Qi-Core Implementation Guide (Release 2.1 Trial-Use Ballot)
This page is part of the Quality Improvement Core Framework (v2.1.0: STU 3 Ballot 1) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions 
| Penicillin MedicationRequest Example |
The official URL for this profile is:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
This profile builds on US Core Medication Request Profile.
This profile was published on Mon Aug 21 16:00:00 AEST 2017 as a draft by Health Level Seven International (Clinical Quality Information - QICore).
Description of Profiles, Differentials, and Snapshots.
Summary
Mandatory: 0 element (3 nested mandatory elements)
Must-Support: 10 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  MedicationRequest | I | 0..* | Ordering of medication for patient or group | |
  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: Common Languages (extensible) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
 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 | |
 definition | Σ | 0..* | Reference(ActivityDefinition), Reference(PlanDefinition) | Protocol or definition |
| basedOn | Σ | 0..* | Reference(CarePlan), Reference(MedicationRequest), Reference(ProcedureRequest), Reference(ReferralRequest) | What request fulfills |
| groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of |
| status | ?!SΣ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required) |
| intent | ?!Σ | 1..1 | code | proposal | plan | order | instance-order Binding: MedicationRequestIntent (required) |
| category | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred) | |
| priority | Σ | 0..1 | code | routine | urgent | stat | asap Binding: MedicationRequestPriority (required) |
 medication[x] | SΣ | 1..1 | CodeableConcept, Reference(QICore-Medication) | Medication to be taken Binding: Medication Clinical Drug (RxNorm) (preferred) |
| subject | SΣ | 1..1 | Reference(QICore-Patient), Reference(Group) | Who or group medication request is for |
| context | S | 0..1 | Reference(QICore-Encounter), Reference(Group) | Created during encounter/admission/stay |
| supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | |
| authoredOn | SΣ | 1..1 | dateTime | When request was initially authored |
| requester | SΣI | 1..1 | BackboneElement | Who/What requested the Request |
 id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| agent | SΣ | 1..1 | Reference(QICore-Practitioner) | Who ordered the initial medication(s) |
 onBehalfOf | ΣI | 0..1 | Reference(QICore-Organization) | Organization agent is acting for |
| recorder | 0..1 | Reference(Practitioner) | Person who entered the request | |
| reasonCode | 0..* | CodeableConcept | Reason or indication for writing the prescription Binding: Problem Value Set (preferred) | |
| reasonReference | 0..* | Reference(Condition), Reference(Observation) | Condition or Observation that supports why the prescription is being written | |
| note | 0..* | Annotation | Information about the prescription | |
| dosageInstruction | S | 0..* | Dosage | How the medication should be taken |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| pharmacy-core-doseType | 0..1 | CodeableConcept | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-doseType | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-doseType" | |
| valueCodeableConcept | 0..1 | CodeableConcept | Value of extension | |
| pharmacy-core-infuseOver | 0..1 | Duration | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-infuseOver | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-infuseOver" | |
| valueDuration | 0..1 | Duration | Value of extension | |
| pharmacy-core-rateIncrement | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrement | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrement" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-rateIncrementInterval | 0..1 | Duration | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrementInterval | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrementInterval" | |
| valueDuration | 0..1 | Duration | Value of extension | |
| pharmacy-core-rateGoal | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateGoal | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateGoal" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-minDosePerPeriod | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-minDosePerPeriod | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-minDosePerPeriod" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-maxDeliveryRate | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryRate | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryRate" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-maxDeliveryVolume | 0..1 | Quantity | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryVolume | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryVolume" | |
| valueQuantity | 0..1 | Quantity | Value of extension | |
| sequence | Σ | 0..1 | integer | The order of the dosage instructions |
| text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG |
| additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction - e.g. "with meals" Binding: SNOMED CT Additional Dosage Instructions (example) |
| 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 | boolean, CodeableConcept | Take "as needed" (for x) Binding: SNOMED CT Medication As Needed Reason Codes (example) |
| site | SΣ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example) |
| route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMED CT Route Codes (example) |
| method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMED CT Administration Method Codes (example) |
| dose[x] | Σ | 0..1 | Range, SimpleQuantity | Amount of medication per dose |
| 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 |
| rate[x] | Σ | 0..1 | Ratio, Range, SimpleQuantity | Amount of medication per unit of time |
| dispenseRequest | SI | 0..1 | BackboneElement | Medication supply authorization |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| validityPeriod | 0..1 | Period | Time period supply is authorized for | |
| numberOfRepeatsAllowed | 0..1 | positiveInt | 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 | I | 0..1 | BackboneElement | Any restrictions on medication substitution |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| allowed | ?! | 1..1 | boolean | Whether substitution is allowed or not |
| reason | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example) | |
| 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 | ||||
Summary
Mandatory: 0 element (3 nested mandatory elements)
Must-Support: 10 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Differential View
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationRequest | I | 0..* | Ordering of medication for patient or group | |
| 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: Common Languages (extensible) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
| 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 | |
| definition | Σ | 0..* | Reference(ActivityDefinition), Reference(PlanDefinition) | Protocol or definition |
| basedOn | Σ | 0..* | Reference(CarePlan), Reference(MedicationRequest), Reference(ProcedureRequest), Reference(ReferralRequest) | What request fulfills |
| groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of |
| status | ?!SΣ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: MedicationRequestStatus (required) |
| intent | ?!Σ | 1..1 | code | proposal | plan | order | instance-order Binding: MedicationRequestIntent (required) |
| category | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationRequestCategory (preferred) | |
| priority | Σ | 0..1 | code | routine | urgent | stat | asap Binding: MedicationRequestPriority (required) |
| medication[x] | SΣ | 1..1 | CodeableConcept, Reference(QICore-Medication) | Medication to be taken Binding: Medication Clinical Drug (RxNorm) (preferred) |
| subject | SΣ | 1..1 | Reference(QICore-Patient), Reference(Group) | Who or group medication request is for |
| context | S | 0..1 | Reference(QICore-Encounter), Reference(Group) | Created during encounter/admission/stay |
| supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | |
| authoredOn | SΣ | 1..1 | dateTime | When request was initially authored |
| requester | SΣI | 1..1 | BackboneElement | Who/What requested the Request |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| agent | SΣ | 1..1 | Reference(QICore-Practitioner) | Who ordered the initial medication(s) |
| onBehalfOf | ΣI | 0..1 | Reference(QICore-Organization) | Organization agent is acting for |
| recorder | 0..1 | Reference(Practitioner) | Person who entered the request | |
| reasonCode | 0..* | CodeableConcept | Reason or indication for writing the prescription Binding: Problem Value Set (preferred) | |
| reasonReference | 0..* | Reference(Condition), Reference(Observation) | Condition or Observation that supports why the prescription is being written | |
| note | 0..* | Annotation | Information about the prescription | |
| dosageInstruction | S | 0..* | Dosage | How the medication should be taken |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| pharmacy-core-doseType | 0..1 | CodeableConcept | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-doseType | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-doseType" | |
| valueCodeableConcept | 0..1 | CodeableConcept | Value of extension | |
| pharmacy-core-infuseOver | 0..1 | Duration | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-infuseOver | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-infuseOver" | |
| valueDuration | 0..1 | Duration | Value of extension | |
| pharmacy-core-rateIncrement | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrement | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrement" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-rateIncrementInterval | 0..1 | Duration | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrementInterval | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateIncrementInterval" | |
| valueDuration | 0..1 | Duration | Value of extension | |
| pharmacy-core-rateGoal | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateGoal | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-rateGoal" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-minDosePerPeriod | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-minDosePerPeriod | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-minDosePerPeriod" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-maxDeliveryRate | 0..1 | Ratio | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryRate | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryRate" | |
| valueRatio | 0..1 | Ratio | Value of extension | |
| pharmacy-core-maxDeliveryVolume | 0..1 | Quantity | Extension URL: http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryVolume | |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| url | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/pharmacy-core-maxDeliveryVolume" | |
| valueQuantity | 0..1 | Quantity | Value of extension | |
| sequence | Σ | 0..1 | integer | The order of the dosage instructions |
| text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG |
| additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction - e.g. "with meals" Binding: SNOMED CT Additional Dosage Instructions (example) |
| 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 | boolean, CodeableConcept | Take "as needed" (for x) Binding: SNOMED CT Medication As Needed Reason Codes (example) |
| site | SΣ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMED CT Anatomical Structure for Administration Site Codes (example) |
| route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMED CT Route Codes (example) |
| method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMED CT Administration Method Codes (example) |
| dose[x] | Σ | 0..1 | Range, SimpleQuantity | Amount of medication per dose |
| 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 |
| rate[x] | Σ | 0..1 | Ratio, Range, SimpleQuantity | Amount of medication per unit of time |
| dispenseRequest | SI | 0..1 | BackboneElement | Medication supply authorization |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| validityPeriod | 0..1 | Period | Time period supply is authorized for | |
| numberOfRepeatsAllowed | 0..1 | positiveInt | 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 | I | 0..1 | BackboneElement | Any restrictions on medication substitution |
| id | 0..1 | string | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| allowed | ?! | 1..1 | boolean | Whether substitution is allowed or not |
| reason | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example) | |
| 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 | Name | Conformance | ValueSet |
| MedicationRequest.language | Common Languages | extensible | Common Languages |
| MedicationRequest.status | MedicationRequestStatus | required | MedicationRequestStatus |
| MedicationRequest.intent | MedicationRequestIntent | required | MedicationRequestIntent |
| MedicationRequest.category | MedicationRequestCategory | preferred | MedicationRequestCategory |
| MedicationRequest.priority | MedicationRequestPriority | required | MedicationRequestPriority |
| MedicationRequest.medication[x] | Medication Clinical Drug (RxNorm) | preferred | Medication Clinical Drug (RxNorm) |
| MedicationRequest.reasonCode | Problem Value Set | preferred | Problem Value Set |
| MedicationRequest.dosageInstruction.additionalInstruction | SNOMED CT Additional Dosage Instructions | example | SNOMED CT Additional Dosage Instructions |
| MedicationRequest.dosageInstruction.asNeeded[x] | SNOMED CT Medication As Needed Reason Codes | example | SNOMED CT Medication As Needed Reason Codes |
| MedicationRequest.dosageInstruction.site | SNOMED CT Anatomical Structure for Administration Site Codes | example | SNOMED CT Anatomical Structure for Administration Site Codes |
| MedicationRequest.dosageInstruction.route | SNOMED CT Route Codes | example | SNOMED CT Route Codes |
| MedicationRequest.dosageInstruction.method | SNOMED CT Administration Method Codes | example | SNOMED CT Administration Method Codes |
| MedicationRequest.substitution.reason | SubstanceAdminSubstitutionReason | example | SubstanceAdminSubstitutionReason |
| Id | Path | Details | Requirements |
| dom-2 | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-1 | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty() | |
| dom-4 | 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-3 | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty() | |
| ele-1 | MedicationRequest.requester | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) | |
| mps-1 | MedicationRequest.requester | onBehalfOf can only be specified if agent is practitioner or device : (agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not() | |
| ele-1 | MedicationRequest.dispenseRequest | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) | |
| ele-1 | MedicationRequest.substitution | All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count()) |
© HL7.org 2011+. QICore STU 3 Ballot (v2.1.0, based on FHIR v3.0.1-11917) generated on Wed, Dec 20, 2017 12:42+1100. QA Page
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