| Left: | US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest) | 
| Right: | US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest) | 
| Warning | MedicationRequest.dosageInstruction.route | Elements differ in definition for mustSupport: 'false' vs 'true' | 
| Name | Value | Comments | |
|---|---|---|---|
|  abstract | false | ||
|  baseDefinition | http://hl7.org/fhir/StructureDefinition/MedicationRequest | ||
|  copyright | Used by permission of HL7 International, all rights reserved Creative Commons License | ||
|  description | The US Core MedicationRequest Profile inherits from the FHIR [MedicationRequest](https://hl7.org/fhir/R4/medicationrequest.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) *Medications* Data Class. This profile sets minimum expectations for the MedicationRequest resource to record, search, and fetch a patient's medication prescriptions or orders. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | The US Core MedicationRequest Profile inherits from the FHIR [MedicationRequest](https://hl7.org/fhir/R4/medicationrequest.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the [U.S. Core Data for Interoperability (USCDI)](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi) *Medications* Data Class. This profile sets minimum expectations for the MedicationRequest resource to record, search, and fetch a patient's medication prescriptions or orders. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | 
 | 
|  experimental | false | ||
|  fhirVersion | 4.0.1 | ||
|  jurisdiction | |||
|   jurisdiction[0] | urn:iso:std:iso:3166#US | ||
|  kind | resource | ||
|  name | USCoreMedicationRequestProfile | ||
|  publisher | HL7 International / Cross-Group Projects | ||
|  purpose | |||
|  status | active | ||
|  title | US Core MedicationRequest Profile | ||
|  type | MedicationRequest | ||
|  url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest | ||
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments  | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|   MedicationRequest | C | 0..* | MedicationRequest | Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order" | C | 0..* | MedicationRequest | Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order" | |||||||||
|    id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
|    language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language. 
 | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language. 
 | |||||||||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
|    contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
|    Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
|    modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
|    identifier | 0..* | Identifier | External ids for this request | 0..* | Identifier | External ids for this request | |||||||||||
|    status | ?!SΣ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ?!SΣ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | |||||||||
|    statusReason | 0..1 | CodeableConcept | Reason for current status Binding: ?? (example): Identifies the reasons for a given status. | 0..1 | CodeableConcept | Reason for current status Binding: ?? (example): Identifies the reasons for a given status. | |||||||||||
|    intent | ?!SΣC | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. | ?!SΣC | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. | |||||||||
|    Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: ?? (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by value:$this Binding: ?? (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. | |||||||||
|    priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. | |||||||||
|    doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action | ?!Σ | 0..1 | boolean | True if request is prohibiting action | |||||||||
|    reported[x] | SΣ | 0..1 | boolean S, Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | Reported rather than primary record | SΣ | 0..1 | boolean S, Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | Reported rather than primary record | |||||||||
|    medication[x] | SΣ | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | Medication to be taken Binding: ?? (extensible) | SΣ | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | Medication to be taken Binding: ?? (extensible) | |||||||||
|    subject | SΣ | 1..1 | Reference(US Core Patient Profile S | Group) | Who or group medication request is for | SΣ | 1..1 | Reference(US Core Patient Profile S | Group) | Who or group medication request is for | |||||||||
|    encounter | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of encounter/admission/stay | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of encounter/admission/stay | |||||||||
|    supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | 0..* | Reference(Resource) | Information to support ordering of the medication | |||||||||||
|    authoredOn | SΣ | 0..1 | dateTime | When request was initially authored | SΣ | 0..1 | dateTime | When request was initially authored | |||||||||
|    requester | SΣC | 0..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Who/What requested the Request | SΣC | 0..1 | Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) | Who/What requested the Request | |||||||||
|    performer | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration | 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: ?? (example): Identifies the type of individual that is desired to administer the medication. | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ?? (example): Identifies the type of individual that is desired to administer the medication. | |||||||||
|    recorder | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request | |||||||||||
|    reasonCode | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: ?? (extensible) | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: ?? (extensible) | |||||||||||
|    reasonReference | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription | |||||||||||
|    instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | |||||||||
|    instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | Σ | 0..* | uri | Instantiates external protocol or definition | |||||||||
|    basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | |||||||||
|    groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | Σ | 0..1 | Identifier | Composite request this is part of | |||||||||
|    courseOfTherapyType | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio. | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio. | |||||||||||
|    insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||||||||
|    note | 0..* | Annotation | Information about the prescription | 0..* | Annotation | Information about the prescription | |||||||||||
|    dosageInstruction | S | 0..* | Dosage | How the medication should be taken | S | 0..* | Dosage | How the medication should be taken | |||||||||
|     id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
|     Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 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 | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
|     sequence | Σ | 0..1 | integer | The order of the dosage instructions | Σ | 0..1 | integer | The order of the dosage instructions | |||||||||
|     text | SΣ | 0..1 | string | Free text dosage instructions e.g. SIG | SΣ | 0..1 | string | 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: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (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 | Σ | 0..1 | string | Patient or consumer oriented instructions | |||||||||
|     timing | SΣ | 0..1 | Timing | When medication should be administered | SΣ | 0..1 | Timing | When medication should be administered | |||||||||
|     asNeeded[x] | Σ | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) Binding: ?? (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. | Σ | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) Binding: ?? (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. | |||||||||
|     site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (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: ?? (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | SΣ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (extensible): ☞☞☞ Use SNOMED CT and SPL(NCI Thesaurus) values in final version to meet USCDI terminology requirements | 
 | ||||||||
|     method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. | |||||||||
|     doseAndRate | SΣ | 0..* | Element | Amount of medication administered | SΣ | 0..* | Element | Amount of medication administered | |||||||||
|      id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
|      Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 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: ?? (example): The kind of dose or rate specified. | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified. | |||||||||
|      dose[x] | SΣ | 0..1 | ??, Range | Amount of medication per dose Binding: ?? (preferred) 
 | SΣ | 0..1 | ??, Range | Amount of medication per dose Binding: ?? (preferred) 
 | |||||||||
|      rate[x] | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time | |||||||||
|     maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | |||||||||
|     maxDosePerAdministration | Σ | 0..1 | ?? | Upper limit on medication per administration | Σ | 0..1 | ?? | Upper limit on medication per administration | |||||||||
|     maxDosePerLifetime | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient | |||||||||
|    dispenseRequest | S | 0..1 | BackboneElement | Medication supply authorization | S | 0..1 | BackboneElement | Medication supply authorization | |||||||||
|     id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
|     extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
|     initialFill | 0..1 | BackboneElement | First fill details | 0..1 | BackboneElement | First fill details | |||||||||||
|      id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
|      extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
|      modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
|      quantity | 0..1 | ?? | First fill quantity | 0..1 | ?? | First fill quantity | |||||||||||
|      duration | 0..1 | Duration | First fill duration | 0..1 | Duration | First fill duration | |||||||||||
|     dispenseInterval | 0..1 | Duration | Minimum period of time between dispenses | 0..1 | Duration | Minimum period of time between dispenses | |||||||||||
|     validityPeriod | 0..1 | Period | Time period supply is authorized for | 0..1 | Period | Time period supply is authorized for | |||||||||||
|     numberOfRepeatsAllowed | S | 0..1 | unsignedInt | Number of refills authorized | S | 0..1 | unsignedInt | Number of refills authorized | |||||||||
|     quantity | S | 0..1 | ?? | Amount of medication to supply per dispense | S | 0..1 | ?? | Amount of medication to supply per dispense | |||||||||
|     expectedSupplyDuration | 0..1 | Duration | Number of days supply per dispense | 0..1 | Duration | Number of days supply per dispense | |||||||||||
|     performer | 0..1 | Reference(Organization) | Intended dispenser | 0..1 | Reference(Organization) | Intended dispenser | |||||||||||
|    substitution | 0..1 | BackboneElement | Any restrictions on medication substitution | 0..1 | BackboneElement | Any restrictions on medication substitution | |||||||||||
|     id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
|     extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
|     allowed[x] | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed. | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed. | |||||||||||
|     reason | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: ?? (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 | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced | |||||||||||
|    detectedIssue | 0..* | Reference(DetectedIssue) | Clinical Issue with action | 0..* | Reference(DetectedIssue) | Clinical Issue with action | |||||||||||
|    eventHistory | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |||||||||||
|  Documentation for this format | |||||||||||||||||