minimal Common Oncology Data Elements (mCODE) Implementation Guide
3.0.0 - STU3 Release
minimal Common Oncology Data Elements (mCODE) Implementation Guide
3.0.0 - STU3 Release
This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v3.0.0: STU 3) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request | Version: 3.0.0 | |||
| Draft as of 2023-10-25 | Maturity Level: 3 | Computable Name: CancerRelatedMedicationRequest | ||
A record of a medication prescription or consumption associated with cancer treatment. The medication may reported by the prescriber, prescribing organization, or patient. It does not have to be directly observed.
MedicationRequest resources associated with an in-scope patient and associated with cancer treatment SHALL conform to this profile. Beyond this requirement, a producer of resources SHOULD ensure that any resource instance associated with an in-scope patient that would reasonably be expected to conform to this profile (i.e., a prescription, administration, or medication exposure) SHOULD be published in this form.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCoreMedicationRequestProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped |
  Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
 treatmentIntent | S | 0..1 | CodeableConcept | Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible) |
 statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: Treatment Termination Reason Value Set (preferred) |
 subject | 1..1 | Reference(Cancer Patient Profile) | Who or group medication request is for | |
| requester | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile | Cancer Patient Profile) | Who/What requested the Request | |
| reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Cancer Disorder Value Set (extensible) |
 reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile) | Condition or observation that supports why the prescription is being written |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| MedicationRequest.statusReason | preferred | TreatmentTerminationReasonVS |
| MedicationRequest.reasonCode | extensible | CancerDisorderVS |
| Id | Grade | Path(s) | Details | Requirements |
| mcode-reason-required | warning | MedicationRequest | One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists() | |
| termination-reason-code-invariant | error | MedicationRequest | When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) | |
| termination-reason-invariant | error | MedicationRequest | Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped' |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped |
 implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| treatmentIntent | S | 0..1 | CodeableConcept | Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible) |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| status | ?!SΣ | 1..1 | code | 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. |
 statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: Treatment Termination Reason Value Set (preferred) |
| intent | ?!SΣ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. |
  Slices for category | S | 0..* | CodeableConcept | 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 | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. |
| doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action |
 reported[x] | SΣ | 0..1 | Reported rather than primary record | |
| reportedBoolean | boolean | |||
| reportedReference | Reference(US Core Practitioner Profile) | |||
| medication[x] | SΣ | 1..1 | Medication to be taken Binding: Medication Clinical Drug (extensible) | |
| medicationCodeableConcept | CodeableConcept | |||
| medicationReference | Reference(US Core Medication Profile) | |||
| subject | SΣ | 1..1 | Reference(Cancer Patient Profile) | Who or group medication request is for |
| encounter | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of encounter/admission/stay |
| authoredOn | SΣ | 0..1 | dateTime | When request was initially authored |
| requester | SΣ | 1..1 | Reference(US Core Practitioner Profile) | Who/What requested the Request |
| reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Cancer Disorder Value Set (extensible) |
| reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile) | Condition or observation that supports why the prescription is being written |
 dosageInstruction | S | 0..* | Dosage | How the medication should be taken |
 modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| text | SΣ | 0..1 | string | Free text dosage instructions e.g. SIG |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| MedicationRequest.status | required | medicationrequest Status |
| MedicationRequest.statusReason | preferred | TreatmentTerminationReasonVS |
| MedicationRequest.intent | required | medicationRequest Intent |
| MedicationRequest.category | example | medicationRequest Category Codes |
| MedicationRequest.category:us-core | required | medicationRequest Category Codes |
| MedicationRequest.medication[x] | extensible | Medication Clinical Drug |
| MedicationRequest.reasonCode | extensible | CancerDisorderVS |
| Id | Grade | Path(s) | Details | Requirements |
| mcode-reason-required | warning | MedicationRequest | One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists() | |
| termination-reason-code-invariant | error | MedicationRequest | When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) | |
| termination-reason-invariant | error | MedicationRequest | Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped' |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped | ||||
| 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 | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url | ||||
| treatmentIntent | S | 0..1 | CodeableConcept | Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible) | ||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | 0..* | Identifier | External ids for this request | |||||
| status | ?!SΣ | 1..1 | code | 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. | ||||
| statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: Treatment Termination Reason Value Set (preferred) | ||||
| intent | ?!SΣ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. | ||||
| Slices for category | S | 0..* | CodeableConcept | 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 | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. | ||||
| 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 | True if request is prohibiting action | ||||
| reported[x] | SΣ | 0..1 | Reported rather than primary record | |||||
| reportedBoolean | boolean S | |||||||
| reportedReference | Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | |||||||
| medication[x] | SΣ | 1..1 | Medication to be taken Binding: Medication Clinical Drug (extensible) | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(US Core Medication Profile) | |||||||
| subject | SΣ | 1..1 | Reference(Cancer Patient Profile) | Who or group medication request is for | ||||
| encounter | 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 | |||||
| authoredOn | SΣ | 0..1 | dateTime | When request was initially authored | ||||
| requester | SΣ | 1..1 | Reference(US Core Practitioner Profile S | US Core Organization Profile | Cancer Patient Profile) | 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 | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Cancer Disorder Value Set (extensible) | ||||
| reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile) | Condition or observation that supports why the prescription is being written | ||||
| 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 | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. | |||||
| insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
| note | 0..* | Annotation | Information about the prescription | |||||
| dosageInstruction | S | 0..* | Dosage | How the 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 | 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 | Σ | 0..1 | Timing | When medication should be administered | ||||
| asNeeded[x] | Σ | 0..1 | 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 | Σ | 0..* | Element | 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] | Σ | 0..1 | Amount of medication per dose | |||||
| doseRange | Range | |||||||
| doseQuantity | Quantity(SimpleQuantity) | |||||||
| 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 | 0..1 | BackboneElement | 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 | ||||
| initialFill | 0..1 | BackboneElement | First fill details | |||||
| 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 | ||||
| quantity | 0..1 | SimpleQuantity | First fill quantity | |||||
| duration | 0..1 | Duration | First fill duration | |||||
| dispenseInterval | 0..1 | Duration | Minimum period of time between dispenses | |||||
| validityPeriod | 0..1 | Period | Time period supply is authorized for | |||||
| numberOfRepeatsAllowed | 0..1 | unsignedInt | Number of refills authorized | |||||
| quantity | 0..1 | SimpleQuantity | Amount of medication to supply per dispense | |||||
| expectedSupplyDuration | 0..1 | Duration | Number of days supply per dispense | |||||
| 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 | ||||
| MedicationRequest.language | preferred | CommonLanguages
| ||||
| MedicationRequest.status | required | medicationrequest Status | ||||
| MedicationRequest.statusReason | preferred | TreatmentTerminationReasonVS | ||||
| MedicationRequest.intent | required | medicationRequest Intent | ||||
| MedicationRequest.category | example | medicationRequest Category Codes | ||||
| MedicationRequest.category:us-core | required | medicationRequest Category Codes | ||||
| MedicationRequest.priority | required | RequestPriority | ||||
| MedicationRequest.medication[x] | extensible | Medication Clinical Drug | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodes | ||||
| MedicationRequest.reasonCode | extensible | CancerDisorderVS | ||||
| MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes | ||||
| MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes | ||||
| MedicationRequest.dosageInstruction.route | example | SNOMEDCTRouteCodes | ||||
| MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes | ||||
| MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType | ||||
| MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode | ||||
| MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| mcode-reason-required | warning | MedicationRequest | One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists() | |
| termination-reason-code-invariant | error | MedicationRequest | When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) | |
| termination-reason-invariant | error | MedicationRequest | Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped' |
This structure is derived from USCoreMedicationRequestProfile
Summary
Must-Support: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 3
Differential View
This structure is derived from USCoreMedicationRequestProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped |
| Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| treatmentIntent | S | 0..1 | CodeableConcept | Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible) |
| statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: Treatment Termination Reason Value Set (preferred) |
| subject | 1..1 | Reference(Cancer Patient Profile) | Who or group medication request is for | |
| requester | 1..1 | Reference(US Core Practitioner Profile | US Core Organization Profile | Cancer Patient Profile) | Who/What requested the Request | |
| reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Cancer Disorder Value Set (extensible) |
| reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile) | Condition or observation that supports why the prescription is being written |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| MedicationRequest.statusReason | preferred | TreatmentTerminationReasonVS |
| MedicationRequest.reasonCode | extensible | CancerDisorderVS |
| Id | Grade | Path(s) | Details | Requirements |
| mcode-reason-required | warning | MedicationRequest | One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists() | |
| termination-reason-code-invariant | error | MedicationRequest | When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) | |
| termination-reason-invariant | error | MedicationRequest | Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped' |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| treatmentIntent | S | 0..1 | CodeableConcept | Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible) |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| status | ?!SΣ | 1..1 | code | 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. |
| statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: Treatment Termination Reason Value Set (preferred) |
| intent | ?!SΣ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. |
| Slices for category | S | 0..* | CodeableConcept | 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 | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. |
| doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action |
| reported[x] | SΣ | 0..1 | Reported rather than primary record | |
| reportedBoolean | boolean | |||
| reportedReference | Reference(US Core Practitioner Profile) | |||
| medication[x] | SΣ | 1..1 | Medication to be taken Binding: Medication Clinical Drug (extensible) | |
| medicationCodeableConcept | CodeableConcept | |||
| medicationReference | Reference(US Core Medication Profile) | |||
| subject | SΣ | 1..1 | Reference(Cancer Patient Profile) | Who or group medication request is for |
| encounter | S | 0..1 | Reference(US Core Encounter Profile) | Encounter created as part of encounter/admission/stay |
| authoredOn | SΣ | 0..1 | dateTime | When request was initially authored |
| requester | SΣ | 1..1 | Reference(US Core Practitioner Profile) | Who/What requested the Request |
| reasonCode | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Cancer Disorder Value Set (extensible) |
| reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile) | Condition or observation that supports why the prescription is being written |
| dosageInstruction | S | 0..* | Dosage | How the medication should be taken |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| text | SΣ | 0..1 | string | Free text dosage instructions e.g. SIG |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| MedicationRequest.status | required | medicationrequest Status |
| MedicationRequest.statusReason | preferred | TreatmentTerminationReasonVS |
| MedicationRequest.intent | required | medicationRequest Intent |
| MedicationRequest.category | example | medicationRequest Category Codes |
| MedicationRequest.category:us-core | required | medicationRequest Category Codes |
| MedicationRequest.medication[x] | extensible | Medication Clinical Drug |
| MedicationRequest.reasonCode | extensible | CancerDisorderVS |
| Id | Grade | Path(s) | Details | Requirements |
| mcode-reason-required | warning | MedicationRequest | One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists() | |
| termination-reason-code-invariant | error | MedicationRequest | When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) | |
| termination-reason-invariant | error | MedicationRequest | Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped' |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped | ||||
| 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 | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| Slices for extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url | ||||
| treatmentIntent | S | 0..1 | CodeableConcept | Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible) | ||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | 0..* | Identifier | External ids for this request | |||||
| status | ?!SΣ | 1..1 | code | 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. | ||||
| statusReason | S | 0..1 | CodeableConcept | Reason for current status Binding: Treatment Termination Reason Value Set (preferred) | ||||
| intent | ?!SΣ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. | ||||
| Slices for category | S | 0..* | CodeableConcept | 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 | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. | ||||
| 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 | True if request is prohibiting action | ||||
| reported[x] | SΣ | 0..1 | Reported rather than primary record | |||||
| reportedBoolean | boolean S | |||||||
| reportedReference | Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | |||||||
| medication[x] | SΣ | 1..1 | Medication to be taken Binding: Medication Clinical Drug (extensible) | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(US Core Medication Profile) | |||||||
| subject | SΣ | 1..1 | Reference(Cancer Patient Profile) | Who or group medication request is for | ||||
| encounter | 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 | |||||
| authoredOn | SΣ | 0..1 | dateTime | When request was initially authored | ||||
| requester | SΣ | 1..1 | Reference(US Core Practitioner Profile S | US Core Organization Profile | Cancer Patient Profile) | 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 | S | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Cancer Disorder Value Set (extensible) | ||||
| reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile) | Condition or observation that supports why the prescription is being written | ||||
| 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 | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. | |||||
| insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
| note | 0..* | Annotation | Information about the prescription | |||||
| dosageInstruction | S | 0..* | Dosage | How the 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 | 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 | Σ | 0..1 | Timing | When medication should be administered | ||||
| asNeeded[x] | Σ | 0..1 | 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 | Σ | 0..* | Element | 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] | Σ | 0..1 | Amount of medication per dose | |||||
| doseRange | Range | |||||||
| doseQuantity | Quantity(SimpleQuantity) | |||||||
| 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 | 0..1 | BackboneElement | 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 | ||||
| initialFill | 0..1 | BackboneElement | First fill details | |||||
| 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 | ||||
| quantity | 0..1 | SimpleQuantity | First fill quantity | |||||
| duration | 0..1 | Duration | First fill duration | |||||
| dispenseInterval | 0..1 | Duration | Minimum period of time between dispenses | |||||
| validityPeriod | 0..1 | Period | Time period supply is authorized for | |||||
| numberOfRepeatsAllowed | 0..1 | unsignedInt | Number of refills authorized | |||||
| quantity | 0..1 | SimpleQuantity | Amount of medication to supply per dispense | |||||
| expectedSupplyDuration | 0..1 | Duration | Number of days supply per dispense | |||||
| 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 | ||||
| MedicationRequest.language | preferred | CommonLanguages
| ||||
| MedicationRequest.status | required | medicationrequest Status | ||||
| MedicationRequest.statusReason | preferred | TreatmentTerminationReasonVS | ||||
| MedicationRequest.intent | required | medicationRequest Intent | ||||
| MedicationRequest.category | example | medicationRequest Category Codes | ||||
| MedicationRequest.category:us-core | required | medicationRequest Category Codes | ||||
| MedicationRequest.priority | required | RequestPriority | ||||
| MedicationRequest.medication[x] | extensible | Medication Clinical Drug | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodes | ||||
| MedicationRequest.reasonCode | extensible | CancerDisorderVS | ||||
| MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes | ||||
| MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes | ||||
| MedicationRequest.dosageInstruction.route | example | SNOMEDCTRouteCodes | ||||
| MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes | ||||
| MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType | ||||
| MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode | ||||
| MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason |
| Id | Grade | Path(s) | Details | Requirements |
| mcode-reason-required | warning | MedicationRequest | One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists() | |
| termination-reason-code-invariant | error | MedicationRequest | When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) | |
| termination-reason-invariant | error | MedicationRequest | Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped' |
This structure is derived from USCoreMedicationRequestProfile
Summary
Must-Support: 5 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 3
Other representations of profile: CSV, Excel, Schematron
IG © 2019+ HL7 International / Clinical Interoperability Council. Package hl7.fhir.us.mcode#3.0.0 based on FHIR 4.0.1. Generated 2023-10-25
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