FHIR Clinical Guidelines (v1.0.0) (STU1)

This page is part of the Clinical Guidelines (v1.0.0: STU 1) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

D.4.1 StructureDefinition-chf-lasix-po-request

Introduction:

This profile is a _case feature definition_ as part of the Congestive Heart Failure example.

Examples:

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is: 

http://hl7.org/fhir/uv/cpg/StructureDefinition/chf-lasix-po-request

Request to administer LASIX PO as part of a congestive heart failure pathway

This profile builds on CPGMedicationRequest.

This profile was published on Thu Jun 06 00:00:00 UTC 2019 as a draft by Health Level Seven, Inc. - CDS WG.

Description of Profiles, Differentials, and Snapshots.

Summary

Must-Support: 1 element

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*CPGMedicationRequestOrdering of medication for patient or group
... medication[x] S1..1CodeableConcept, Reference(Medication)Medication to be taken

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*CPGMedicationRequestOrdering of medication for patient or group
... 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..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-rationale S0..1markdownExplanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*IdentifierExternal ids for this request
... status ?!SΣ1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... 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.


... priority SΣ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ0..1booleanTrue if request is prohibiting action
... reported[x] Σ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ1..1Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject SΣ1..1Reference(CPGPatient)Who or group medication request is for
... encounter S0..1Reference(CPGEncounter)Encounter created as part of encounter/admission/stay
... supportingInformation S0..*Reference(Resource)Pertinent information
... authoredOn Σ0..1dateTimeWhen request was initially authored
... requester Σ0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)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(Practitioner | PractitionerRole)Person who entered the request
... reasonCode 0..*CodeableConceptReason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... reasonReference 0..*Reference(Condition | Observation)Condition or observation that supports why the prescription is being written
... instantiatesCanonical SΣ0..*canonical()Source
... 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 0..*DosageHow the medication should be taken
... 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

Summary

Must-Support: 1 element

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*CPGMedicationRequestOrdering of medication for patient or group
... medication[x] S1..1CodeableConcept, Reference(Medication)Medication to be taken

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*CPGMedicationRequestOrdering of medication for patient or group
... 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..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-rationale S0..1markdownExplanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*IdentifierExternal ids for this request
... status ?!SΣ1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

... 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.


... priority SΣ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ0..1booleanTrue if request is prohibiting action
... reported[x] Σ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
... medication[x] SΣ1..1Medication to be taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject SΣ1..1Reference(CPGPatient)Who or group medication request is for
... encounter S0..1Reference(CPGEncounter)Encounter created as part of encounter/admission/stay
... supportingInformation S0..*Reference(Resource)Pertinent information
... authoredOn Σ0..1dateTimeWhen request was initially authored
... requester Σ0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)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(Practitioner | PractitionerRole)Person who entered the request
... reasonCode 0..*CodeableConceptReason or indication for ordering or not ordering the medication
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.


... reasonReference 0..*Reference(Condition | Observation)Condition or observation that supports why the prescription is being written
... instantiatesCanonical SΣ0..*canonical()Source
... 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 0..*DosageHow the medication should be taken
... 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

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet
MedicationRequest.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationRequest.statusrequiredmedicationrequest Status
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
MedicationRequest.intentrequiredmedicationRequest Intent
MedicationRequest.categoryexamplemedicationRequest Category Codes
MedicationRequest.priorityrequiredRequestPriority
MedicationRequest.medication[x]exampleSNOMEDCTMedicationCodes
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
MedicationRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2MedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3MedicationRequestIf 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-4MedicationRequestIf 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-5MedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6MedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1MedicationRequest.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.extension:rationaleAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.extension:rationaleMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.statusReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.intentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.priorityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.doNotPerformAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.reported[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.medication[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.supportingInformationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.authoredOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.requesterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.performerTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.reasonCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.reasonReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.instantiatesCanonicalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.instantiatesUriAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.groupIdentifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.courseOfTherapyTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.insuranceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dosageInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequestAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.dispenseRequest.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.dispenseRequest.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.dispenseRequest.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.dispenseRequest.initialFillAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.initialFill.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.dispenseRequest.initialFill.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.dispenseRequest.initialFill.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.dispenseRequest.initialFill.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.dispenseRequest.initialFill.quantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.initialFill.durationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.dispenseIntervalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.validityPeriodAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.numberOfRepeatsAllowedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.quantityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.expectedSupplyDurationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.dispenseRequest.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.substitutionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.substitution.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.substitution.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.substitution.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1MedicationRequest.substitution.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1MedicationRequest.substitution.allowed[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.substitution.reasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.priorPrescriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.detectedIssueAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1MedicationRequest.eventHistoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())