Data Exchange For Quality Measures STU2 for FHIR R4 Implementation Guide (Release 1.1.0 STU2 Ballot)

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v1.1.0: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition-medicationrequest-deqm

The DEQM MedicationRequest Profile describes a medication prescription

Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present).

Each MedicationRequest must have:

  1. A medication code that identifies the medication being requested

Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/medicationrequest-deqm

Published on Tue Jun 19 00:00:00 UTC 2018 as a active by Da Vinci Project.

This profile builds on QICoreMedicationRequest

Summary

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*QICoreMedicationRequestOrdering of medication for patient or group
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal ids for this request
... status ?!SΣ1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required)
... statusReason 0..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (example)
... intent ?!Σ1..1codeproposal | plan | order | original-order | instance-order | option
Binding: medicationRequest Intent (required)
... category S0..*CodeableConceptType of medication usage
Binding: medicationRequest Category Codes (preferred)
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required)
... doNotPerform ?!SΣ0..1booleanTrue if request is prohibiting action
... reported[x] Σ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] Σ1..1CodeableConceptMedication to be taken
Binding: US Core Medication Codes (RxNorm) (preferred)
... subject SΣ1..1Reference(QICorePatient)Who or group medication request is for
... encounter S0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... supportingInformation 0..*Reference(Resource)Information to support ordering of the medication
... authoredOn SΣ1..1dateTimeWhen request was initially authored
... requester SΣ1..1Reference(QICorePractitioner | QICorePractitionerRole | QICorePatient | QICoreRelatedPerson | QICoreOrganization | QICoreDevice)Who/What requested the Request
... performer 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)Intended performer of administration
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example)
... recorder 0..1Reference(QICorePractitioner | QICorePractitionerRole)Person who entered the request
... reasonCode 0..*CodeableConceptReason or indication for ordering or not ordering the medication
Binding: http://hl7.org/fhir/us/core/ValueSet/us-core-problem (preferred)
... reasonReference 0..*Reference(Condition | Observation)Condition or observation that supports why the prescription is being written
... instantiatesCanonical Σ0..*canonical()Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... courseOfTherapyType 0..1CodeableConceptOverall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example)
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... note 0..*AnnotationInformation about the prescription
... dosageInstruction S0..*DosageHow the medication should be taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example)
.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing Σ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example)
..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site SΣ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)
.... route Σ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example)
.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example)
.... doseAndRate ΣI0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example)
..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... dispenseRequest SI0..1BackboneElementMedication supply authorization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... initialFill I0..1BackboneElementFirst fill details
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... quantity 0..1SimpleQuantityFirst fill quantity
..... duration 0..1DurationFirst fill duration
.... dispenseInterval 0..1DurationMinimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed 0..1unsignedIntNumber of refills authorized
.... quantity 0..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... performer 0..1Reference(Organization)Intended dispenser
... substitution I0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: V3 Value SetActSubstanceAdminSubstitutionCode (example)
..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy should (not) substitution be made
Binding: V3 Value SetSubstanceAdminSubstitutionReason (example)
... priorPrescription 0..1Reference(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

doco Documentation for this format

Summary

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*QICoreMedicationRequestOrdering of medication for patient or group
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal ids for this request
... status ?!SΣ1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required)
... statusReason 0..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (example)
... intent ?!Σ1..1codeproposal | plan | order | original-order | instance-order | option
Binding: medicationRequest Intent (required)
... category S0..*CodeableConceptType of medication usage
Binding: medicationRequest Category Codes (preferred)
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required)
... doNotPerform ?!SΣ0..1booleanTrue if request is prohibiting action
... reported[x] Σ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] Σ1..1CodeableConceptMedication to be taken
Binding: US Core Medication Codes (RxNorm) (preferred)
... subject SΣ1..1Reference(QICorePatient)Who or group medication request is for
... encounter S0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... supportingInformation 0..*Reference(Resource)Information to support ordering of the medication
... authoredOn SΣ1..1dateTimeWhen request was initially authored
... requester SΣ1..1Reference(QICorePractitioner | QICorePractitionerRole | QICorePatient | QICoreRelatedPerson | QICoreOrganization | QICoreDevice)Who/What requested the Request
... performer 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)Intended performer of administration
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example)
... recorder 0..1Reference(QICorePractitioner | QICorePractitionerRole)Person who entered the request
... reasonCode 0..*CodeableConceptReason or indication for ordering or not ordering the medication
Binding: http://hl7.org/fhir/us/core/ValueSet/us-core-problem (preferred)
... reasonReference 0..*Reference(Condition | Observation)Condition or observation that supports why the prescription is being written
... instantiatesCanonical Σ0..*canonical()Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... courseOfTherapyType 0..1CodeableConceptOverall pattern of medication administration
Binding: medicationRequest Course of Therapy Codes (example)
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... note 0..*AnnotationInformation about the prescription
... dosageInstruction S0..*DosageHow the medication should be taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example)
.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing Σ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example)
..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site SΣ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)
.... route Σ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example)
.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example)
.... doseAndRate ΣI0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example)
..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... dispenseRequest SI0..1BackboneElementMedication supply authorization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... initialFill I0..1BackboneElementFirst fill details
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... quantity 0..1SimpleQuantityFirst fill quantity
..... duration 0..1DurationFirst fill duration
.... dispenseInterval 0..1DurationMinimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed 0..1unsignedIntNumber of refills authorized
.... quantity 0..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... performer 0..1Reference(Organization)Intended dispenser
... substitution I0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: V3 Value SetActSubstanceAdminSubstitutionCode (example)
..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy should (not) substitution be made
Binding: V3 Value SetSubstanceAdminSubstitutionReason (example)
... priorPrescription 0..1Reference(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

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron


Quick Start

Below is an overview of the required set of RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.

Use cases:

  • currently none defined