Data Exchange Profiles for 2022 CDC Clinical Practice Guideline for Prescribing Opioids
1.0.0-ballot - STU 1 - Ballot
Data Exchange Profiles for 2022 CDC Clinical Practice Guideline for Prescribing Opioids
1.0.0-ballot - STU 1 - Ballot
This page is part of the Data Exchange Profiles for 2022 CDC Clinical Practice Guideline for Prescribing Opioids (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/cdc-opioid-cpg/StructureDefinition/ChronicPainManagementMedicationRequest | Version: 1.0.0-ballot | |||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: ChronicPainManagementMedicationRequest | ||
Defines the essential criteria for a MedicationRequest intended for chronic pain management, with a duration of more than 56 days.
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:   | ||||
|---|---|---|---|---|---|---|---|---|
  MedicationRequest |
C | 0..* | OpioidMedicationRequest | Ordering of medication for patient or group Constraints: us-core-21, dom-7, chronic-pain-required-elements-invariant | ||||
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| status |
?!SΣC | 1..1 | code | (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Constraints: oru-medreq-status-allowed | ||||
| intent |
?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order | ||||
  Slices for category |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
   category:us-core |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
| doNotPerform |
?!Σ | 0..1 | boolean | (QI-Core) True if medication was not requested Fixed Value: false | ||||
 reported[x] |
SΣ | 0..1 | Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) | (QI-Core)(USCDI) Reported rather than primary record | ||||
 medication[x] |
SΣ | 1..1 | (USCDI) Medication to be taken Binding: Opioid analgesics with ambulatory misuse potential (required) | |||||
 medicationCodeableConcept |
CodeableConcept | |||||||
 medicationReference |
Reference(Opioid Medication Profile) | |||||||
| subject |
SΣ | 1..1 | Reference(Opioid Review Useful Patient Profile) | (QI-Core)(USCDI) Who or group medication request is for | ||||
| encounter |
S | 0..1 | Reference(QICore Encounter) | (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay | ||||
| authoredOn |
SΣ | 1..1 | dateTime | (QI-Core)(USCDI) When request was initially authored | ||||
| requester |
SΣC | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) | (QI-Core)(USCDI) Who/What requested the Request | ||||
| courseOfTherapyType |
S | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
 coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: continuous | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| dosageInstruction |
S | 0..* | Dosage | (QI-Core)(USCDI) How medication should be taken | ||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| text |
SΣ | 0..1 | string | (USCDI) Free text dosage instructions e.g. SIG | ||||
| timing |
SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
 repeat |
ΣC | 0..1 | Element | (QI-Core) When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10 | ||||
 Slices for bounds[x] |
Σ | 0..1 | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Closed by type:$this | |||||
 boundsDuration |
Duration | |||||||
| boundsRange |
Range | |||||||
| boundsPeriod |
Period | |||||||
| bounds[x]:boundsPeriod |
SΣC | 0..1 | Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-period-invariant | ||||
| bounds[x]:boundsDuration |
SΣC | 0..1 | Duration | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-duration-invariant | ||||
| bounds[x]:boundsRange |
SΣC | 0..1 | Range | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-range-invariant | ||||
| doseAndRate |
SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| dose[x] |
SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity |
Quantity S | |||||||
| doseRange |
Range | |||||||
| dispenseRequest |
S | 0..1 | BackboneElement | (QI-Core)(USCDI) Medication supply authorization | ||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| numberOfRepeatsAllowed |
S | 0..1 | unsignedInt | (QI-Core)(USCDI) Number of refills authorized | ||||
| quantity |
S | 0..1 | SimpleQuantity | (QI-Core)(USCDI) Amount of medication to supply per dispense | ||||
| expectedSupplyDuration |
SC | 0..1 | Duration | (QI-Core) Number of days supply per dispense Constraints: chronic-pain-expected-supply-duration-invariant | ||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-statusFrom the FHIR Standard | ||||
| MedicationRequest.intent | required | Pattern Value: orderhttp://hl7.org/fhir/ValueSet/medicationrequest-intentFrom the FHIR Standard | ||||
| MedicationRequest.category | example | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.category:us-core | required | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.medication[x] | required | OPIOID_ANALGESICS_WITH_AMBULATORY_MISUSE_POTENTIALhttp://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potentialFrom this IG | ||||
| MedicationRequest.courseOfTherapyType | example | Pattern Value: continuoushttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapyFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM unitshttp://hl7.org/fhir/ValueSet/ucum-commonFrom the FHIR Standard
|
| Id | Grade | Path(s) | Details | Requirements |
| chronic-pain-bounds-duration-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-bounds-period-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists(end.toDateTime() > (start.toDateTime() + 56 days)) | |
| chronic-pain-bounds-range-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((high.value.toString() + high.unit).toQuantity() > 56 days) | |
| chronic-pain-expected-supply-duration-invariant | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-required-elements-invariant | error | MedicationRequest | One of courseOfTherapyType, dosageInstruction.timing.repeat.bounds[x] or dispenseRequest.expectedSupplyDuration SHALL be present. : courseOfTherapyType.exists() or dosageInstruction.timing.repeat.bounds.exists() or dispenseRequest.expectedSupplyDuration.exists() | |
| dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| oru-medreq-status-allowed | error | MedicationRequest.status | status must be active, completed, or stopped. : $this = 'active' or $this = 'completed' or $this = 'stopped' | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() | |
| us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists() |
This structure is derived from OpioidMedicationRequest
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| MedicationRequest |
C | 0..* | OpioidMedicationRequest | Ordering of medication for patient or group Constraints: chronic-pain-required-elements-invariant |
 courseOfTherapyType |
S | 0..1 | CodeableConcept | Overall pattern of medication administration Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: continuous | |
| dosageInstruction |
||||
| timing |
||||
| repeat |
||||
| Slices for bounds[x] |
0..1 | Duration, Range, Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Open by type:$this | |
| bounds[x]:boundsPeriod |
SC | 0..1 | Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-period-invariant |
| bounds[x]:boundsDuration |
SC | 0..1 | Duration | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-duration-invariant |
| bounds[x]:boundsRange |
SC | 0..1 | Range | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-range-invariant |
| dispenseRequest |
||||
| expectedSupplyDuration |
SC | 0..1 | Duration | (QI-Core) Number of days supply per dispense Constraints: chronic-pain-expected-supply-duration-invariant |
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| chronic-pain-bounds-duration-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-bounds-period-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists(end.toDateTime() > (start.toDateTime() + 56 days)) | |
| chronic-pain-bounds-range-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((high.value.toString() + high.unit).toQuantity() > 56 days) | |
| chronic-pain-expected-supply-duration-invariant | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-required-elements-invariant | error | MedicationRequest | One of courseOfTherapyType, dosageInstruction.timing.repeat.bounds[x] or dispenseRequest.expectedSupplyDuration SHALL be present. : courseOfTherapyType.exists() or dosageInstruction.timing.repeat.bounds.exists() or dispenseRequest.expectedSupplyDuration.exists() |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest |
C | 0..* | OpioidMedicationRequest | Ordering of medication for patient or group Constraints: us-core-21, dom-7, chronic-pain-required-elements-invariant | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
 extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
0..* | Identifier | External ids for this request | |||||
| status |
?!SΣC | 1..1 | code | (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Constraints: oru-medreq-status-allowed | ||||
| statusReason |
0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status. | |||||
| intent |
?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order | ||||
| Slices for category |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
| category:us-core |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
| priority |
Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | ||||
| doNotPerform |
?!Σ | 0..1 | boolean | (QI-Core) True if medication was not requested Fixed Value: false | ||||
| reported[x] |
SΣ | 0..1 | Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) | (QI-Core)(USCDI) Reported rather than primary record | ||||
| medication[x] |
SΣ | 1..1 | (USCDI) Medication to be taken Binding: Opioid analgesics with ambulatory misuse potential (required) | |||||
| medicationCodeableConcept |
CodeableConcept | |||||||
| medicationReference |
Reference(Opioid Medication Profile) | |||||||
| subject |
SΣ | 1..1 | Reference(Opioid Review Useful Patient Profile) | (QI-Core)(USCDI) Who or group medication request is for | ||||
| encounter |
S | 0..1 | Reference(QICore Encounter) | (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay | ||||
| supportingInformation |
0..* | Reference(Resource) | Information to support ordering of the medication | |||||
| authoredOn |
SΣ | 1..1 | dateTime | (QI-Core)(USCDI) When request was initially authored | ||||
| requester |
SΣC | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) | (QI-Core)(USCDI) Who/What requested the Request | ||||
| performer |
0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration | |||||
| performerType |
Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. | ||||
| recorder |
0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request | |||||
| reasonCode |
0..* | CodeableConcept | (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) | |||||
| reasonReference |
0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription | |||||
| instantiatesCanonical |
Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | ||||
| instantiatesUri |
Σ | 0..* | uri | Instantiates external protocol or definition | ||||
| basedOn |
Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | ||||
| groupIdentifier |
Σ | 0..1 | Identifier | Composite request this is part of | ||||
| courseOfTherapyType |
S | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: continuous | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| insurance |
0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
| note |
0..* | Annotation | Information about the prescription | |||||
| dosageInstruction |
S | 0..* | Dosage | (QI-Core)(USCDI) How medication should be taken | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| sequence |
Σ | 0..1 | integer | The order of the dosage instructions | ||||
| text |
SΣ | 0..1 | string | (USCDI) Free text dosage instructions e.g. SIG | ||||
| additionalInstruction |
Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
| patientInstruction |
Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
| timing |
SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| event |
Σ | 0..* | dateTime | When the event occurs | ||||
| repeat |
ΣC | 0..1 | Element | (QI-Core) When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for bounds[x] |
Σ | 0..1 | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Closed by type:$this | |||||
| boundsDuration |
Duration | |||||||
| boundsRange |
Range | |||||||
| boundsPeriod |
Period | |||||||
| bounds[x]:boundsPeriod |
SΣC | 0..1 | Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-period-invariant | ||||
| bounds[x]:boundsDuration |
SΣC | 0..1 | Duration | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-duration-invariant | ||||
| bounds[x]:boundsRange |
SΣC | 0..1 | Range | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-range-invariant | ||||
| count |
Σ | 0..1 | positiveInt | Number of times to repeat | ||||
| countMax |
Σ | 0..1 | positiveInt | Maximum number of times to repeat | ||||
| duration |
Σ | 0..1 | decimal | How long when it happens | ||||
| durationMax |
Σ | 0..1 | decimal | How long when it happens (Max) | ||||
| durationUnit |
Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| frequency |
Σ | 0..1 | positiveInt | (QI-Core) Event occurs frequency times per period | ||||
| frequencyMax |
Σ | 0..1 | positiveInt | (QI-Core) Event occurs frequencyMax times per period | ||||
| period |
Σ | 0..1 | decimal | (QI-Core) Event occurs frequency times per period | ||||
| periodMax |
Σ | 0..1 | decimal | (QI-Core) Upper limit of period (3-4 hours) | ||||
| periodUnit |
Σ | 0..1 | code | (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| dayOfWeek |
Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required) | ||||
| timeOfDay |
Σ | 0..* | time | Time of day for action | ||||
| when |
Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule. | ||||
| offset |
Σ | 0..1 | unsignedInt | Minutes from event (before or after) | ||||
| code |
Σ | 0..1 | CodeableConcept | BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern. | ||||
| asNeeded[x] |
Σ | 0..1 | (QI-Core) Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | |||||
| asNeededBoolean |
boolean | |||||||
| asNeededCodeableConcept |
CodeableConcept | |||||||
| site |
Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | ||||
| route |
Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | ||||
| method |
Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | ||||
| doseAndRate |
SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| type |
Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. | ||||
| dose[x] |
SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity |
Quantity S | |||||||
| doseRange |
Range | |||||||
| rate[x] |
Σ | 0..1 | Amount of medication per unit of time | |||||
| rateRatio |
Ratio | |||||||
| rateRange |
Range | |||||||
| rateQuantity |
Quantity(SimpleQuantity) | |||||||
| maxDosePerPeriod |
Σ | 0..1 | Ratio | Upper limit on medication per unit of time | ||||
| maxDosePerAdministration |
Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration | ||||
| maxDosePerLifetime |
Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient | ||||
| dispenseRequest |
S | 0..1 | BackboneElement | (QI-Core)(USCDI) Medication supply authorization | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| dispenseInterval |
0..1 | Duration | (QI-Core) Minimum period of time between dispenses | |||||
| validityPeriod |
0..1 | Period | Time period supply is authorized for | |||||
| numberOfRepeatsAllowed |
S | 0..1 | unsignedInt | (QI-Core)(USCDI) Number of refills authorized | ||||
| quantity |
S | 0..1 | SimpleQuantity | (QI-Core)(USCDI) Amount of medication to supply per dispense | ||||
| expectedSupplyDuration |
SC | 0..1 | Duration | (QI-Core) Number of days supply per dispense Constraints: chronic-pain-expected-supply-duration-invariant | ||||
| performer |
0..1 | Reference(Organization) | Intended dispenser | |||||
| substitution |
0..1 | BackboneElement | Any restrictions on medication substitution | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| allowed[x] |
1..1 | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. | ||||||
| allowedBoolean |
boolean | |||||||
| allowedCodeableConcept |
CodeableConcept | |||||||
| reason |
0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | |||||
| priorPrescription |
0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced | |||||
| detectedIssue |
0..* | Reference(DetectedIssue) | Clinical Issue with action | |||||
| eventHistory |
0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| MedicationRequest.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesFrom the FHIR Standard
| ||||
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-statusFrom the FHIR Standard | ||||
| MedicationRequest.statusReason | example | medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reasonFrom the FHIR Standard | ||||
| MedicationRequest.intent | required | Pattern Value: orderhttp://hl7.org/fhir/ValueSet/medicationrequest-intentFrom the FHIR Standard | ||||
| MedicationRequest.category | example | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.category:us-core | required | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.priority | required | RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1From the FHIR Standard | ||||
| MedicationRequest.medication[x] | required | OPIOID_ANALGESICS_WITH_AMBULATORY_MISUSE_POTENTIALhttp://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potentialFrom this IG | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-roleFrom the FHIR Standard | ||||
| MedicationRequest.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code | ||||
| MedicationRequest.courseOfTherapyType | example | Pattern Value: continuoushttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapyFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.durationUnit | required | UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.periodUnit | required | UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek | required | DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.when | required | EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.code | preferred | TimingAbbreviationhttp://hl7.org/fhir/ValueSet/timing-abbreviationFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-typeFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM unitshttp://hl7.org/fhir/ValueSet/ucum-commonFrom the FHIR Standard
| ||||
| MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode | ||||
| MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| chronic-pain-bounds-duration-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-bounds-period-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists(end.toDateTime() > (start.toDateTime() + 56 days)) | |
| chronic-pain-bounds-range-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((high.value.toString() + high.unit).toQuantity() > 56 days) | |
| chronic-pain-expected-supply-duration-invariant | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-required-elements-invariant | error | MedicationRequest | One of courseOfTherapyType, dosageInstruction.timing.repeat.bounds[x] or dispenseRequest.expectedSupplyDuration SHALL be present. : courseOfTherapyType.exists() or dosageInstruction.timing.repeat.bounds.exists() or dispenseRequest.expectedSupplyDuration.exists() | |
| dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| oru-medreq-status-allowed | error | MedicationRequest.status | status must be active, completed, or stopped. : $this = 'active' or $this = 'completed' or $this = 'stopped' | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() | |
| us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists() |
This structure is derived from OpioidMedicationRequest
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest |
C | 0..* | OpioidMedicationRequest | Ordering of medication for patient or group Constraints: us-core-21, dom-7, chronic-pain-required-elements-invariant | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| status |
?!SΣC | 1..1 | code | (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Constraints: oru-medreq-status-allowed | ||||
| intent |
?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order | ||||
| Slices for category |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
| category:us-core |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
| doNotPerform |
?!Σ | 0..1 | boolean | (QI-Core) True if medication was not requested Fixed Value: false | ||||
| reported[x] |
SΣ | 0..1 | Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) | (QI-Core)(USCDI) Reported rather than primary record | ||||
| medication[x] |
SΣ | 1..1 | (USCDI) Medication to be taken Binding: Opioid analgesics with ambulatory misuse potential (required) | |||||
| medicationCodeableConcept |
CodeableConcept | |||||||
| medicationReference |
Reference(Opioid Medication Profile) | |||||||
| subject |
SΣ | 1..1 | Reference(Opioid Review Useful Patient Profile) | (QI-Core)(USCDI) Who or group medication request is for | ||||
| encounter |
S | 0..1 | Reference(QICore Encounter) | (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay | ||||
| authoredOn |
SΣ | 1..1 | dateTime | (QI-Core)(USCDI) When request was initially authored | ||||
| requester |
SΣC | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) | (QI-Core)(USCDI) Who/What requested the Request | ||||
| courseOfTherapyType |
S | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: continuous | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| dosageInstruction |
S | 0..* | Dosage | (QI-Core)(USCDI) How medication should be taken | ||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| text |
SΣ | 0..1 | string | (USCDI) Free text dosage instructions e.g. SIG | ||||
| timing |
SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| repeat |
ΣC | 0..1 | Element | (QI-Core) When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10 | ||||
| Slices for bounds[x] |
Σ | 0..1 | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Closed by type:$this | |||||
| boundsDuration |
Duration | |||||||
| boundsRange |
Range | |||||||
| boundsPeriod |
Period | |||||||
| bounds[x]:boundsPeriod |
SΣC | 0..1 | Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-period-invariant | ||||
| bounds[x]:boundsDuration |
SΣC | 0..1 | Duration | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-duration-invariant | ||||
| bounds[x]:boundsRange |
SΣC | 0..1 | Range | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-range-invariant | ||||
| doseAndRate |
SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| dose[x] |
SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity |
Quantity S | |||||||
| doseRange |
Range | |||||||
| dispenseRequest |
S | 0..1 | BackboneElement | (QI-Core)(USCDI) Medication supply authorization | ||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| numberOfRepeatsAllowed |
S | 0..1 | unsignedInt | (QI-Core)(USCDI) Number of refills authorized | ||||
| quantity |
S | 0..1 | SimpleQuantity | (QI-Core)(USCDI) Amount of medication to supply per dispense | ||||
| expectedSupplyDuration |
SC | 0..1 | Duration | (QI-Core) Number of days supply per dispense Constraints: chronic-pain-expected-supply-duration-invariant | ||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-statusFrom the FHIR Standard | ||||
| MedicationRequest.intent | required | Pattern Value: orderhttp://hl7.org/fhir/ValueSet/medicationrequest-intentFrom the FHIR Standard | ||||
| MedicationRequest.category | example | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.category:us-core | required | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.medication[x] | required | OPIOID_ANALGESICS_WITH_AMBULATORY_MISUSE_POTENTIALhttp://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potentialFrom this IG | ||||
| MedicationRequest.courseOfTherapyType | example | Pattern Value: continuoushttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapyFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM unitshttp://hl7.org/fhir/ValueSet/ucum-commonFrom the FHIR Standard
|
| Id | Grade | Path(s) | Details | Requirements |
| chronic-pain-bounds-duration-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-bounds-period-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists(end.toDateTime() > (start.toDateTime() + 56 days)) | |
| chronic-pain-bounds-range-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((high.value.toString() + high.unit).toQuantity() > 56 days) | |
| chronic-pain-expected-supply-duration-invariant | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-required-elements-invariant | error | MedicationRequest | One of courseOfTherapyType, dosageInstruction.timing.repeat.bounds[x] or dispenseRequest.expectedSupplyDuration SHALL be present. : courseOfTherapyType.exists() or dosageInstruction.timing.repeat.bounds.exists() or dispenseRequest.expectedSupplyDuration.exists() | |
| dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| oru-medreq-status-allowed | error | MedicationRequest.status | status must be active, completed, or stopped. : $this = 'active' or $this = 'completed' or $this = 'stopped' | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() | |
| us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists() |
Differential View
This structure is derived from OpioidMedicationRequest
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| MedicationRequest |
C | 0..* | OpioidMedicationRequest | Ordering of medication for patient or group Constraints: chronic-pain-required-elements-invariant |
| courseOfTherapyType |
S | 0..1 | CodeableConcept | Overall pattern of medication administration Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: continuous | |
| dosageInstruction |
||||
| timing |
||||
| repeat |
||||
| Slices for bounds[x] |
0..1 | Duration, Range, Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Open by type:$this | |
| bounds[x]:boundsPeriod |
SC | 0..1 | Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-period-invariant |
| bounds[x]:boundsDuration |
SC | 0..1 | Duration | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-duration-invariant |
| bounds[x]:boundsRange |
SC | 0..1 | Range | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-range-invariant |
| dispenseRequest |
||||
| expectedSupplyDuration |
SC | 0..1 | Duration | (QI-Core) Number of days supply per dispense Constraints: chronic-pain-expected-supply-duration-invariant |
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| chronic-pain-bounds-duration-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-bounds-period-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists(end.toDateTime() > (start.toDateTime() + 56 days)) | |
| chronic-pain-bounds-range-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((high.value.toString() + high.unit).toQuantity() > 56 days) | |
| chronic-pain-expected-supply-duration-invariant | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-required-elements-invariant | error | MedicationRequest | One of courseOfTherapyType, dosageInstruction.timing.repeat.bounds[x] or dispenseRequest.expectedSupplyDuration SHALL be present. : courseOfTherapyType.exists() or dosageInstruction.timing.repeat.bounds.exists() or dispenseRequest.expectedSupplyDuration.exists() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest |
C | 0..* | OpioidMedicationRequest | Ordering of medication for patient or group Constraints: us-core-21, dom-7, chronic-pain-required-elements-invariant | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
0..* | Identifier | External ids for this request | |||||
| status |
?!SΣC | 1..1 | code | (QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Constraints: oru-medreq-status-allowed | ||||
| statusReason |
0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status. | |||||
| intent |
?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: order | ||||
| Slices for category |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
| category:us-core |
S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
| priority |
Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | ||||
| doNotPerform |
?!Σ | 0..1 | boolean | (QI-Core) True if medication was not requested Fixed Value: false | ||||
| reported[x] |
SΣ | 0..1 | Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) | (QI-Core)(USCDI) Reported rather than primary record | ||||
| medication[x] |
SΣ | 1..1 | (USCDI) Medication to be taken Binding: Opioid analgesics with ambulatory misuse potential (required) | |||||
| medicationCodeableConcept |
CodeableConcept | |||||||
| medicationReference |
Reference(Opioid Medication Profile) | |||||||
| subject |
SΣ | 1..1 | Reference(Opioid Review Useful Patient Profile) | (QI-Core)(USCDI) Who or group medication request is for | ||||
| encounter |
S | 0..1 | Reference(QICore Encounter) | (QI-Core)(USCDI) Encounter created as part of encounter/admission/stay | ||||
| supportingInformation |
0..* | Reference(Resource) | Information to support ordering of the medication | |||||
| authoredOn |
SΣ | 1..1 | dateTime | (QI-Core)(USCDI) When request was initially authored | ||||
| requester |
SΣC | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) | (QI-Core)(USCDI) Who/What requested the Request | ||||
| performer |
0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration | |||||
| performerType |
Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. | ||||
| recorder |
0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request | |||||
| reasonCode |
0..* | CodeableConcept | (QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) | |||||
| reasonReference |
0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription | |||||
| instantiatesCanonical |
Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | ||||
| instantiatesUri |
Σ | 0..* | uri | Instantiates external protocol or definition | ||||
| basedOn |
Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | ||||
| groupIdentifier |
Σ | 0..1 | Identifier | Composite request this is part of | ||||
| courseOfTherapyType |
S | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: continuous | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| insurance |
0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
| note |
0..* | Annotation | Information about the prescription | |||||
| dosageInstruction |
S | 0..* | Dosage | (QI-Core)(USCDI) How medication should be taken | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| sequence |
Σ | 0..1 | integer | The order of the dosage instructions | ||||
| text |
SΣ | 0..1 | string | (USCDI) Free text dosage instructions e.g. SIG | ||||
| additionalInstruction |
Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
| patientInstruction |
Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
| timing |
SΣ | 0..1 | Timing | (QI-Core)(USCDI) When medication should be administered | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| event |
Σ | 0..* | dateTime | When the event occurs | ||||
| repeat |
ΣC | 0..1 | Element | (QI-Core) When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for bounds[x] |
Σ | 0..1 | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Closed by type:$this | |||||
| boundsDuration |
Duration | |||||||
| boundsRange |
Range | |||||||
| boundsPeriod |
Period | |||||||
| bounds[x]:boundsPeriod |
SΣC | 0..1 | Period | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-period-invariant | ||||
| bounds[x]:boundsDuration |
SΣC | 0..1 | Duration | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-duration-invariant | ||||
| bounds[x]:boundsRange |
SΣC | 0..1 | Range | (QI-Core) Length/Range of lengths, or (Start and/or end) limits Constraints: chronic-pain-bounds-range-invariant | ||||
| count |
Σ | 0..1 | positiveInt | Number of times to repeat | ||||
| countMax |
Σ | 0..1 | positiveInt | Maximum number of times to repeat | ||||
| duration |
Σ | 0..1 | decimal | How long when it happens | ||||
| durationMax |
Σ | 0..1 | decimal | How long when it happens (Max) | ||||
| durationUnit |
Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| frequency |
Σ | 0..1 | positiveInt | (QI-Core) Event occurs frequency times per period | ||||
| frequencyMax |
Σ | 0..1 | positiveInt | (QI-Core) Event occurs frequencyMax times per period | ||||
| period |
Σ | 0..1 | decimal | (QI-Core) Event occurs frequency times per period | ||||
| periodMax |
Σ | 0..1 | decimal | (QI-Core) Upper limit of period (3-4 hours) | ||||
| periodUnit |
Σ | 0..1 | code | (QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| dayOfWeek |
Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required) | ||||
| timeOfDay |
Σ | 0..* | time | Time of day for action | ||||
| when |
Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule. | ||||
| offset |
Σ | 0..1 | unsignedInt | Minutes from event (before or after) | ||||
| code |
Σ | 0..1 | CodeableConcept | BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern. | ||||
| asNeeded[x] |
Σ | 0..1 | (QI-Core) Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | |||||
| asNeededBoolean |
boolean | |||||||
| asNeededCodeableConcept |
CodeableConcept | |||||||
| site |
Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. | ||||
| route |
Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | ||||
| method |
Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. | ||||
| doseAndRate |
SΣ | 0..* | Element | (QI-Core)(USCDI) Amount of medication administered | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| type |
Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. | ||||
| dose[x] |
SΣ | 0..1 | (QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
| doseQuantity |
Quantity S | |||||||
| doseRange |
Range | |||||||
| rate[x] |
Σ | 0..1 | Amount of medication per unit of time | |||||
| rateRatio |
Ratio | |||||||
| rateRange |
Range | |||||||
| rateQuantity |
Quantity(SimpleQuantity) | |||||||
| maxDosePerPeriod |
Σ | 0..1 | Ratio | Upper limit on medication per unit of time | ||||
| maxDosePerAdministration |
Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration | ||||
| maxDosePerLifetime |
Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient | ||||
| dispenseRequest |
S | 0..1 | BackboneElement | (QI-Core)(USCDI) Medication supply authorization | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| dispenseInterval |
0..1 | Duration | (QI-Core) Minimum period of time between dispenses | |||||
| validityPeriod |
0..1 | Period | Time period supply is authorized for | |||||
| numberOfRepeatsAllowed |
S | 0..1 | unsignedInt | (QI-Core)(USCDI) Number of refills authorized | ||||
| quantity |
S | 0..1 | SimpleQuantity | (QI-Core)(USCDI) Amount of medication to supply per dispense | ||||
| expectedSupplyDuration |
SC | 0..1 | Duration | (QI-Core) Number of days supply per dispense Constraints: chronic-pain-expected-supply-duration-invariant | ||||
| performer |
0..1 | Reference(Organization) | Intended dispenser | |||||
| substitution |
0..1 | BackboneElement | Any restrictions on medication substitution | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| allowed[x] |
1..1 | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. | ||||||
| allowedBoolean |
boolean | |||||||
| allowedCodeableConcept |
CodeableConcept | |||||||
| reason |
0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | |||||
| priorPrescription |
0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced | |||||
| detectedIssue |
0..* | Reference(DetectedIssue) | Clinical Issue with action | |||||
| eventHistory |
0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| MedicationRequest.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesFrom the FHIR Standard
| ||||
| MedicationRequest.status | required | medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-statusFrom the FHIR Standard | ||||
| MedicationRequest.statusReason | example | medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reasonFrom the FHIR Standard | ||||
| MedicationRequest.intent | required | Pattern Value: orderhttp://hl7.org/fhir/ValueSet/medicationrequest-intentFrom the FHIR Standard | ||||
| MedicationRequest.category | example | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.category:us-core | required | medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-categoryFrom the FHIR Standard | ||||
| MedicationRequest.priority | required | RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1From the FHIR Standard | ||||
| MedicationRequest.medication[x] | required | OPIOID_ANALGESICS_WITH_AMBULATORY_MISUSE_POTENTIALhttp://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potentialFrom this IG | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-roleFrom the FHIR Standard | ||||
| MedicationRequest.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code | ||||
| MedicationRequest.courseOfTherapyType | example | Pattern Value: continuoushttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapyFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.durationUnit | required | UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.periodUnit | required | UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek | required | DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.repeat.when | required | EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1From the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.timing.code | preferred | TimingAbbreviationhttp://hl7.org/fhir/ValueSet/timing-abbreviationFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reasonFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.route | example | SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codesFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-typeFrom the FHIR Standard | ||||
| MedicationRequest.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM unitshttp://hl7.org/fhir/ValueSet/ucum-commonFrom the FHIR Standard
| ||||
| MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode | ||||
| MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| chronic-pain-bounds-duration-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-bounds-period-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists(end.toDateTime() > (start.toDateTime() + 56 days)) | |
| chronic-pain-bounds-range-invariant | error | MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((high.value.toString() + high.unit).toQuantity() > 56 days) | |
| chronic-pain-expected-supply-duration-invariant | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | Chronic pain MedicationRequest SHALL have a duration of > 56 days : exists((value.toString() + unit).toQuantity() > 56 days) | |
| chronic-pain-required-elements-invariant | error | MedicationRequest | One of courseOfTherapyType, dosageInstruction.timing.repeat.bounds[x] or dispenseRequest.expectedSupplyDuration SHALL be present. : courseOfTherapyType.exists() or dosageInstruction.timing.repeat.bounds.exists() or dispenseRequest.expectedSupplyDuration.exists() | |
| dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| oru-medreq-status-allowed | error | MedicationRequest.status | status must be active, completed, or stopped. : $this = 'active' or $this = 'completed' or $this = 'stopped' | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() | |
| us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists() |
This structure is derived from OpioidMedicationRequest
Other representations of profile: CSV, Excel, Schematron
IG © 2024+ HL7 International / Clinical Decision Support. Package hl7.fhir.us.cdc-opioid-cpg#1.0.0-ballot based on FHIR 4.0.1. Generated 2025-08-01
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