See the patterns page for implementation and usage patterns.

The MedicationRequest and MedicationNotRequested profiles represent the positive and negative statements for a medication order. To ensure instances retrieved meet negative intent, applications should check the status and doNotPerform elements as illustrated in this example:

define MedicationNotRequested:
  [MedicationRequest] R
    where R.status = 'completed'
      and R.doNotPerform is true

The following example illustrates the use of the MedicationNotRequested profile:

define "Antithrombotic Not Given at Discharge":
  ["MedicationRequest": medication in "Antithrombotic Therapy"] NoAntithromboticDischarge
    where NoAntithromboticDischarge.doNotPerform is true
			and (NoAntithromboticDischarge.reasonCode in "Medical Reason"
				or NoAntithromboticDischarge.reasonCode in "Patient Refusal")
      and (NoAntithromboticDischarge.isCommunity() or NoAntimthromboticDischarge.isDischarge())
      and NoAntithromboticDischarge.status = 'completed'
      and NoAntithromboticDischarge.intent = 'order'

Examples

Both of these example instances meet measure intent for exclusion as defined in the following example CQL:

define "No VTE Prophylaxis Medication Ordered":
  ( ["MedicationRequest": "Low Dose Unfractionated Heparin for VTE Prophylaxis"]
    union ["MedicationRequest": "Low Molecular Weight Heparin for VTE Prophylaxis"]
    union ["MedicationRequest": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
    union ["MedicationRequest": "Warfarin"]
    union ["MedicationRequest": "Rivaroxaban for VTE Prophylaxis"]
  ) MedicationOrder
    where MedicationOrder.doNotPerform is true
      and MedicationOrder.status in { 'completed', 'cancelled' }
    return {
      id: MedicationOrder.id,
      MedicationStatusReason: MedicationOrder.reasonCode,
      authoredOn: MedicationOrder.authoredOn
    }

For a more complete discussion of representation of negation within QICore and quality improvement artifacts, see the Negation in QI Core topic.