R6 Ballot (1st Draft)

This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions

12.21 Resource VisionPrescription - Content

Orders and Observations icon Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner

An authorization for the provision of glasses and/or contact lenses to a patient.

12.21.1 Scope and Usage

The VisionPrescription resource is intended to support the information requirements for a prescription for glasses and contact lenses for a patient. Corrective optical lenses are considered a controlled substance and therefore a prescription is typically required for the provision of patient-specific lenses.

Vision prescriptions may only be issued by providers who have optical diagnosis within their scope of practice, typically ophthalmologists and optometrists. The prescription is a time-limited, typically two years, authorization for the provision of an unlimited number of lenses, glasses or contacts, which conform to the authorized specification by providers which have lens provision within their scope of practice, typically ophthalmologists , optometrists and opticians.

Health insurers typically require a copy of the prescription to ensure that a vision professional has examined the patient and that the power of the lenses exceeds some minimum, such as +- 0.75 diopters, to qualify for reimbursement under the insurance coverage.

The VisionPrescription resource is an "request" resource from a FHIR workflow perspective - see Workflow Request.

12.21.1.1 Additional Information

Additional information regarding resources conveying electronic claims content and usage may be found at:

12.21.2 Boundaries and Relationships

The VisionPrescription resource is used to provide the authorized specification of lenses for glasses and contacts which have well known and internationally consistent requirements, which is distinct from other types of health care authorizations detailed below.

The health care domain includes a number of related resources
VisionPrescription The VisionPrescription resource is used to provide the authorized specification of lenses for glasses and contacts.
DeviceRequest This resource is used to prescribe, authorize, and request provision of a health care device such as a halter monitor or a wheelchair services.
MedicationRequest This resource is used to prescribe, authorize, and request provision of medications such a pharmaceuticals and vaccines.
ServiceRequest This resource is used to prescribe, authorize, and request provision of health care services such as consultative or rehabilitative services.

12.21.3 References to this Resource

12.21.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. VisionPrescription TUDomainResourcePrescription for vision correction products for a patient

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierBusiness Identifier for vision prescription

... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (Required)
... created Σ1..1dateTimeResponse creation date
... encounter 0..1Reference(Encounter)Created during encounter / admission / stay
... dateWritten Σ1..1dateTimeWhen prescription was authorized
... prescriber Σ1..1Reference(Practitioner | PractitionerRole)Who authorized the vision prescription
... lensSpecification Σ1..*BackboneElementVision lens authorization

.... product Σ1..1CodeableConceptProduct to be supplied
Binding: Example Vision Prescription Product Codes (Example)
.... eye Σ1..1coderight | left
Binding: Vision Eyes (Required)
.... sphere 0..1decimalPower of the lens
.... cylinder 0..1decimalLens power for astigmatism
.... axis 0..1integerLens meridian which contain no power for astigmatism
.... prism 0..*BackboneElementEye alignment compensation

..... amount 1..1decimalAmount of adjustment
..... base 1..1codeup | down | in | out
Binding: Vision Base (Required)
.... add 0..1decimalAdded power for multifocal levels
.... power 0..1decimalContact lens power
.... backCurve 0..1decimalContact lens back curvature
.... diameter 0..1decimalContact lens diameter
.... duration 0..1SimpleQuantityLens wear duration
.... color 0..1stringColor required
.... brand 0..1stringBrand required
.... note 0..*AnnotationNotes for coatings


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

VisionPrescription (DomainResource)A unique identifier assigned to this vision prescriptionidentifier : Identifier [0..*]The status of the resource instance (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)FinancialResourceStatusCodes! »The date this resource was createdcreated : dateTime [1..1]A resource reference to the person to whom the vision prescription appliespatient : Reference [1..1] « Patient »A reference to a resource that identifies the particular occurrence of contact between patient and health care provider during which the prescription was issuedencounter : Reference [0..1] « Encounter »The date (and perhaps time) when the prescription was writtendateWritten : dateTime [1..1]The healthcare professional responsible for authorizing the prescriptionprescriber : Reference [1..1] « Practitioner|PractitionerRole »LensSpecificationIdentifies the type of vision correction product which is required for the patientproduct : CodeableConcept [1..1] « null (Strength=Example)ExampleVisionPrescriptionProd...?? »The eye for which the lens specification applieseye : code [1..1] « null (Strength=Required)VisionEyes! »Lens power measured in dioptres (0.25 units)sphere : decimal [0..1]Power adjustment for astigmatism measured in dioptres (0.25 units)cylinder : decimal [0..1]Adjustment for astigmatism measured in integer degreesaxis : integer [0..1]Power adjustment for multifocal lenses measured in dioptres (0.25 units)add : decimal [0..1]Contact lens power measured in dioptres (0.25 units)power : decimal [0..1]Back curvature measured in millimetresbackCurve : decimal [0..1]Contact lens diameter measured in millimetresdiameter : decimal [0..1]The recommended maximum wear period for the lensduration : Quantity(SimpleQuantity) [0..1]Special color or patterncolor : string [0..1]Brand recommendations or restrictionsbrand : string [0..1]Notes for special requirements such as coatings and lens materialsnote : Annotation [0..*]PrismAmount of prism to compensate for eye alignment in fractional unitsamount : decimal [1..1]The relative base, or reference lens edge, for the prismbase : code [1..1] « null (Strength=Required)VisionBase! »Allows for adjustment on two axisprism[0..*]Contain the details of the individual lens specifications and serves as the authorization for the fullfillment by certified professionalslensSpecification[1..*]

XML Template

<VisionPrescription xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for vision prescription --></identifier>
 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <created value="[dateTime]"/><!-- 1..1 Response creation date -->
 <patient><!-- 1..1 Reference(Patient) Who prescription is for --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Created during encounter / admission / stay --></encounter>
 <dateWritten value="[dateTime]"/><!-- 1..1 When prescription was authorized -->
 <prescriber><!-- 1..1 Reference(Practitioner|PractitionerRole) Who authorized the vision prescription --></prescriber>
 <lensSpecification>  <!-- 1..* Vision lens authorization -->
  <product><!-- 1..1 CodeableConcept Product to be supplied --></product>
  <eye value="[code]"/><!-- 1..1 right | left -->
  <sphere value="[decimal]"/><!-- 0..1 Power of the lens -->
  <cylinder value="[decimal]"/><!-- 0..1 Lens power for astigmatism -->
  <axis value="[integer]"/><!-- 0..1 Lens meridian which contain no power for astigmatism -->
  <prism>  <!-- 0..* Eye alignment compensation -->
   <amount value="[decimal]"/><!-- 1..1 Amount of adjustment -->
   <base value="[code]"/><!-- 1..1 up | down | in | out -->
  </prism>
  <add value="[decimal]"/><!-- 0..1 Added power for multifocal levels -->
  <power value="[decimal]"/><!-- 0..1 Contact lens power -->
  <backCurve value="[decimal]"/><!-- 0..1 Contact lens back curvature -->
  <diameter value="[decimal]"/><!-- 0..1 Contact lens diameter -->
  <duration><!-- 0..1 Quantity(SimpleQuantity) Lens wear duration --></duration>
  <color value="[string]"/><!-- 0..1 Color required -->
  <brand value="[string]"/><!-- 0..1 Brand required -->
  <note><!-- 0..* Annotation Notes for coatings --></note>
 </lensSpecification>
</VisionPrescription>

JSON Template

{doco
  "resourceType" : "VisionPrescription",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for vision prescription
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "created" : "<dateTime>", // R!  Response creation date
  "patient" : { Reference(Patient) }, // R!  Who prescription is for
  "encounter" : { Reference(Encounter) }, // Created during encounter / admission / stay
  "dateWritten" : "<dateTime>", // R!  When prescription was authorized
  "prescriber" : { Reference(Practitioner|PractitionerRole) }, // R!  Who authorized the vision prescription
  "lensSpecification" : [{ // R!  Vision lens authorization
    "product" : { CodeableConcept }, // R!  Product to be supplied
    "eye" : "<code>", // R!  right | left
    "sphere" : <decimal>, // Power of the lens
    "cylinder" : <decimal>, // Lens power for astigmatism
    "axis" : <integer>, // Lens meridian which contain no power for astigmatism
    "prism" : [{ // Eye alignment compensation
      "amount" : <decimal>, // R!  Amount of adjustment
      "base" : "<code>" // R!  up | down | in | out
    }],
    "add" : <decimal>, // Added power for multifocal levels
    "power" : <decimal>, // Contact lens power
    "backCurve" : <decimal>, // Contact lens back curvature
    "diameter" : <decimal>, // Contact lens diameter
    "duration" : { Quantity(SimpleQuantity) }, // Lens wear duration
    "color" : "<string>", // Color required
    "brand" : "<string>", // Brand required
    "note" : [{ Annotation }] // Notes for coatings
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:VisionPrescription;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for vision prescription
  fhir:status [ code ] ; # 1..1 active | cancelled | draft | entered-in-error
  fhir:created [ dateTime ] ; # 1..1 Response creation date
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who prescription is for
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Created during encounter / admission / stay
  fhir:dateWritten [ dateTime ] ; # 1..1 When prescription was authorized
  fhir:prescriber [ Reference(Practitioner|PractitionerRole) ] ; # 1..1 Who authorized the vision prescription
  fhir:lensSpecification ( [ # 1..* Vision lens authorization
    fhir:product [ CodeableConcept ] ; # 1..1 Product to be supplied
    fhir:eye [ code ] ; # 1..1 right | left
    fhir:sphere [ decimal ] ; # 0..1 Power of the lens
    fhir:cylinder [ decimal ] ; # 0..1 Lens power for astigmatism
    fhir:axis [ integer ] ; # 0..1 Lens meridian which contain no power for astigmatism
    fhir:prism ( [ # 0..* Eye alignment compensation
      fhir:amount [ decimal ] ; # 1..1 Amount of adjustment
      fhir:base [ code ] ; # 1..1 up | down | in | out
    ] ... ) ;
    fhir:add [ decimal ] ; # 0..1 Added power for multifocal levels
    fhir:power [ decimal ] ; # 0..1 Contact lens power
    fhir:backCurve [ decimal ] ; # 0..1 Contact lens back curvature
    fhir:diameter [ decimal ] ; # 0..1 Contact lens diameter
    fhir:duration [ Quantity(SimpleQuantity) ] ; # 0..1 Lens wear duration
    fhir:color [ string ] ; # 0..1 Color required
    fhir:brand [ string ] ; # 0..1 Brand required
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Notes for coatings
  ] ... ) ;
]

Changes from both R4 and R4B

VisionPrescription
  • No Changes

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. VisionPrescription TUDomainResourcePrescription for vision correction products for a patient

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierBusiness Identifier for vision prescription

... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (Required)
... created Σ1..1dateTimeResponse creation date
... encounter 0..1Reference(Encounter)Created during encounter / admission / stay
... dateWritten Σ1..1dateTimeWhen prescription was authorized
... prescriber Σ1..1Reference(Practitioner | PractitionerRole)Who authorized the vision prescription
... lensSpecification Σ1..*BackboneElementVision lens authorization

.... product Σ1..1CodeableConceptProduct to be supplied
Binding: Example Vision Prescription Product Codes (Example)
.... eye Σ1..1coderight | left
Binding: Vision Eyes (Required)
.... sphere 0..1decimalPower of the lens
.... cylinder 0..1decimalLens power for astigmatism
.... axis 0..1integerLens meridian which contain no power for astigmatism
.... prism 0..*BackboneElementEye alignment compensation

..... amount 1..1decimalAmount of adjustment
..... base 1..1codeup | down | in | out
Binding: Vision Base (Required)
.... add 0..1decimalAdded power for multifocal levels
.... power 0..1decimalContact lens power
.... backCurve 0..1decimalContact lens back curvature
.... diameter 0..1decimalContact lens diameter
.... duration 0..1SimpleQuantityLens wear duration
.... color 0..1stringColor required
.... brand 0..1stringBrand required
.... note 0..*AnnotationNotes for coatings


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

VisionPrescription (DomainResource)A unique identifier assigned to this vision prescriptionidentifier : Identifier [0..*]The status of the resource instance (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)FinancialResourceStatusCodes! »The date this resource was createdcreated : dateTime [1..1]A resource reference to the person to whom the vision prescription appliespatient : Reference [1..1] « Patient »A reference to a resource that identifies the particular occurrence of contact between patient and health care provider during which the prescription was issuedencounter : Reference [0..1] « Encounter »The date (and perhaps time) when the prescription was writtendateWritten : dateTime [1..1]The healthcare professional responsible for authorizing the prescriptionprescriber : Reference [1..1] « Practitioner|PractitionerRole »LensSpecificationIdentifies the type of vision correction product which is required for the patientproduct : CodeableConcept [1..1] « null (Strength=Example)ExampleVisionPrescriptionProd...?? »The eye for which the lens specification applieseye : code [1..1] « null (Strength=Required)VisionEyes! »Lens power measured in dioptres (0.25 units)sphere : decimal [0..1]Power adjustment for astigmatism measured in dioptres (0.25 units)cylinder : decimal [0..1]Adjustment for astigmatism measured in integer degreesaxis : integer [0..1]Power adjustment for multifocal lenses measured in dioptres (0.25 units)add : decimal [0..1]Contact lens power measured in dioptres (0.25 units)power : decimal [0..1]Back curvature measured in millimetresbackCurve : decimal [0..1]Contact lens diameter measured in millimetresdiameter : decimal [0..1]The recommended maximum wear period for the lensduration : Quantity(SimpleQuantity) [0..1]Special color or patterncolor : string [0..1]Brand recommendations or restrictionsbrand : string [0..1]Notes for special requirements such as coatings and lens materialsnote : Annotation [0..*]PrismAmount of prism to compensate for eye alignment in fractional unitsamount : decimal [1..1]The relative base, or reference lens edge, for the prismbase : code [1..1] « null (Strength=Required)VisionBase! »Allows for adjustment on two axisprism[0..*]Contain the details of the individual lens specifications and serves as the authorization for the fullfillment by certified professionalslensSpecification[1..*]

XML Template

<VisionPrescription xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for vision prescription --></identifier>
 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <created value="[dateTime]"/><!-- 1..1 Response creation date -->
 <patient><!-- 1..1 Reference(Patient) Who prescription is for --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Created during encounter / admission / stay --></encounter>
 <dateWritten value="[dateTime]"/><!-- 1..1 When prescription was authorized -->
 <prescriber><!-- 1..1 Reference(Practitioner|PractitionerRole) Who authorized the vision prescription --></prescriber>
 <lensSpecification>  <!-- 1..* Vision lens authorization -->
  <product><!-- 1..1 CodeableConcept Product to be supplied --></product>
  <eye value="[code]"/><!-- 1..1 right | left -->
  <sphere value="[decimal]"/><!-- 0..1 Power of the lens -->
  <cylinder value="[decimal]"/><!-- 0..1 Lens power for astigmatism -->
  <axis value="[integer]"/><!-- 0..1 Lens meridian which contain no power for astigmatism -->
  <prism>  <!-- 0..* Eye alignment compensation -->
   <amount value="[decimal]"/><!-- 1..1 Amount of adjustment -->
   <base value="[code]"/><!-- 1..1 up | down | in | out -->
  </prism>
  <add value="[decimal]"/><!-- 0..1 Added power for multifocal levels -->
  <power value="[decimal]"/><!-- 0..1 Contact lens power -->
  <backCurve value="[decimal]"/><!-- 0..1 Contact lens back curvature -->
  <diameter value="[decimal]"/><!-- 0..1 Contact lens diameter -->
  <duration><!-- 0..1 Quantity(SimpleQuantity) Lens wear duration --></duration>
  <color value="[string]"/><!-- 0..1 Color required -->
  <brand value="[string]"/><!-- 0..1 Brand required -->
  <note><!-- 0..* Annotation Notes for coatings --></note>
 </lensSpecification>
</VisionPrescription>

JSON Template

{doco
  "resourceType" : "VisionPrescription",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for vision prescription
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "created" : "<dateTime>", // R!  Response creation date
  "patient" : { Reference(Patient) }, // R!  Who prescription is for
  "encounter" : { Reference(Encounter) }, // Created during encounter / admission / stay
  "dateWritten" : "<dateTime>", // R!  When prescription was authorized
  "prescriber" : { Reference(Practitioner|PractitionerRole) }, // R!  Who authorized the vision prescription
  "lensSpecification" : [{ // R!  Vision lens authorization
    "product" : { CodeableConcept }, // R!  Product to be supplied
    "eye" : "<code>", // R!  right | left
    "sphere" : <decimal>, // Power of the lens
    "cylinder" : <decimal>, // Lens power for astigmatism
    "axis" : <integer>, // Lens meridian which contain no power for astigmatism
    "prism" : [{ // Eye alignment compensation
      "amount" : <decimal>, // R!  Amount of adjustment
      "base" : "<code>" // R!  up | down | in | out
    }],
    "add" : <decimal>, // Added power for multifocal levels
    "power" : <decimal>, // Contact lens power
    "backCurve" : <decimal>, // Contact lens back curvature
    "diameter" : <decimal>, // Contact lens diameter
    "duration" : { Quantity(SimpleQuantity) }, // Lens wear duration
    "color" : "<string>", // Color required
    "brand" : "<string>", // Brand required
    "note" : [{ Annotation }] // Notes for coatings
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:VisionPrescription;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for vision prescription
  fhir:status [ code ] ; # 1..1 active | cancelled | draft | entered-in-error
  fhir:created [ dateTime ] ; # 1..1 Response creation date
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who prescription is for
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Created during encounter / admission / stay
  fhir:dateWritten [ dateTime ] ; # 1..1 When prescription was authorized
  fhir:prescriber [ Reference(Practitioner|PractitionerRole) ] ; # 1..1 Who authorized the vision prescription
  fhir:lensSpecification ( [ # 1..* Vision lens authorization
    fhir:product [ CodeableConcept ] ; # 1..1 Product to be supplied
    fhir:eye [ code ] ; # 1..1 right | left
    fhir:sphere [ decimal ] ; # 0..1 Power of the lens
    fhir:cylinder [ decimal ] ; # 0..1 Lens power for astigmatism
    fhir:axis [ integer ] ; # 0..1 Lens meridian which contain no power for astigmatism
    fhir:prism ( [ # 0..* Eye alignment compensation
      fhir:amount [ decimal ] ; # 1..1 Amount of adjustment
      fhir:base [ code ] ; # 1..1 up | down | in | out
    ] ... ) ;
    fhir:add [ decimal ] ; # 0..1 Added power for multifocal levels
    fhir:power [ decimal ] ; # 0..1 Contact lens power
    fhir:backCurve [ decimal ] ; # 0..1 Contact lens back curvature
    fhir:diameter [ decimal ] ; # 0..1 Contact lens diameter
    fhir:duration [ Quantity(SimpleQuantity) ] ; # 0..1 Lens wear duration
    fhir:color [ string ] ; # 0..1 Color required
    fhir:brand [ string ] ; # 0..1 Brand required
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Notes for coatings
  ] ... ) ;
]

Changes from both R4 and R4B

VisionPrescription
  • No Changes

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

12.21.4.1 Terminology Bindings

PathValueSetTypeDocumentation
VisionPrescription.status FinancialResourceStatusCodes Required

This value set includes Status codes.
VisionPrescription.lensSpecification.product ExampleVisionPrescriptionProductCodes Example

This value set includes a smattering of Prescription Product codes.
VisionPrescription.lensSpecification.eye VisionEyes Required

A coded concept listing the eye codes.
VisionPrescription.lensSpecification.prism.base VisionBase Required

A coded concept listing the base codes.

12.21.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
datewrittendateReturn prescriptions written on this dateVisionPrescription.dateWritten
encounterreferenceReturn prescriptions with this encounter identifierVisionPrescription.encounter
(Encounter)		29 Resources
identifiertokenReturn prescriptions with this external identifierVisionPrescription.identifier65 Resources
patientreferenceThe identity of a patient to list dispenses forVisionPrescription.patient
(Patient)		66 Resources
prescriberreferenceWho authorized the vision prescriptionVisionPrescription.prescriber
(Practitioner, PractitionerRole)
statustokenThe status of the vision prescriptionVisionPrescription.status