriod" : {
      "start" : "2015-01-15",
      "end" : "2016-01-15"
    },
    "numberOfRepeatsAllowed" : 0,
    "quantity" : {
      "value" : 30,
      "unit" : "TAB",
      "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
      "code" : "TAB"
    },
    "expectedSupplyDuration" : {
      "value" : 10,
      "unit" : "days",
      "system" : "http://unitsofmeasure.org",
      "code" : "d"
    },
    "dispenser" : {
      "reference" : "Organization/2.16.840.1.113883.19.5"
    }
  },
  "substitution" : {
    "allowedBoolean" : true,
    "reason" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "FP",
        "display" : "formulary policy"
      }]
    }
  },
  "eventHistory" : [{
    "reference" : "#signature",
    "display" : "Author's Signature"
  }]
}

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.