QI-Core Implementation Guide
4.1.0 - release
This page is part of the Quality Improvement Core Framework (v4.1.0: STU 4) based on FHIR R4. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions
Defining URL: | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested |
Version: | 4.1.0 |
Name: | QICoreMedicationNotRequested |
Status: | Draft as of 8/22/18 |
Definition: | Negation profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. |
Publisher: | http://www.hl7.org/Special/committees/cqi/index.cfm |
Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-mednotrequested
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'
Negation Example using Valueset |
Negation Example using code |
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCoreMedicationRequestProfile
Summary
Mandatory: 4 elements
Must-Support: 10 elements
Fixed Value: 3 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
This structure is derived from USCoreMedicationRequestProfile
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MedicationRequest | I | 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 | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Fixed Value: completed |
category | S | 0..* | CodeableConcept | Type of medication usage Fixed Value: As shown (Community) |
coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: community | |
doNotPerform | S | 1..1 | boolean | True if request is prohibiting action Fixed Value: true |
medication[x] | S | 1..1 | CodeableConcept | Medication to be taken |
qicore-notDoneValueSet | SI | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
coding | I | 0..* | Coding | Code defined by a terminology system |
subject | S | 1..1 | Reference(QICorePatient) | Who or group medication request is for |
encounter | S | 0..1 | Reference(QICoreEncounter) | Encounter created as part of encounter/admission/stay |
authoredOn | S | 1..1 | dateTime | When request was initially authored |
requester | S | 1..1 | Reference(QICorePractitioner | QICorePatient | QICoreOrganization) | Who/What requested the Request |
recorder | 0..1 | Reference(QICorePractitioner | QICorePractitionerRole) | Person who entered the request | |
reasonCode | S | 1..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Negation Reason Codes (extensible): The reason the medication was not requested |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MedicationRequest | I | 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 | string | 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) Max Binding: AllLanguages: 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 | 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. Fixed Value: completed |
statusReason | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status. | |
intent | ?!SΣ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. |
category | S | 0..* | CodeableConcept | Type of medication usage 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. Fixed Value: As shown (Community) |
id | 0..0 | string | Unique id for inter-element referencing | |
extension | 0..0 | Extension | Additional content defined by implementations | |
coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..0 | string | Unique id for inter-element referencing | |
extension | 0..0 | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category | |
version | 0..0 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: community | |
display | 0..0 | string | Representation defined by the system | |
userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
text | 0..0 | string | Plain text representation of the concept | |
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 request is prohibiting action Fixed Value: true |
reported[x] | SΣ | 0..1 | Reported rather than primary record | |
reportedBoolean | boolean | |||
reportedReference | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | |||
medication[x] | SΣ | 1..1 | CodeableConcept | Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications |
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 | |
qicore-notDoneValueSet | SI | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
coding | ΣI | 0..* | Coding | Code defined by a terminology system |
text | Σ | 0..1 | string | Plain text representation of the concept |
subject | SΣ | 1..1 | Reference(QICorePatient) | Who or group medication request is for |
encounter | S | 0..1 | Reference(QICoreEncounter) | Encounter created as part of encounter/admission/stay |
supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | |
authoredOn | SΣ | 1..1 | dateTime | When request was initially authored |
requester | SΣ | 1..1 | Reference(QICorePractitioner | QICorePatient | QICoreOrganization) | 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(QICorePractitioner | QICorePractitionerRole) | Person who entered the request | |
reasonCode | S | 1..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Negation Reason Codes (extensible): The reason the medication was not requested |
reasonReference | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written | |
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills |
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of |
courseOfTherapyType | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. | |
insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |
note | 0..* | Annotation | Information about the prescription | |
dosageInstruction | S | 0..* | Dosage | How the medication should be taken |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence | Σ | 0..1 | integer | The order of the dosage instructions |
text | SΣ | 0..1 | string | Free text dosage instructions e.g. SIG |
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions |
timing | Σ | 0..1 | Timing | When medication should be administered |
asNeeded[x] | Σ | 0..1 | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | |
asNeededBoolean | boolean | |||
asNeededCodeableConcept | CodeableConcept | |||
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. |
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. |
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. |
doseAndRate | Σ | 0..* | Element | Amount of medication administered |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. |
dose[x] | Σ | 0..1 | Amount of medication per dose | |
doseRange | Range | |||
doseQuantity | Quantity(SimpleQuantity) | |||
rate[x] | Σ | 0..1 | Amount of medication per unit of time | |
rateRatio | Ratio | |||
rateRange | Range | |||
rateQuantity | Quantity(SimpleQuantity) | |||
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time |
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration |
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient |
dispenseRequest | 0..1 | BackboneElement | Medication supply authorization | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
initialFill | 0..1 | BackboneElement | First fill details | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
quantity | 0..1 | SimpleQuantity | First fill quantity | |
duration | 0..1 | Duration | First fill duration | |
dispenseInterval | 0..1 | Duration | Minimum period of time between dispenses | |
validityPeriod | 0..1 | Period | Time period supply is authorized for | |
numberOfRepeatsAllowed | 0..1 | unsignedInt | Number of refills authorized | |
quantity | 0..1 | SimpleQuantity | Amount of medication to supply per dispense | |
expectedSupplyDuration | 0..1 | Duration | Number of days supply per dispense | |
performer | 0..1 | Reference(Organization) | Intended dispenser | |
substitution | 0..1 | BackboneElement | Any restrictions on medication substitution | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
allowed[x] | 1..1 | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. | ||
allowedBoolean | boolean | |||
allowedCodeableConcept | CodeableConcept | |||
reason | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | |
priorPrescription | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced | |
detectedIssue | 0..* | Reference(DetectedIssue) | Clinical Issue with action | |
eventHistory | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MedicationRequest | I | 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 | ?!Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Fixed Value: completed |
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. |
category | 0..* | CodeableConcept | Type of medication usage 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. Fixed Value: As shown (Community) | |
id | 0..0 | string | Unique id for inter-element referencing | |
extension | 0..0 | Extension | Additional content defined by implementations | |
coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..0 | string | Unique id for inter-element referencing | |
extension | 0..0 | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category | |
version | 0..0 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: community | |
display | 0..0 | string | Representation defined by the system | |
userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
text | 0..0 | string | Plain text representation of the concept | |
doNotPerform | ?!Σ | 1..1 | boolean | True if request is prohibiting action Fixed Value: true |
reported[x] | Σ | 0..1 | Reported rather than primary record | |
reportedBoolean | boolean | |||
reportedReference | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | |||
medication[x] | Σ | 1..1 | CodeableConcept | Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications |
qicore-notDoneValueSet | I | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
subject | Σ | 1..1 | Reference(QICorePatient) | Who or group medication request is for |
encounter | 0..1 | Reference(QICoreEncounter) | Encounter created as part of encounter/admission/stay | |
authoredOn | Σ | 1..1 | dateTime | When request was initially authored |
requester | Σ | 1..1 | Reference(QICorePractitioner | QICorePatient | QICoreOrganization) | Who/What requested the Request |
reasonCode | 1..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Negation Reason Codes (extensible): The reason the medication was not requested | |
dosageInstruction | 0..* | Dosage | How the medication should be taken | |
text | Σ | 0..1 | string | Free text dosage instructions e.g. SIG |
Documentation for this format |
This structure is derived from USCoreMedicationRequestProfile
Summary
Mandatory: 4 elements
Must-Support: 10 elements
Fixed Value: 3 elements
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 | I | 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 | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Fixed Value: completed |
category | S | 0..* | CodeableConcept | Type of medication usage Fixed Value: As shown (Community) |
coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: community | |
doNotPerform | S | 1..1 | boolean | True if request is prohibiting action Fixed Value: true |
medication[x] | S | 1..1 | CodeableConcept | Medication to be taken |
qicore-notDoneValueSet | SI | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
coding | I | 0..* | Coding | Code defined by a terminology system |
subject | S | 1..1 | Reference(QICorePatient) | Who or group medication request is for |
encounter | S | 0..1 | Reference(QICoreEncounter) | Encounter created as part of encounter/admission/stay |
authoredOn | S | 1..1 | dateTime | When request was initially authored |
requester | S | 1..1 | Reference(QICorePractitioner | QICorePatient | QICoreOrganization) | Who/What requested the Request |
recorder | 0..1 | Reference(QICorePractitioner | QICorePractitionerRole) | Person who entered the request | |
reasonCode | S | 1..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Negation Reason Codes (extensible): The reason the medication was not requested |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
MedicationRequest | I | 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 | string | 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) Max Binding: AllLanguages: 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 | 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. Fixed Value: completed |
statusReason | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status. | |
intent | ?!SΣ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. |
category | S | 0..* | CodeableConcept | Type of medication usage 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. Fixed Value: As shown (Community) |
id | 0..0 | string | Unique id for inter-element referencing | |
extension | 0..0 | Extension | Additional content defined by implementations | |
coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
id | 0..0 | string | Unique id for inter-element referencing | |
extension | 0..0 | Extension | Additional content defined by implementations | |
system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category | |
version | 0..0 | string | Version of the system - if relevant | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: community | |
display | 0..0 | string | Representation defined by the system | |
userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
text | 0..0 | string | Plain text representation of the concept | |
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 request is prohibiting action Fixed Value: true |
reported[x] | SΣ | 0..1 | Reported rather than primary record | |
reportedBoolean | boolean | |||
reportedReference | Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile) | |||
medication[x] | SΣ | 1..1 | CodeableConcept | Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications |
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 | |
qicore-notDoneValueSet | SI | 0..1 | canonical(ValueSet) | What was not requested URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet |
coding | ΣI | 0..* | Coding | Code defined by a terminology system |
text | Σ | 0..1 | string | Plain text representation of the concept |
subject | SΣ | 1..1 | Reference(QICorePatient) | Who or group medication request is for |
encounter | S | 0..1 | Reference(QICoreEncounter) | Encounter created as part of encounter/admission/stay |
supportingInformation | 0..* | Reference(Resource) | Information to support ordering of the medication | |
authoredOn | SΣ | 1..1 | dateTime | When request was initially authored |
requester | SΣ | 1..1 | Reference(QICorePractitioner | QICorePatient | QICoreOrganization) | 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(QICorePractitioner | QICorePractitionerRole) | Person who entered the request | |
reasonCode | S | 1..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Negation Reason Codes (extensible): The reason the medication was not requested |
reasonReference | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written | |
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills |
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of |
courseOfTherapyType | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio. | |
insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |
note | 0..* | Annotation | Information about the prescription | |
dosageInstruction | S | 0..* | Dosage | How the medication should be taken |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence | Σ | 0..1 | integer | The order of the dosage instructions |
text | SΣ | 0..1 | string | Free text dosage instructions e.g. SIG |
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions |
timing | Σ | 0..1 | Timing | When medication should be administered |
asNeeded[x] | Σ | 0..1 | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. | |
asNeededBoolean | boolean | |||
asNeededCodeableConcept | CodeableConcept | |||
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body. |
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. |
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered. |
doseAndRate | Σ | 0..* | Element | Amount of medication administered |
id | 0..1 | string | Unique id for inter-element referencing | |
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified. |
dose[x] | Σ | 0..1 | Amount of medication per dose | |
doseRange | Range | |||
doseQuantity | Quantity(SimpleQuantity) | |||
rate[x] | Σ | 0..1 | Amount of medication per unit of time | |
rateRatio | Ratio | |||
rateRange | Range | |||
rateQuantity | Quantity(SimpleQuantity) | |||
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time |
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration |
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient |
dispenseRequest | 0..1 | BackboneElement | Medication supply authorization | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
initialFill | 0..1 | BackboneElement | First fill details | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
quantity | 0..1 | SimpleQuantity | First fill quantity | |
duration | 0..1 | Duration | First fill duration | |
dispenseInterval | 0..1 | Duration | Minimum period of time between dispenses | |
validityPeriod | 0..1 | Period | Time period supply is authorized for | |
numberOfRepeatsAllowed | 0..1 | unsignedInt | Number of refills authorized | |
quantity | 0..1 | SimpleQuantity | Amount of medication to supply per dispense | |
expectedSupplyDuration | 0..1 | Duration | Number of days supply per dispense | |
performer | 0..1 | Reference(Organization) | Intended dispenser | |
substitution | 0..1 | BackboneElement | Any restrictions on medication substitution | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
allowed[x] | 1..1 | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. | ||
allowedBoolean | boolean | |||
allowedCodeableConcept | CodeableConcept | |||
reason | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. | |
priorPrescription | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced | |
detectedIssue | 0..* | Reference(DetectedIssue) | Clinical Issue with action | |
eventHistory | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle | |
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet / Code |
MedicationRequest.language | preferred | CommonLanguages Max Binding: AllLanguages |
MedicationRequest.status | required | Fixed Value: completed |
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes |
MedicationRequest.intent | required | medicationRequest Intent |
MedicationRequest.category | example | Fixed Value: community |
MedicationRequest.priority | required | RequestPriority |
MedicationRequest.medication[x] | extensible | USCoreMedicationCodes |
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.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode |
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason |
Id | Grade | Path | 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() | |
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() | |
ele-1 | error | MedicationRequest.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.statusReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.intent | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.priority | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.doNotPerform | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.reported[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.medication[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.medication[x].extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.medication[x].extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.medication[x].extension:notDoneValueSet | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.medication[x].extension:notDoneValueSet | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.medication[x].coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.medication[x].text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.supportingInformation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.authoredOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.requester | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.performer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.performerType | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.recorder | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.reasonCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.reasonReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.instantiatesCanonical | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.instantiatesUri | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.basedOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.groupIdentifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.courseOfTherapyType | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.insurance | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dosageInstruction.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dosageInstruction.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dosageInstruction.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dosageInstruction.sequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.additionalInstruction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.patientInstruction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.timing | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.asNeeded[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.site | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.route | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.method | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.doseAndRate | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.doseAndRate.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dosageInstruction.doseAndRate.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dosageInstruction.doseAndRate.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.doseAndRate.dose[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.doseAndRate.rate[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.maxDosePerPeriod | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.maxDosePerAdministration | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dosageInstruction.maxDosePerLifetime | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dispenseRequest.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dispenseRequest.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dispenseRequest.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dispenseRequest.initialFill | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.initialFill.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dispenseRequest.initialFill.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dispenseRequest.initialFill.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.dispenseRequest.initialFill.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.dispenseRequest.initialFill.quantity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.initialFill.duration | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.dispenseInterval | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.validityPeriod | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.numberOfRepeatsAllowed | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.quantity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.expectedSupplyDuration | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.dispenseRequest.performer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.substitution | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.substitution.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.substitution.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.substitution.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | MedicationRequest.substitution.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | MedicationRequest.substitution.allowed[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.substitution.reason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.priorPrescription | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.detectedIssue | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | MedicationRequest.eventHistory | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |