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

Resource Profile: QICoreMedicationNotRequested

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
Usage

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

Negation Example using Valueset
Negation Example using code

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreMedicationRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*USCoreMedicationRequestProfileOrdering 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 S1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Fixed Value: completed
... category S0..*CodeableConceptType of medication usage
Fixed Value: As shown (Community)
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: community
... doNotPerform S1..1booleanTrue if request is prohibiting action
Fixed Value: true
.... qicore-notDoneValueSet SI0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding I0..*CodingCode defined by a terminology system
... subject S1..1Reference(QICorePatient)Who or group medication request is for
... encounter S0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... authoredOn S1..1dateTimeWhen request was initially authored
... requester S1..1Reference(QICorePractitioner | QICorePatient | QICoreOrganization)Who/What requested the Request
... recorder 0..1Reference(QICorePractitioner | QICorePractitionerRole)Person who entered the request
... reasonCode S1..1CodeableConceptReason or indication for ordering or not ordering the medication
Binding: Negation Reason Codes (extensible): The reason the medication was not requested


doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*USCoreMedicationRequestProfileOrdering 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 Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal ids for this request
... status ?!SΣ1..1codeactive | 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..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣ1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category S0..*CodeableConceptType 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)
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: community
..... display0..0stringRepresentation defined by the system
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ1..1booleanTrue if request is prohibiting action
Fixed Value: true
... reported[x] SΣ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
... medication[x] SΣ1..1CodeableConceptMedication to be taken
Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications

.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... qicore-notDoneValueSet SI0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding ΣI0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(QICorePatient)Who or group medication request is for
... encounter S0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... supportingInformation 0..*Reference(Resource)Information to support ordering of the medication
... authoredOn SΣ1..1dateTimeWhen request was initially authored
... requester SΣ1..1Reference(QICorePractitioner | QICorePatient | QICoreOrganization)Who/What requested the Request
... performer 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)Intended performer of administration
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1Reference(QICorePractitioner | QICorePractitionerRole)Person who entered the request
... reasonCode S1..1CodeableConceptReason 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 Σ0..*canonical()Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... courseOfTherapyType 0..1CodeableConceptOverall 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..*AnnotationInformation about the prescription
... dosageInstruction S0..*DosageHow the medication should be taken
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental 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 Σ0..1stringPatient or consumer oriented instructions
.... timing Σ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ0..1CodeableConceptHow 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 Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... dispenseRequest 0..1BackboneElementMedication supply authorization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... initialFill 0..1BackboneElementFirst fill details
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... quantity 0..1SimpleQuantityFirst fill quantity
..... duration 0..1DurationFirst fill duration
.... dispenseInterval 0..1DurationMinimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed 0..1unsignedIntNumber of refills authorized
.... quantity 0..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... performer 0..1Reference(Organization)Intended dispenser
... substitution 0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy 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..1Reference(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

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*USCoreMedicationRequestProfileOrdering 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 ?!Σ1..1codeactive | 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 ?!Σ1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category 0..*CodeableConceptType 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)
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: community
..... display0..0stringRepresentation defined by the system
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... reported[x] Σ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
... medication[x] Σ1..1CodeableConceptMedication to be taken
Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications

.... qicore-notDoneValueSet I0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject Σ1..1Reference(QICorePatient)Who or group medication request is for
... encounter 0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... authoredOn Σ1..1dateTimeWhen request was initially authored
... requester Σ1..1Reference(QICorePractitioner | QICorePatient | QICoreOrganization)Who/What requested the Request
... reasonCode 1..1CodeableConceptReason or indication for ordering or not ordering the medication
Binding: Negation Reason Codes (extensible): The reason the medication was not requested


... dosageInstruction 0..*DosageHow the medication should be taken
.... text Σ0..1stringFree text dosage instructions e.g. SIG

doco Documentation for this format

Differential View

This structure is derived from USCoreMedicationRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*USCoreMedicationRequestProfileOrdering 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 S1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Fixed Value: completed
... category S0..*CodeableConceptType of medication usage
Fixed Value: As shown (Community)
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: community
... doNotPerform S1..1booleanTrue if request is prohibiting action
Fixed Value: true
.... qicore-notDoneValueSet SI0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding I0..*CodingCode defined by a terminology system
... subject S1..1Reference(QICorePatient)Who or group medication request is for
... encounter S0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... authoredOn S1..1dateTimeWhen request was initially authored
... requester S1..1Reference(QICorePractitioner | QICorePatient | QICoreOrganization)Who/What requested the Request
... recorder 0..1Reference(QICorePractitioner | QICorePractitionerRole)Person who entered the request
... reasonCode S1..1CodeableConceptReason or indication for ordering or not ordering the medication
Binding: Negation Reason Codes (extensible): The reason the medication was not requested


doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest I0..*USCoreMedicationRequestProfileOrdering 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 Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal ids for this request
... status ?!SΣ1..1codeactive | 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..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣ1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... category S0..*CodeableConceptType 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)
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/medicationrequest-category
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: community
..... display0..0stringRepresentation defined by the system
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ1..1booleanTrue if request is prohibiting action
Fixed Value: true
... reported[x] SΣ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
... medication[x] SΣ1..1CodeableConceptMedication to be taken
Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications

.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... qicore-notDoneValueSet SI0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding ΣI0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(QICorePatient)Who or group medication request is for
... encounter S0..1Reference(QICoreEncounter)Encounter created as part of encounter/admission/stay
... supportingInformation 0..*Reference(Resource)Information to support ordering of the medication
... authoredOn SΣ1..1dateTimeWhen request was initially authored
... requester SΣ1..1Reference(QICorePractitioner | QICorePatient | QICoreOrganization)Who/What requested the Request
... performer 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)Intended performer of administration
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1Reference(QICorePractitioner | QICorePractitionerRole)Person who entered the request
... reasonCode S1..1CodeableConceptReason 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 Σ0..*canonical()Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... courseOfTherapyType 0..1CodeableConceptOverall 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..*AnnotationInformation about the prescription
... dosageInstruction S0..*DosageHow the medication should be taken
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental 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 Σ0..1stringPatient or consumer oriented instructions
.... timing Σ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ0..1CodeableConceptHow 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 Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] Σ0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... dispenseRequest 0..1BackboneElementMedication supply authorization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... initialFill 0..1BackboneElementFirst fill details
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... quantity 0..1SimpleQuantityFirst fill quantity
..... duration 0..1DurationFirst fill duration
.... dispenseInterval 0..1DurationMinimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed 0..1unsignedIntNumber of refills authorized
.... quantity 0..1SimpleQuantityAmount of medication to supply per dispense
.... expectedSupplyDuration 0..1DurationNumber of days supply per dispense
.... performer 0..1Reference(Organization)Intended dispenser
... substitution 0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy 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..1Reference(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

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
MedicationRequest.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationRequest.statusrequiredFixed Value: completed
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
MedicationRequest.intentrequiredmedicationRequest Intent
MedicationRequest.categoryexampleFixed Value: community
MedicationRequest.priorityrequiredRequestPriority
MedicationRequest.medication[x]extensibleUSCoreMedicationCodes
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
MedicationRequest.reasonCodeextensibleNegationReasonCodes
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason

Constraints

IdGradePathDetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6Best PracticeMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
mnr-1errorMedicationRequestTo 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-1errorMedicationRequest.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.statusReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.intentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.priorityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.doNotPerformAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.reported[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.medication[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.medication[x].extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.medication[x].extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.medication[x].extension:notDoneValueSetAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.medication[x].extension:notDoneValueSetMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.medication[x].codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.medication[x].textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.supportingInformationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.authoredOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.requesterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.performerTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.reasonCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.reasonReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.instantiatesCanonicalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.instantiatesUriAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.groupIdentifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.courseOfTherapyTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.insuranceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dosageInstruction.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dosageInstruction.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dosageInstruction.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dosageInstruction.sequenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.additionalInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.patientInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.timingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.asNeeded[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.siteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.routeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.methodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.doseAndRateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.doseAndRate.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dosageInstruction.doseAndRate.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dosageInstruction.doseAndRate.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.doseAndRate.dose[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.doseAndRate.rate[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.maxDosePerPeriodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.maxDosePerAdministrationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dosageInstruction.maxDosePerLifetimeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequestAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dispenseRequest.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dispenseRequest.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dispenseRequest.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dispenseRequest.initialFillAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.initialFill.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dispenseRequest.initialFill.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dispenseRequest.initialFill.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.dispenseRequest.initialFill.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.dispenseRequest.initialFill.quantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.initialFill.durationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.dispenseIntervalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.validityPeriodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.numberOfRepeatsAllowedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.quantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.expectedSupplyDurationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.dispenseRequest.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.substitutionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.substitution.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.substitution.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.substitution.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorMedicationRequest.substitution.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorMedicationRequest.substitution.allowed[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.substitution.reasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.priorPrescriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.detectedIssueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorMedicationRequest.eventHistoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())