R6 Ballot (2nd Draft)

Publish-box (todo)

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",
  "contained" : [{
    "resourceType" : "Medication",
    "id" : "med0310",
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "430127000",
        "display" : "Oxycodone-containing product in oral dose form"
      }]
    }
  },
  {
    "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"
  }],
  "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.