International Patient Access
0.1.0 - STU 1 ballot

This page is part of the International Patient Access (v0.1.0: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: IPA-MedicationRequest

Defining URL:http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medicationrequest
Version:0.1.0
Name:IPAMedicationRequest
Title:IPA-MedicationRequest
Status:Draft as of 8/26/19 3:10 PM
Definition:

Minimum expectations for a MedicationRequest resource when accessed via a International Patient Access API

Publisher:HL7 International - Patient Care Workgroup
Copyright:

Creative Commons Public Domain

Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medicationrequest

The MedicationRequest resource represents an order or request for both supply of the medication and the instructions for administration of the medication to a patient.

Medication Statement and Medication Request

While the relationship between Medication Statement and Medication Request is clear in principle, in practice, when patients report medications, these may also be implicitly treated as statements of intent about what the patient should be taking. As such, information systems may record these statements as either Medication Requests or Medication Statements, or as both. The choice between these options may be influenced by many factors including wording in legislation and regulations.

For this reason, clients implementing the International Patient Access specification SHALL query for both MedicationStatement and MedicationRequest when fetching patient Medication information.

Formal Views of Profile Content

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

This structure is derived from MedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*MedicationRequestOrdering of medication for patient or group
... status S1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
... intent S1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
... reported[x] S0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(IPA-Medication)
... subject S1..1Reference(IPA-Patient)Who or group medication request is for
... encounter S0..1Reference(Encounter)Encounter created as part of encounter/admission/stay
... authoredOn S1..1dateTimeWhen request was initially authored
... requester S1..1Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient)Who/What requested the Request
... dosageInstruction S0..*DosageHow the medication should be taken
.... text S0..1stringFree text dosage instructions e.g. SIG

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*MedicationRequestOrdering 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..*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 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 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.


... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

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

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(IPA-Medication)
... subject SΣ1..1Reference(IPA-Patient)Who or group medication request is for
... encounter S0..1Reference(Encounter)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(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient)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 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 0..*MedicationRequestOrdering of medication for patient or group
... status ?!Σ1..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.

... intent ?!Σ1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: medicationRequest Intent (required): The kind of medication order.

... reported[x] Σ0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(IPA-Medication)
... subject Σ1..1Reference(IPA-Patient)Who or group medication request is for
... encounter 0..1Reference(Encounter)Encounter created as part of encounter/admission/stay
... authoredOn Σ1..1dateTimeWhen request was initially authored
... requester Σ1..1Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient)Who/What requested the Request
... 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 MedicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*MedicationRequestOrdering of medication for patient or group
... status S1..1codeactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
... intent S1..1codeproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
... reported[x] S0..1Reported rather than primary record
.... reportedBooleanboolean
.... reportedReferenceReference(IPA-Patient | IPA-Practitioner | IPA-PractitionerRole)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(IPA-Medication)
... subject S1..1Reference(IPA-Patient)Who or group medication request is for
... encounter S0..1Reference(Encounter)Encounter created as part of encounter/admission/stay
... authoredOn S1..1dateTimeWhen request was initially authored
... requester S1..1Reference(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient)Who/What requested the Request
... dosageInstruction S0..*DosageHow the medication should be taken
.... text S0..1stringFree text dosage instructions e.g. SIG

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*MedicationRequestOrdering 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..*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 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 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.


... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

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

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(IPA-Medication)
... subject SΣ1..1Reference(IPA-Patient)Who or group medication request is for
... encounter S0..1Reference(Encounter)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(IPA-Practitioner | IPA-PractitionerRole | IPA-Patient)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 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
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.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