This page is part of the Quality Improvement Core Framework (v6.0.0-ballot: STU6 (v6.0.0) Ballot 1) based on FHIR R4. The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested | Version: 6.0.0-ballot | |||
Active as of 2018-08-22 | Computable Name: QICoreMedicationNotRequested |
Negation profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
The MedicationRequest and MedicationNotRequested profiles represent the positive and negative statements for a medication order.
Negation Example using Valueset | Medication not indicated; indicates that none of the medications in the given not done value set were requested. |
Negation Example using code | Medication not indicated; indicates that the medication specified by code was not requested. |
Both of these example instances meet measure intent for exclusion as defined in the following example CQL:
define "Reason for Not Ordering Antithrombotic":
["MedicationNotRequested": "Antithrombotic Therapy"] NoAntithromboticDischarge
where (NoAntithromboticDischarge.reasonCode in "Medical Reason"
or NoAntithromboticDischarge.reasonCode in "Patient Refusal")
and (NoAntithromboticDischarge.isCommunity() or NoAntithromboticDischarge.isDischarge())
and NoAntithromboticDischarge.status in { 'active', 'completed' }
and NoAntithromboticDischarge.intent = 'order'
For a more complete discussion of representation of negation within QICore and quality improvement artifacts, see the Negation in QI Core topic.
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 mnr-1: To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided |
status | S | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown |
doNotPerform | S | 1..1 | boolean | True if medication was not requested Fixed Value: true |
reported[x] | S | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient S | QICore RelatedPerson S) | (USCDI) Reported rather than primary record |
medication[x] | S | 1..1 | CodeableConcept | (USCDI) Medication to be taken Binding: SNOMEDCTMedicationCodes (preferred) |
notDoneValueSet | SC | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
coding | C | 0..* | Coding | Code defined by a terminology system |
subject | S | 1..1 | Reference(QICore Patient) | (USCDI) Who or group medication request is for |
encounter | S | 0..1 | Reference(QICore Encounter) | (USCDI) Encounter created as part of encounter/admission/stay |
authoredOn | S | 1..1 | dateTime | (USCDI) When request was initially authored |
requester | S | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient) | (USCDI) Who/What requested the Request |
reasonCode | S | 1..1 | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: QICore Negation Reason Codes (extensible): The reason the medication was not requested |
Documentation for this format |
Path | Conformance | ValueSet |
MedicationRequest.medication[x] | preferred | SNOMEDCTMedicationCodes |
MedicationRequest.reasonCode | extensible | NegationReasonCodes |
Id | Grade | Path(s) | Details | Requirements |
mnr-1 | error | MedicationRequest | To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided : medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists() |
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mnr-1: To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
status | ?!SΣ | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||
intent | ?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. | ||||
Slices for category | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
category:us-core | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
doNotPerform | ?!SΣ | 1..1 | boolean | True if medication was not requested Fixed Value: true | ||||
reported[x] | SΣ | 0..1 | Reference(QICore Practitioner | QICore Patient | QICore RelatedPerson) | (USCDI) Reported rather than primary record | ||||
medication[x] | SΣ | 1..1 | CodeableConcept | (USCDI) Medication to be taken Binding: SNOMEDCTMedicationCodes (preferred) | ||||
notDoneValueSet | SC | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet | ||||
coding | ΣC | 0..* | Coding | Code defined by a terminology system | ||||
subject | SΣ | 1..1 | Reference(QICore Patient) | (USCDI) Who or group medication request is for | ||||
encounter | S | 0..1 | Reference(QICore Encounter) | (USCDI) Encounter created as part of encounter/admission/stay | ||||
authoredOn | SΣ | 1..1 | dateTime | (USCDI) When request was initially authored | ||||
requester | SΣC | 0..1 | Reference(QICore Practitioner) | (USCDI) Who/What requested the Request | ||||
reasonCode | S | 1..1 | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: QICore Negation Reason Codes (extensible): The reason the medication was not requested | ||||
dosageInstruction | S | 0..* | Dosage | (USCDI) How the medication should be taken | ||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
text | SΣ | 0..1 | string | (USCDI) Free text dosage instructions e.g. SIG | ||||
timing | SΣ | 0..1 | Timing | (USCDI) When medication should be administered | ||||
doseAndRate | SΣ | 0..* | Element | (USCDI) Amount of medication administered | ||||
dose[x] | SΣ | 0..1 | (USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
doseQuantity | Quantity | |||||||
dispenseRequest | S | 0..1 | BackboneElement | (USCDI) Medication supply authorization | ||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized | ||||
quantity | S | 0..1 | SimpleQuantity | (USCDI) Amount of medication to supply per dispense | ||||
Documentation for this format |
Path | Conformance | ValueSet | ||||
MedicationRequest.status | required | medicationrequest Status | ||||
MedicationRequest.intent | required | medicationRequest Intent | ||||
MedicationRequest.category | example | medicationRequest Category Codes | ||||
MedicationRequest.category:us-core | required | medicationRequest Category Codes | ||||
MedicationRequest.medication[x] | preferred | SNOMEDCTMedicationCodes | ||||
MedicationRequest.reasonCode | extensible | NegationReasonCodes | ||||
MedicationRequest.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
|
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
mnr-1 | error | MedicationRequest | To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided : medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists() | |
us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists() |
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mnr-1: To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided | ||||
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 | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | 0..* | Identifier | External ids for this request | |||||
status | ?!SΣ | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||
statusReason | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status. | |||||
intent | ?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. | ||||
Slices for category | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
category:us-core | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | ||||
doNotPerform | ?!SΣ | 1..1 | boolean | True if medication was not requested Fixed Value: true | ||||
reported[x] | SΣ | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient S | QICore RelatedPerson S) | (USCDI) Reported rather than primary record | ||||
medication[x] | SΣ | 1..1 | CodeableConcept | (USCDI) Medication to be taken Binding: SNOMEDCTMedicationCodes (preferred) | ||||
id | 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 | |||||
notDoneValueSet | SC | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet | ||||
coding | ΣC | 0..* | Coding | Code defined by a terminology system | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
subject | SΣ | 1..1 | Reference(QICore Patient) | (USCDI) Who or group medication request is for | ||||
encounter | S | 0..1 | Reference(QICore Encounter) | (USCDI) Encounter created as part of encounter/admission/stay | ||||
supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | |||||
authoredOn | SΣ | 1..1 | dateTime | (USCDI) When request was initially authored | ||||
requester | SΣC | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient) | (USCDI) Who/What requested the Request | ||||
performer | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration | |||||
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. | ||||
recorder | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request | |||||
reasonCode | S | 1..1 | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: QICore Negation Reason Codes (extensible): The reason the medication was not requested | ||||
reasonReference | 0..* | Reference(Condition | Observation) | (USCDI) US Core Condition or Observation that supports the prescription | |||||
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | ||||
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | ||||
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | ||||
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | ||||
courseOfTherapyType | 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 | (USCDI) 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 | (USCDI) Free text dosage instructions e.g. SIG | ||||
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
timing | SΣ | 0..1 | Timing | (USCDI) 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 | SΣ | 0..* | Element | (USCDI) Amount of medication administered | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. | ||||
dose[x] | SΣ | 0..1 | (USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
doseQuantity | Quantity S | |||||||
doseRange | Range | |||||||
rate[x] | Σ | 0..1 | Amount of medication per unit of time | |||||
rateRatio | Ratio | |||||||
rateRange | Range | |||||||
rateQuantity | Quantity(SimpleQuantity) | |||||||
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | ||||
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration | ||||
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient | ||||
dispenseRequest | S | 0..1 | BackboneElement | (USCDI) Medication supply authorization | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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 | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized | ||||
quantity | S | 0..1 | SimpleQuantity | (USCDI) 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 | example | medicationRequest Status Reason Codes | ||||
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] | preferred | SNOMEDCTMedicationCodes | ||||
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes | ||||
MedicationRequest.reasonCode | extensible | NegationReasonCodes | ||||
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.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
| ||||
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode | ||||
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason |
Id | Grade | Path(s) | Details | Requirements |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from USCoreMedicationRequestProfile
Summary
Mandatory: 3 elements
Must-Support: 10 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
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 mnr-1: To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided |
status | S | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown |
doNotPerform | S | 1..1 | boolean | True if medication was not requested Fixed Value: true |
reported[x] | S | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient S | QICore RelatedPerson S) | (USCDI) Reported rather than primary record |
medication[x] | S | 1..1 | CodeableConcept | (USCDI) Medication to be taken Binding: SNOMEDCTMedicationCodes (preferred) |
notDoneValueSet | SC | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
coding | C | 0..* | Coding | Code defined by a terminology system |
subject | S | 1..1 | Reference(QICore Patient) | (USCDI) Who or group medication request is for |
encounter | S | 0..1 | Reference(QICore Encounter) | (USCDI) Encounter created as part of encounter/admission/stay |
authoredOn | S | 1..1 | dateTime | (USCDI) When request was initially authored |
requester | S | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient) | (USCDI) Who/What requested the Request |
reasonCode | S | 1..1 | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: QICore Negation Reason Codes (extensible): The reason the medication was not requested |
Documentation for this format |
Path | Conformance | ValueSet |
MedicationRequest.medication[x] | preferred | SNOMEDCTMedicationCodes |
MedicationRequest.reasonCode | extensible | NegationReasonCodes |
Id | Grade | Path(s) | Details | Requirements |
mnr-1 | error | MedicationRequest | To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided : medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists() |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mnr-1: To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
status | ?!SΣ | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||
intent | ?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. | ||||
Slices for category | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
category:us-core | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
doNotPerform | ?!SΣ | 1..1 | boolean | True if medication was not requested Fixed Value: true | ||||
reported[x] | SΣ | 0..1 | Reference(QICore Practitioner | QICore Patient | QICore RelatedPerson) | (USCDI) Reported rather than primary record | ||||
medication[x] | SΣ | 1..1 | CodeableConcept | (USCDI) Medication to be taken Binding: SNOMEDCTMedicationCodes (preferred) | ||||
notDoneValueSet | SC | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet | ||||
coding | ΣC | 0..* | Coding | Code defined by a terminology system | ||||
subject | SΣ | 1..1 | Reference(QICore Patient) | (USCDI) Who or group medication request is for | ||||
encounter | S | 0..1 | Reference(QICore Encounter) | (USCDI) Encounter created as part of encounter/admission/stay | ||||
authoredOn | SΣ | 1..1 | dateTime | (USCDI) When request was initially authored | ||||
requester | SΣC | 0..1 | Reference(QICore Practitioner) | (USCDI) Who/What requested the Request | ||||
reasonCode | S | 1..1 | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: QICore Negation Reason Codes (extensible): The reason the medication was not requested | ||||
dosageInstruction | S | 0..* | Dosage | (USCDI) How the medication should be taken | ||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
text | SΣ | 0..1 | string | (USCDI) Free text dosage instructions e.g. SIG | ||||
timing | SΣ | 0..1 | Timing | (USCDI) When medication should be administered | ||||
doseAndRate | SΣ | 0..* | Element | (USCDI) Amount of medication administered | ||||
dose[x] | SΣ | 0..1 | (USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
doseQuantity | Quantity | |||||||
dispenseRequest | S | 0..1 | BackboneElement | (USCDI) Medication supply authorization | ||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized | ||||
quantity | S | 0..1 | SimpleQuantity | (USCDI) Amount of medication to supply per dispense | ||||
Documentation for this format |
Path | Conformance | ValueSet | ||||
MedicationRequest.status | required | medicationrequest Status | ||||
MedicationRequest.intent | required | medicationRequest Intent | ||||
MedicationRequest.category | example | medicationRequest Category Codes | ||||
MedicationRequest.category:us-core | required | medicationRequest Category Codes | ||||
MedicationRequest.medication[x] | preferred | SNOMEDCTMedicationCodes | ||||
MedicationRequest.reasonCode | extensible | NegationReasonCodes | ||||
MedicationRequest.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
|
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
mnr-1 | error | MedicationRequest | To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided : medication.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor medication.coding.exists() | |
us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists() |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group mnr-1: To indicate what medication was not requested, either at least one coding in the medication or a notDoneValueSet extension shall be provided | ||||
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 | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | 0..* | Identifier | External ids for this request | |||||
status | ?!SΣ | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ||||
statusReason | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status. | |||||
intent | ?!SΣC | 1..1 | code | (USCDI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. | ||||
Slices for category | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | ||||
category:us-core | S | 0..* | CodeableConcept | (USCDI) Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets | ||||
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | ||||
doNotPerform | ?!SΣ | 1..1 | boolean | True if medication was not requested Fixed Value: true | ||||
reported[x] | SΣ | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient S | QICore RelatedPerson S) | (USCDI) Reported rather than primary record | ||||
medication[x] | SΣ | 1..1 | CodeableConcept | (USCDI) Medication to be taken Binding: SNOMEDCTMedicationCodes (preferred) | ||||
id | 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 | |||||
notDoneValueSet | SC | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet | ||||
coding | ΣC | 0..* | Coding | Code defined by a terminology system | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
subject | SΣ | 1..1 | Reference(QICore Patient) | (USCDI) Who or group medication request is for | ||||
encounter | S | 0..1 | Reference(QICore Encounter) | (USCDI) Encounter created as part of encounter/admission/stay | ||||
supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | |||||
authoredOn | SΣ | 1..1 | dateTime | (USCDI) When request was initially authored | ||||
requester | SΣC | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient) | (USCDI) Who/What requested the Request | ||||
performer | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration | |||||
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication. | ||||
recorder | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request | |||||
reasonCode | S | 1..1 | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: QICore Negation Reason Codes (extensible): The reason the medication was not requested | ||||
reasonReference | 0..* | Reference(Condition | Observation) | (USCDI) US Core Condition or Observation that supports the prescription | |||||
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | ||||
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | ||||
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | ||||
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | ||||
courseOfTherapyType | 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 | (USCDI) 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 | (USCDI) Free text dosage instructions e.g. SIG | ||||
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | ||||
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions | ||||
timing | SΣ | 0..1 | Timing | (USCDI) 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 | SΣ | 0..* | Element | (USCDI) Amount of medication administered | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. | ||||
dose[x] | SΣ | 0..1 | (USCDI) Amount of medication per dose Binding: Common UCUM units (preferred)
| |||||
doseQuantity | Quantity S | |||||||
doseRange | Range | |||||||
rate[x] | Σ | 0..1 | Amount of medication per unit of time | |||||
rateRatio | Ratio | |||||||
rateRange | Range | |||||||
rateQuantity | Quantity(SimpleQuantity) | |||||||
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | ||||
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration | ||||
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient | ||||
dispenseRequest | S | 0..1 | BackboneElement | (USCDI) Medication supply authorization | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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 | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized | ||||
quantity | S | 0..1 | SimpleQuantity | (USCDI) 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 | example | medicationRequest Status Reason Codes | ||||
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] | preferred | SNOMEDCTMedicationCodes | ||||
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes | ||||
MedicationRequest.reasonCode | extensible | NegationReasonCodes | ||||
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.dosageInstruction.doseAndRate.dose[x] | preferred | Common UCUM units
| ||||
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode | ||||
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason |
Id | Grade | Path(s) | Details | Requirements |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from USCoreMedicationRequestProfile
Summary
Mandatory: 3 elements
Must-Support: 10 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron