QI-Core Implementation Guide
6.0.0-ballot - ballot
QI-Core Implementation Guide
6.0.0-ballot - ballot
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-medicationrequest | Version: 6.0.0-ballot | |||
| Active as of 2018-08-22 | Computable Name: QICoreMedicationRequest | |||
Profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
To create an expression specifically requesting information that a MedicationRequest intentionally did not occur for a medical, patient or system reason, use the profile QICore-Medicationnotrequested.
The following example illustrates the use of the MedicationRequest profile:
define "Antithrombotic Therapy at Discharge":
["MedicationRequest": medication in "Antithrombotic Therapy"] Antithrombotic
where (Antithrombotic.isCommunity() or Antithrombotic.isDischarge())
and Antithrombotic.status in { 'active', 'completed' }
and Antithrombotic.intent = 'order'
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 | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group dom-7: if doNotPerform is present, it SHALL be false | |
  status | S | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown |
 doNotPerform | S | 0..1 | boolean | True if medication was not requested Fixed Value: false |
 reported[x] | S | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient S | QICore RelatedPerson S) | (USCDI) Reported rather than primary record |
| 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 | 0..* | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication |
| reasonReference | S | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (USCDI) US Core Condition or Observation that supports the prescription |
 dosageInstruction | S | 0..* | Dosage | (USCDI) How the medication should be taken |
 timing | S | 0..1 | Timing | (USCDI) When medication should be administered |
 repeat | S | 0..1 | Element | When the event is to occur |
 bounds[x] | S | 0..1 | Duration, Range, Period | Length/Range of lengths, or (Start and/or end) limits |
| frequency | S | 0..1 | positiveInt | Event occurs frequency times per period |
| frequencyMax | S | 0..1 | positiveInt | Event occurs up to frequencyMax times per period |
| period | S | 0..1 | decimal | Event occurs frequency times per period |
| periodMax | S | 0..1 | decimal | Upper limit of period (3-4 hours) |
 periodUnit | S | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) |
| asNeeded[x] | S | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) |
| doseAndRate | S | 0..* | Element | (USCDI) Amount of medication administered |
| dose[x] | S | 0..1 | Quantity S, Range | (USCDI) Amount of medication per dose |
| dispenseRequest | S | 0..1 | BackboneElement | (USCDI) Medication supply authorization |
| initialFill | S | 0..0 | ||
| dispenseInterval | S | 0..1 | Duration | Minimum period of time between dispenses |
| numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized |
| quantity | S | 0..1 | SimpleQuantity | (USCDI) Amount of medication to supply per dispense |
| expectedSupplyDuration | S | 0..1 | Duration | Number of days supply per dispense |
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group dom-7: if doNotPerform is present, it SHALL be false | ||||
| 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 | 0..1 | boolean | True if medication was not requested Fixed Value: false | ||||
| reported[x] | SΣ | 0..1 | Reference(QICore Practitioner | QICore Patient | QICore RelatedPerson) | (USCDI) Reported rather than primary record | ||||
 medication[x] | SΣ | 1..1 | (USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible) | |||||
 medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(US Core Medication Profile) | |||||||
| 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 | 0..* | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) | ||||
| reasonReference | S | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (USCDI) US Core Condition or Observation that supports the prescription | ||||
| 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 | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| repeat | SΣC | 0..1 | Element | When the event is to occur | ||||
| bounds[x] | SΣ | 0..1 | Length/Range of lengths, or (Start and/or end) limits | |||||
| boundsDuration | Duration | |||||||
| boundsRange | Range | |||||||
| boundsPeriod | Period | |||||||
| frequency | SΣ | 0..1 | positiveInt | Event occurs frequency times per period | ||||
| frequencyMax | SΣ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period | ||||
| period | SΣ | 0..1 | decimal | Event occurs frequency times per period | ||||
| periodMax | SΣ | 0..1 | decimal | Upper limit of period (3-4 hours) | ||||
| periodUnit | SΣ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| asNeeded[x] | SΣ | 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 | |||||||
| 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 | ||||
| dispenseInterval | S | 0..1 | Duration | Minimum period of time between dispenses | ||||
| numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized | ||||
| quantity | S | 0..1 | SimpleQuantity | (USCDI) Amount of medication to supply per dispense | ||||
| expectedSupplyDuration | S | 0..1 | Duration | Number of days 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] | extensible | Medication Clinical Drug | ||||
| MedicationRequest.reasonCode | extensible | USCoreConditionCodes | ||||
| MedicationRequest.dosageInstruction.timing.repeat.periodUnit | required | UnitsOfTime | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes | ||||
| 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() | |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false | |
| 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() | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() | |
| 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 dom-7: if doNotPerform is present, it SHALL be false | ||||
| 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 | 0..1 | boolean | True if medication was not requested Fixed Value: false | ||||
| 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 | (USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible) | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(US Core Medication Profile) | |||||||
| 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 | 0..* | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) | ||||
| reasonReference | S | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple 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 | ||||
| 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 | ||||
| event | Σ | 0..* | dateTime | When the event occurs | ||||
| repeat | SΣC | 0..1 | Element | When the event is to occur | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| bounds[x] | SΣ | 0..1 | Length/Range of lengths, or (Start and/or end) limits | |||||
| boundsDuration | Duration | |||||||
| boundsRange | Range | |||||||
| boundsPeriod | Period | |||||||
| count | Σ | 0..1 | positiveInt | Number of times to repeat | ||||
| countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat | ||||
| duration | Σ | 0..1 | decimal | How long when it happens | ||||
| durationMax | Σ | 0..1 | decimal | How long when it happens (Max) | ||||
| durationUnit | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| frequency | SΣ | 0..1 | positiveInt | Event occurs frequency times per period | ||||
| frequencyMax | SΣ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period | ||||
| period | SΣ | 0..1 | decimal | Event occurs frequency times per period | ||||
| periodMax | SΣ | 0..1 | decimal | Upper limit of period (3-4 hours) | ||||
| periodUnit | SΣ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required) | ||||
| timeOfDay | Σ | 0..* | time | Time of day for action | ||||
| when | Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule. | ||||
| offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after) | ||||
| code | Σ | 0..1 | CodeableConcept | BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern. | ||||
| asNeeded[x] | SΣ | 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 | ||||
| dispenseInterval | S | 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 | S | 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] | extensible | Medication Clinical Drug | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodes | ||||
| MedicationRequest.reasonCode | extensible | USCoreConditionCodes | ||||
| MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions | ||||
| MedicationRequest.dosageInstruction.timing.repeat.durationUnit | required | UnitsOfTime | ||||
| MedicationRequest.dosageInstruction.timing.repeat.periodUnit | required | UnitsOfTime | ||||
| MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek | required | DaysOfWeek | ||||
| MedicationRequest.dosageInstruction.timing.repeat.when | required | EventTiming | ||||
| MedicationRequest.dosageInstruction.timing.code | preferred | TimingAbbreviation | ||||
| 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() | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() |
This structure is derived from USCoreMedicationRequestProfile
Summary
Mandatory: 1 element
Must-Support: 27 elements
Fixed Value: 1 element
Prohibited: 1 element
Structures
This structure refers to these other structures:
Differential View
This structure is derived from USCoreMedicationRequestProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| MedicationRequest | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group dom-7: if doNotPerform is present, it SHALL be false | |
| status | S | 1..1 | code | (USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown |
| doNotPerform | S | 0..1 | boolean | True if medication was not requested Fixed Value: false |
| reported[x] | S | 0..1 | Reference(QICore Practitioner S | QICore PractitionerRole | QICore Patient S | QICore RelatedPerson S) | (USCDI) Reported rather than primary record |
| 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 | 0..* | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication |
| reasonReference | S | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (USCDI) US Core Condition or Observation that supports the prescription |
| dosageInstruction | S | 0..* | Dosage | (USCDI) How the medication should be taken |
| timing | S | 0..1 | Timing | (USCDI) When medication should be administered |
| repeat | S | 0..1 | Element | When the event is to occur |
| bounds[x] | S | 0..1 | Duration, Range, Period | Length/Range of lengths, or (Start and/or end) limits |
| frequency | S | 0..1 | positiveInt | Event occurs frequency times per period |
| frequencyMax | S | 0..1 | positiveInt | Event occurs up to frequencyMax times per period |
| period | S | 0..1 | decimal | Event occurs frequency times per period |
| periodMax | S | 0..1 | decimal | Upper limit of period (3-4 hours) |
| periodUnit | S | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) |
| asNeeded[x] | S | 0..1 | boolean, CodeableConcept | Take "as needed" (for x) |
| doseAndRate | S | 0..* | Element | (USCDI) Amount of medication administered |
| dose[x] | S | 0..1 | Quantity S, Range | (USCDI) Amount of medication per dose |
| dispenseRequest | S | 0..1 | BackboneElement | (USCDI) Medication supply authorization |
| initialFill | S | 0..0 | ||
| dispenseInterval | S | 0..1 | Duration | Minimum period of time between dispenses |
| numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized |
| quantity | S | 0..1 | SimpleQuantity | (USCDI) Amount of medication to supply per dispense |
| expectedSupplyDuration | S | 0..1 | Duration | Number of days supply per dispense |
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group dom-7: if doNotPerform is present, it SHALL be false | ||||
| 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 | 0..1 | boolean | True if medication was not requested Fixed Value: false | ||||
| reported[x] | SΣ | 0..1 | Reference(QICore Practitioner | QICore Patient | QICore RelatedPerson) | (USCDI) Reported rather than primary record | ||||
| medication[x] | SΣ | 1..1 | (USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible) | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(US Core Medication Profile) | |||||||
| 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 | 0..* | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) | ||||
| reasonReference | S | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (USCDI) US Core Condition or Observation that supports the prescription | ||||
| 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 | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| repeat | SΣC | 0..1 | Element | When the event is to occur | ||||
| bounds[x] | SΣ | 0..1 | Length/Range of lengths, or (Start and/or end) limits | |||||
| boundsDuration | Duration | |||||||
| boundsRange | Range | |||||||
| boundsPeriod | Period | |||||||
| frequency | SΣ | 0..1 | positiveInt | Event occurs frequency times per period | ||||
| frequencyMax | SΣ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period | ||||
| period | SΣ | 0..1 | decimal | Event occurs frequency times per period | ||||
| periodMax | SΣ | 0..1 | decimal | Upper limit of period (3-4 hours) | ||||
| periodUnit | SΣ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| asNeeded[x] | SΣ | 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 | |||||||
| 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 | ||||
| dispenseInterval | S | 0..1 | Duration | Minimum period of time between dispenses | ||||
| numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (USCDI) Number of refills authorized | ||||
| quantity | S | 0..1 | SimpleQuantity | (USCDI) Amount of medication to supply per dispense | ||||
| expectedSupplyDuration | S | 0..1 | Duration | Number of days 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] | extensible | Medication Clinical Drug | ||||
| MedicationRequest.reasonCode | extensible | USCoreConditionCodes | ||||
| MedicationRequest.dosageInstruction.timing.repeat.periodUnit | required | UnitsOfTime | ||||
| MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes | ||||
| 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() | |
| dom-7 | error | MedicationRequest | if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false | |
| 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() | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() | |
| 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 dom-7: if doNotPerform is present, it SHALL be false | ||||
| 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 | 0..1 | boolean | True if medication was not requested Fixed Value: false | ||||
| 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 | (USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible) | |||||
| medicationCodeableConcept | CodeableConcept | |||||||
| medicationReference | Reference(US Core Medication Profile) | |||||||
| 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 | 0..* | CodeableConcept | (USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) | ||||
| reasonReference | S | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple 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 | ||||
| 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 | ||||
| event | Σ | 0..* | dateTime | When the event occurs | ||||
| repeat | SΣC | 0..1 | Element | When the event is to occur | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| bounds[x] | SΣ | 0..1 | Length/Range of lengths, or (Start and/or end) limits | |||||
| boundsDuration | Duration | |||||||
| boundsRange | Range | |||||||
| boundsPeriod | Period | |||||||
| count | Σ | 0..1 | positiveInt | Number of times to repeat | ||||
| countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat | ||||
| duration | Σ | 0..1 | decimal | How long when it happens | ||||
| durationMax | Σ | 0..1 | decimal | How long when it happens (Max) | ||||
| durationUnit | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| frequency | SΣ | 0..1 | positiveInt | Event occurs frequency times per period | ||||
| frequencyMax | SΣ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period | ||||
| period | SΣ | 0..1 | decimal | Event occurs frequency times per period | ||||
| periodMax | SΣ | 0..1 | decimal | Upper limit of period (3-4 hours) | ||||
| periodUnit | SΣ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM). | ||||
| dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required) | ||||
| timeOfDay | Σ | 0..* | time | Time of day for action | ||||
| when | Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule. | ||||
| offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after) | ||||
| code | Σ | 0..1 | CodeableConcept | BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern. | ||||
| asNeeded[x] | SΣ | 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 | ||||
| dispenseInterval | S | 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 | S | 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] | extensible | Medication Clinical Drug | ||||
| MedicationRequest.performerType | example | ProcedurePerformerRoleCodes | ||||
| MedicationRequest.reasonCode | extensible | USCoreConditionCodes | ||||
| MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes | ||||
| MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions | ||||
| MedicationRequest.dosageInstruction.timing.repeat.durationUnit | required | UnitsOfTime | ||||
| MedicationRequest.dosageInstruction.timing.repeat.periodUnit | required | UnitsOfTime | ||||
| MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek | required | DaysOfWeek | ||||
| MedicationRequest.dosageInstruction.timing.repeat.when | required | EventTiming | ||||
| MedicationRequest.dosageInstruction.timing.code | preferred | TimingAbbreviation | ||||
| 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() | |
| tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists() | |
| tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units : period.empty() or periodUnit.exists() | |
| tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value : duration.exists() implies duration >= 0 | |
| tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value : period.exists() implies period >= 0 | |
| tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period : periodMax.empty() or period.exists() | |
| tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists() | |
| tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count : countMax.empty() or count.exists() | |
| tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())) | |
| tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty() |
This structure is derived from USCoreMedicationRequestProfile
Summary
Mandatory: 1 element
Must-Support: 27 elements
Fixed Value: 1 element
Prohibited: 1 element
Structures
This structure refers to these other structures:
Other representations of profile: CSV, Excel, Schematron
IG © 2019+ http://www.hl7.org/Special/committees/cqi/index.cfm. Package hl7.fhir.us.qicore#6.0.0-ballot based on FHIR 4.0.1. Generated 2023-08-03
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