Extensions for Using Data Elements from FHIR R5 in FHIR STU3
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Extensions for Using Data Elements from FHIR R5 in FHIR STU3 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R5_MedicationRequest_R3 - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-MedicationRequest resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationRequest
Definition

An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

ShortOrdering of medication for patient or group
Control0..*
Alternate NamesPrescription, Order
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
2. MedicationRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. MedicationRequest.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional Content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. MedicationRequest.extension:statusReason
    Slice NamestatusReason
    Definition

    R5: MedicationRequest.statusReason (new:CodeableConcept)

    ShortR5: Reason for current status (new)
    Comments

    Element MedicationRequest.statusReason has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.statusReason has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Reason for current status (new)) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. MedicationRequest.extension:statusChanged
    Slice NamestatusChanged
    Definition

    R5: MedicationRequest.statusChanged (new:dateTime)

    ShortR5: When the status was changed (new)
    Comments

    Element MedicationRequest.statusChanged has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.statusChanged has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: When the status was changed (new)) (Extension Type: dateTime)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. MedicationRequest.extension:informationSource
    Slice NameinformationSource
    Definition

    R5: MedicationRequest.informationSource (new:Reference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization))

    ShortR5: The person or organization who provided the information about this request, if the source is someone other than the requestor (new)
    Comments

    Element MedicationRequest.informationSource has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.informationSource has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: The person or organization who provided the information about this request, if the source is someone other than the requestor (new)) (Extension Type: Reference(Cross-version Profile for R5.Patient for use in FHIR STU3, Patient, Cross-version Profile for R5.Practitioner for use in FHIR STU3, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR STU3, PractitionerRole, Cross-version Profile for R5.RelatedPerson for use in FHIR STU3, RelatedPerson, Cross-version Profile for R5.Organization for use in FHIR STU3, Organization))
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. MedicationRequest.extension:reported
    Slice Namereported
    Definition

    R5: MedicationRequest.reported (new:boolean)

    ShortR5: Reported rather than primary record (new)
    Comments

    Element MedicationRequest.reported has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.reported has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If not populated, then assume that this is the original record and not reported

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Reported rather than primary record (new)) (Extension Type: boolean)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. MedicationRequest.extension:performerType
    Slice NameperformerType
    Definition

    R5: MedicationRequest.performerType (new:CodeableConcept)

    ShortR5: Desired kind of performer of the medication administration (new)
    Comments

    Element MedicationRequest.performerType has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.performerType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Desired kind of performer of the medication administration (new)) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. MedicationRequest.extension:performer
    Slice Nameperformer
    Definition

    R5: MedicationRequest.performer (new:Reference(Practitioner,PractitionerRole,Organization,Patient,DeviceDefinition,RelatedPerson,CareTeam,HealthcareService))

    ShortR5: Intended performer of administration (new)
    Comments

    Element MedicationRequest.performer has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.performer has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Intended performer of administration (new)) (Extension Type: Reference(Cross-version Profile for R5.Practitioner for use in FHIR STU3, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR STU3, PractitionerRole, Cross-version Profile for R5.Organization for use in FHIR STU3, Organization, Cross-version Profile for R5.Patient for use in FHIR STU3, Patient, Cross-version Profile for R5.DeviceDefinition for use in FHIR STU3, Basic, Cross-version Profile for R5.RelatedPerson for use in FHIR STU3, RelatedPerson, Cross-version Profile for R5.CareTeam for use in FHIR STU3, CareTeam, Cross-version Profile for R5.HealthcareService for use in FHIR STU3, HealthcareService))
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. MedicationRequest.extension:device
    Slice Namedevice
    Definition

    R5: MedicationRequest.device (new:CodeableReference(DeviceDefinition))

    ShortR5: Intended type of device for the administration (new)
    Comments

    Element MedicationRequest.device has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.device has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Intended type of device for the administration (new)) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. MedicationRequest.extension:courseOfTherapyType
    Slice NamecourseOfTherapyType
    Definition

    R5: MedicationRequest.courseOfTherapyType (new:CodeableConcept)

    ShortR5: Overall pattern of medication administration (new)
    Comments

    Element MedicationRequest.courseOfTherapyType has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.courseOfTherapyType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This attribute should not be confused with the protocol of the medication.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Overall pattern of medication administration (new)) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    22. MedicationRequest.extension:insurance
    Slice Nameinsurance
    Definition

    R5: MedicationRequest.insurance (new:Reference(Coverage,ClaimResponse))

    ShortR5: Associated insurance coverage (new)
    Comments

    Element MedicationRequest.insurance has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.insurance has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Associated insurance coverage (new)) (Extension Type: Reference(Cross-version Profile for R5.Coverage for use in FHIR STU3, Coverage, Cross-version Profile for R5.ClaimResponse for use in FHIR STU3, ClaimResponse))
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    24. MedicationRequest.extension:renderedDosageInstruction
    Slice NamerenderedDosageInstruction
    Definition

    R5: MedicationRequest.renderedDosageInstruction (new:markdown)

    ShortR5: Full representation of the dosage instructions (new)
    Comments

    Element MedicationRequest.renderedDosageInstruction has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.renderedDosageInstruction has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    26. MedicationRequest.extension:effectiveDosePeriod
    Slice NameeffectiveDosePeriod
    Definition

    R5: MedicationRequest.effectiveDosePeriod (new:Period)

    ShortR5: Period over which the medication is to be taken (new)
    Comments

    Element MedicationRequest.effectiveDosePeriod has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.effectiveDosePeriod has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Period over which the medication is to be taken (new)) (Extension Type: Period)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. MedicationRequest.modifierExtension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    ShortExtensionExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Alternate Namesextensions, user content
    SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 30. MedicationRequest.modifierExtension:doNotPerform
      Slice NamedoNotPerform
      Definition

      R5: MedicationRequest.doNotPerform (new:boolean)

      ShortR5: True if patient is to stop taking or not to start taking the medication (new)
      Comments

      Element MedicationRequest.doNotPerform has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.doNotPerform has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If do not perform is not specified, the request is a positive request e.g. "do perform".

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(R5: True if patient is to stop taking or not to start taking the medication (new)) (Extension Type: boolean)
      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. MedicationRequest.status
      Definition

      A code specifying the current state of the order. Generally this will be active or completed state.

      Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control0..1
      BindingThe codes SHALL be taken from MedicationRequestStatushttp://hl7.org/fhir/ValueSet/medication-request-status|3.0.2
      (required to http://hl7.org/fhir/ValueSet/medication-request-status|3.0.2)

      A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription

      Typecode
      Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      34. MedicationRequest.status.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional Content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control10..*
      TypeExtension
      Alternate Namesextensions, user content
      SlicingThis element introduces a set of slices on MedicationRequest.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 36. MedicationRequest.status.extension:status
        Slice Namestatus
        Definition

        R5: MedicationRequest.status additional codes

        ShortR5: active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown additional codes
        Comments

        Element MedicationRequest.status is mapped to FHIR STU3 element MedicationRequest.status as RelatedTo. The mappings for MedicationRequest.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationRequest.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(R5: active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown additional codes) (Extension Type: code)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        38. MedicationRequest.intent
        Definition

        Whether the request is a proposal, plan, or an original order.

        Shortproposal | plan | order | instance-order
        Comments

        It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

        An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

        This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

        Control1..1
        BindingThe codes SHALL be taken from MedicationRequestIntenthttp://hl7.org/fhir/ValueSet/medication-request-intent|3.0.2
        (required to http://hl7.org/fhir/ValueSet/medication-request-intent|3.0.2)

        The kind of medication order

        Typecode
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        40. MedicationRequest.intent.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional Content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on MedicationRequest.intent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 42. MedicationRequest.intent.extension:intent
          Slice Nameintent
          Definition

          R5: MedicationRequest.intent

          ShortR5: proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
          Comments

          Element MedicationRequest.intent is mapped to FHIR STU3 element MedicationRequest.intent as SourceIsBroaderThanTarget. The target context MedicationRequest.intent is a modifier element, so this extension does not need to be defined as a modifier. It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

          An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

          This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(R5: proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option) (Extension Type: code)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          44. MedicationRequest.medication[x]
          Definition

          Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

          ShortMedication to be taken
          Comments

          If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .

          Control1..1
          BindingFor example codes, see SNOMED CT Medication Codeshttp://hl7.org/fhir/ValueSet/medication-codes|3.0.2
          (example to http://hl7.org/fhir/ValueSet/medication-codes|3.0.2)

          A coded concept identifying substance or product that can be ordered.

          TypeChoice of: CodeableConcept, Reference(Medication)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Summarytrue
          46. MedicationRequest.subject
          Definition

          A link to a resource representing the person or set of individuals to whom the medication will be given.

          ShortWho or group medication request is for
          Comments

          The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

          Control1..1
          TypeReference(Patient, Group)
          Summarytrue
          48. MedicationRequest.subject.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional Content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on MedicationRequest.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 50. MedicationRequest.subject.extension:subject
            Slice Namesubject
            Definition

            R5: MedicationRequest.subject additional types from child elements (display, identifier, reference, type)

            ShortR5: Individual or group for whom the medication has been requested additional types
            Comments

            Element MedicationRequest.subject is mapped to FHIR STU3 element MedicationRequest.subject as SourceIsBroaderThanTarget. The mappings for MedicationRequest.subject do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.subject with unmapped reference targets: Group, Patient. The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

            Control0..1
            TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)

            Guidance on how to interpret the contents of this table can be foundhere

            0. MedicationRequest
            2. MedicationRequest.extension
            Control0..*
            SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 4. MedicationRequest.extension:statusReason
              Slice NamestatusReason
              Definition

              R5: MedicationRequest.statusReason (new:CodeableConcept)

              ShortR5: Reason for current status (new)
              Comments

              Element MedicationRequest.statusReason has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.statusReason has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

              Control0..1
              TypeExtension(R5: Reason for current status (new)) (Extension Type: CodeableConcept)
              6. MedicationRequest.extension:statusChanged
              Slice NamestatusChanged
              Definition

              R5: MedicationRequest.statusChanged (new:dateTime)

              ShortR5: When the status was changed (new)
              Comments

              Element MedicationRequest.statusChanged has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.statusChanged has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..1
              TypeExtension(R5: When the status was changed (new)) (Extension Type: dateTime)
              8. MedicationRequest.extension:informationSource
              Slice NameinformationSource
              Definition

              R5: MedicationRequest.informationSource (new:Reference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization))

              ShortR5: The person or organization who provided the information about this request, if the source is someone other than the requestor (new)
              Comments

              Element MedicationRequest.informationSource has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.informationSource has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..*
              TypeExtension(R5: The person or organization who provided the information about this request, if the source is someone other than the requestor (new)) (Extension Type: Reference(Cross-version Profile for R5.Patient for use in FHIR STU3, Patient, Cross-version Profile for R5.Practitioner for use in FHIR STU3, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR STU3, PractitionerRole, Cross-version Profile for R5.RelatedPerson for use in FHIR STU3, RelatedPerson, Cross-version Profile for R5.Organization for use in FHIR STU3, Organization))
              10. MedicationRequest.extension:reported
              Slice Namereported
              Definition

              R5: MedicationRequest.reported (new:boolean)

              ShortR5: Reported rather than primary record (new)
              Comments

              Element MedicationRequest.reported has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.reported has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If not populated, then assume that this is the original record and not reported

              Control0..1
              TypeExtension(R5: Reported rather than primary record (new)) (Extension Type: boolean)
              12. MedicationRequest.extension:performerType
              Slice NameperformerType
              Definition

              R5: MedicationRequest.performerType (new:CodeableConcept)

              ShortR5: Desired kind of performer of the medication administration (new)
              Comments

              Element MedicationRequest.performerType has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.performerType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

              Control0..1
              TypeExtension(R5: Desired kind of performer of the medication administration (new)) (Extension Type: CodeableConcept)
              14. MedicationRequest.extension:performer
              Slice Nameperformer
              Definition

              R5: MedicationRequest.performer (new:Reference(Practitioner,PractitionerRole,Organization,Patient,DeviceDefinition,RelatedPerson,CareTeam,HealthcareService))

              ShortR5: Intended performer of administration (new)
              Comments

              Element MedicationRequest.performer has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.performer has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..*
              TypeExtension(R5: Intended performer of administration (new)) (Extension Type: Reference(Cross-version Profile for R5.Practitioner for use in FHIR STU3, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR STU3, PractitionerRole, Cross-version Profile for R5.Organization for use in FHIR STU3, Organization, Cross-version Profile for R5.Patient for use in FHIR STU3, Patient, Cross-version Profile for R5.DeviceDefinition for use in FHIR STU3, Basic, Cross-version Profile for R5.RelatedPerson for use in FHIR STU3, RelatedPerson, Cross-version Profile for R5.CareTeam for use in FHIR STU3, CareTeam, Cross-version Profile for R5.HealthcareService for use in FHIR STU3, HealthcareService))
              16. MedicationRequest.extension:device
              Slice Namedevice
              Definition

              R5: MedicationRequest.device (new:CodeableReference(DeviceDefinition))

              ShortR5: Intended type of device for the administration (new)
              Comments

              Element MedicationRequest.device has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.device has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..*
              TypeExtension(R5: Intended type of device for the administration (new)) (Complex Extension)
              18. MedicationRequest.extension:courseOfTherapyType
              Slice NamecourseOfTherapyType
              Definition

              R5: MedicationRequest.courseOfTherapyType (new:CodeableConcept)

              ShortR5: Overall pattern of medication administration (new)
              Comments

              Element MedicationRequest.courseOfTherapyType has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.courseOfTherapyType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This attribute should not be confused with the protocol of the medication.

              Control0..1
              TypeExtension(R5: Overall pattern of medication administration (new)) (Extension Type: CodeableConcept)
              20. MedicationRequest.extension:insurance
              Slice Nameinsurance
              Definition

              R5: MedicationRequest.insurance (new:Reference(Coverage,ClaimResponse))

              ShortR5: Associated insurance coverage (new)
              Comments

              Element MedicationRequest.insurance has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.insurance has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..*
              TypeExtension(R5: Associated insurance coverage (new)) (Extension Type: Reference(Cross-version Profile for R5.Coverage for use in FHIR STU3, Coverage, Cross-version Profile for R5.ClaimResponse for use in FHIR STU3, ClaimResponse))
              22. MedicationRequest.extension:renderedDosageInstruction
              Slice NamerenderedDosageInstruction
              Definition

              R5: MedicationRequest.renderedDosageInstruction (new:markdown)

              ShortR5: Full representation of the dosage instructions (new)
              Comments

              Element MedicationRequest.renderedDosageInstruction has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.renderedDosageInstruction has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..1
              TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
              24. MedicationRequest.extension:effectiveDosePeriod
              Slice NameeffectiveDosePeriod
              Definition

              R5: MedicationRequest.effectiveDosePeriod (new:Period)

              ShortR5: Period over which the medication is to be taken (new)
              Comments

              Element MedicationRequest.effectiveDosePeriod has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.effectiveDosePeriod has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              Control0..1
              TypeExtension(R5: Period over which the medication is to be taken (new)) (Extension Type: Period)
              26. MedicationRequest.modifierExtension
              Control0..*
              SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 28. MedicationRequest.modifierExtension:doNotPerform
                Slice NamedoNotPerform
                Definition

                R5: MedicationRequest.doNotPerform (new:boolean)

                ShortR5: True if patient is to stop taking or not to start taking the medication (new)
                Comments

                Element MedicationRequest.doNotPerform has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.doNotPerform has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If do not perform is not specified, the request is a positive request e.g. "do perform".

                Control0..1
                TypeExtension(R5: True if patient is to stop taking or not to start taking the medication (new)) (Extension Type: boolean)
                30. MedicationRequest.basedOn
                32. MedicationRequest.basedOn.extension
                Control0..*
                SlicingThis element introduces a set of slices on MedicationRequest.basedOn.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 34. MedicationRequest.basedOn.extension:basedOn
                  Slice NamebasedOn
                  Definition

                  R5: MedicationRequest.basedOn

                  ShortR5: A plan or request that is fulfilled in whole or in part by this medication request
                  Comments

                  Element MedicationRequest.basedOn is mapped to FHIR STU3 element MedicationRequest.basedOn as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.basedOn with unmapped reference targets: CarePlan, ImmunizationRecommendation, MedicationRequest, ServiceRequest.

                  Control0..*
                  TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                  36. MedicationRequest.status
                  38. MedicationRequest.status.extension
                  Control1..*
                  SlicingThis element introduces a set of slices on MedicationRequest.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 40. MedicationRequest.status.extension:status
                    Slice Namestatus
                    Definition

                    R5: MedicationRequest.status additional codes

                    ShortR5: active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown additional codes
                    Comments

                    Element MedicationRequest.status is mapped to FHIR STU3 element MedicationRequest.status as RelatedTo. The mappings for MedicationRequest.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationRequest.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                    Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

                    Control1..1
                    TypeExtension(R5: active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown additional codes) (Extension Type: code)
                    42. MedicationRequest.intent
                    44. MedicationRequest.intent.extension
                    Control0..*
                    SlicingThis element introduces a set of slices on MedicationRequest.intent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 46. MedicationRequest.intent.extension:intent
                      Slice Nameintent
                      Definition

                      R5: MedicationRequest.intent

                      ShortR5: proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
                      Comments

                      Element MedicationRequest.intent is mapped to FHIR STU3 element MedicationRequest.intent as SourceIsBroaderThanTarget. The target context MedicationRequest.intent is a modifier element, so this extension does not need to be defined as a modifier. It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                      An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                      This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                      Control0..1
                      TypeExtension(R5: proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option) (Extension Type: code)
                      48. MedicationRequest.subject
                      50. MedicationRequest.subject.extension
                      Control0..*
                      SlicingThis element introduces a set of slices on MedicationRequest.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 52. MedicationRequest.subject.extension:subject
                        Slice Namesubject
                        Definition

                        R5: MedicationRequest.subject additional types from child elements (display, identifier, reference, type)

                        ShortR5: Individual or group for whom the medication has been requested additional types
                        Comments

                        Element MedicationRequest.subject is mapped to FHIR STU3 element MedicationRequest.subject as SourceIsBroaderThanTarget. The mappings for MedicationRequest.subject do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.subject with unmapped reference targets: Group, Patient. The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                        Control0..1
                        TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                        54. MedicationRequest.context
                        56. MedicationRequest.context.extension
                        Control0..*
                        SlicingThis element introduces a set of slices on MedicationRequest.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 58. MedicationRequest.context.extension:encounter
                          Slice Nameencounter
                          Definition

                          R5: MedicationRequest.encounter additional types from child elements (display, identifier, reference, type)

                          ShortR5: Encounter created as part of encounter/admission/stay additional types
                          Comments

                          Element MedicationRequest.encounter is mapped to FHIR STU3 element MedicationRequest.context as SourceIsBroaderThanTarget. The mappings for MedicationRequest.encounter do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.encounter with unmapped reference targets: Encounter. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

                          Control0..1
                          TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                          60. MedicationRequest.supportingInformation
                          62. MedicationRequest.supportingInformation.extension
                          Control0..*
                          SlicingThis element introduces a set of slices on MedicationRequest.supportingInformation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 64. MedicationRequest.supportingInformation.extension:supportingInformation
                            Slice NamesupportingInformation
                            Definition

                            R5: MedicationRequest.supportingInformation additional types from child elements (display, identifier, reference, type)

                            ShortR5: Information to support fulfilling of the medication additional types
                            Comments

                            Element MedicationRequest.supportingInformation is mapped to FHIR STU3 element MedicationRequest.supportingInformation as SourceIsBroaderThanTarget. The mappings for MedicationRequest.supportingInformation do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.supportingInformation with unmapped reference targets: Resource. This attribute can be used to reference a MedicationStatement about the patients' medication use.

                            Control0..*
                            TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                            66. MedicationRequest.requester
                            68. MedicationRequest.requester.agent
                            70. MedicationRequest.requester.agent.extension
                            Control0..*
                            SlicingThis element introduces a set of slices on MedicationRequest.requester.agent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 72. MedicationRequest.requester.agent.extension:requester
                              Slice Namerequester
                              Definition

                              R5: MedicationRequest.requester

                              ShortR5: Who/What requested the Request
                              Comments

                              Element MedicationRequest.requester is mapped to FHIR STU3 element MedicationRequest.requester.agent as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.requester with unmapped reference targets: Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

                              Control0..1
                              TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                              74. MedicationRequest.recorder
                              76. MedicationRequest.recorder.extension
                              Control0..*
                              SlicingThis element introduces a set of slices on MedicationRequest.recorder.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 78. MedicationRequest.recorder.extension:recorder
                                Slice Namerecorder
                                Definition

                                R5: MedicationRequest.recorder additional types from child elements (display, identifier, reference, type)

                                ShortR5: recorder additional types
                                Comments

                                Element MedicationRequest.recorder is mapped to FHIR STU3 element MedicationRequest.recorder as SourceIsBroaderThanTarget. The mappings for MedicationRequest.recorder do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.recorder with unmapped reference targets: Practitioner, PractitionerRole.

                                Control0..1
                                TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                80. MedicationRequest.dispenseRequest
                                82. MedicationRequest.dispenseRequest.extension
                                Control0..*
                                SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 84. MedicationRequest.dispenseRequest.extension:initialFill
                                  Slice NameinitialFill
                                  Definition

                                  R5: MedicationRequest.dispenseRequest.initialFill (new:BackboneElement)

                                  ShortR5: First fill details (new)
                                  Comments

                                  Element MedicationRequest.dispenseRequest.initialFill has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.initialFill has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If populating this element, either the quantity or the duration must be included.

                                  Control0..1
                                  TypeExtension(R5: First fill details (new)) (Complex Extension)
                                  86. MedicationRequest.dispenseRequest.extension:dispenseInterval
                                  Slice NamedispenseInterval
                                  Definition

                                  R5: MedicationRequest.dispenseRequest.dispenseInterval (new:Duration)

                                  ShortR5: Minimum period of time between dispenses (new)
                                  Comments

                                  Element MedicationRequest.dispenseRequest.dispenseInterval has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.dispenseInterval has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                  Control0..1
                                  TypeExtension(R5: Minimum period of time between dispenses (new)) (Extension Type: Duration)
                                  88. MedicationRequest.dispenseRequest.extension:dispenserInstruction
                                  Slice NamedispenserInstruction
                                  Definition

                                  R5: MedicationRequest.dispenseRequest.dispenserInstruction (new:Annotation)

                                  ShortR5: Additional information for the dispenser (new)
                                  Comments

                                  Element MedicationRequest.dispenseRequest.dispenserInstruction has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.dispenserInstruction has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                  Control0..*
                                  TypeExtension(R5: Additional information for the dispenser (new)) (Extension Type: Annotation)
                                  90. MedicationRequest.dispenseRequest.extension:doseAdministrationAid
                                  Slice NamedoseAdministrationAid
                                  Definition

                                  R5: MedicationRequest.dispenseRequest.doseAdministrationAid (new:CodeableConcept)

                                  ShortR5: Type of adherence packaging to use for the dispense (new)
                                  Comments

                                  Element MedicationRequest.dispenseRequest.doseAdministrationAid has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.doseAdministrationAid has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                  Control0..1
                                  TypeExtension(R5: Type of adherence packaging to use for the dispense (new)) (Extension Type: CodeableConcept)
                                  92. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                  94. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.extension
                                  Control0..*
                                  SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 96. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.extension:numberOfRepeatsAllowed
                                    Slice NamenumberOfRepeatsAllowed
                                    Definition

                                    R5: MedicationRequest.dispenseRequest.numberOfRepeatsAllowed additional types (unsignedInt) additional types from child elements (value)

                                    ShortR5: numberOfRepeatsAllowed additional types
                                    Comments

                                    Element MedicationRequest.dispenseRequest.numberOfRepeatsAllowed is mapped to FHIR STU3 element MedicationRequest.dispenseRequest.numberOfRepeatsAllowed as SourceIsBroaderThanTarget. The mappings for MedicationRequest.dispenseRequest.numberOfRepeatsAllowed do not cover the following types: unsignedInt. The mappings for MedicationRequest.dispenseRequest.numberOfRepeatsAllowed do not cover the following types based on type expansion: value. If displaying "number of authorized fills", add 1 to this number.

                                    Control0..1
                                    TypeExtension(R5: numberOfRepeatsAllowed additional types) (Extension Type: unsignedInt)
                                    98. MedicationRequest.dispenseRequest.performer
                                    100. MedicationRequest.dispenseRequest.performer.extension
                                    Control0..*
                                    SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 102. MedicationRequest.dispenseRequest.performer.extension:dispenser
                                      Slice Namedispenser
                                      Definition

                                      R5: MedicationRequest.dispenseRequest.dispenser additional types from child elements (display, identifier, reference, type)

                                      ShortR5: Intended performer of dispense additional types
                                      Comments

                                      Element MedicationRequest.dispenseRequest.dispenser is mapped to FHIR STU3 element MedicationRequest.dispenseRequest.performer as SourceIsBroaderThanTarget. The mappings for MedicationRequest.dispenseRequest.dispenser do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.dispenseRequest.dispenser with unmapped reference targets: Organization.

                                      Control0..1
                                      TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                      104. MedicationRequest.substitution
                                      106. MedicationRequest.substitution.extension
                                      Control0..*
                                      SlicingThis element introduces a set of slices on MedicationRequest.substitution.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 108. MedicationRequest.substitution.extension:allowed
                                        Slice Nameallowed
                                        Definition

                                        R5: MedicationRequest.substitution.allowed[x] additional types (CodeableConcept) additional types from child elements (coding, text)

                                        ShortR5: Whether substitution is allowed or not additional types
                                        Comments

                                        Element MedicationRequest.substitution.allowed[x] is mapped to FHIR STU3 element MedicationRequest.substitution.allowed as SourceIsBroaderThanTarget. The mappings for MedicationRequest.substitution.allowed[x] do not cover the following types: CodeableConcept. The mappings for MedicationRequest.substitution.allowed[x] do not cover the following types based on type expansion: coding, text. This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                        Control0..1
                                        TypeExtension(R5: Whether substitution is allowed or not additional types) (Extension Type: CodeableConcept)
                                        110. MedicationRequest.priorPrescription
                                        112. MedicationRequest.priorPrescription.extension
                                        Control0..*
                                        SlicingThis element introduces a set of slices on MedicationRequest.priorPrescription.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 114. MedicationRequest.priorPrescription.extension:priorPrescription
                                          Slice NamepriorPrescription
                                          Definition

                                          R5: MedicationRequest.priorPrescription additional types from child elements (display, identifier, reference, type)

                                          ShortR5: Reference to an order/prescription that is being replaced by this MedicationRequest additional types
                                          Comments

                                          Element MedicationRequest.priorPrescription is mapped to FHIR STU3 element MedicationRequest.priorPrescription as SourceIsBroaderThanTarget. The mappings for MedicationRequest.priorPrescription do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.priorPrescription with unmapped reference targets: MedicationRequest.

                                          Control0..1
                                          TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                          116. MedicationRequest.eventHistory
                                          118. MedicationRequest.eventHistory.extension
                                          Control0..*
                                          SlicingThis element introduces a set of slices on MedicationRequest.eventHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 120. MedicationRequest.eventHistory.extension:eventHistory
                                            Slice NameeventHistory
                                            Definition

                                            R5: MedicationRequest.eventHistory additional types from child elements (display, identifier, reference, type)

                                            ShortR5: eventHistory additional types
                                            Comments

                                            Element MedicationRequest.eventHistory is mapped to FHIR STU3 element MedicationRequest.eventHistory as SourceIsBroaderThanTarget. The mappings for MedicationRequest.eventHistory do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.eventHistory with unmapped reference targets: Provenance. This might not include provenances for all versions of the request – only those deemed "relevant" or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                            Control0..*
                                            TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)

                                            Guidance on how to interpret the contents of this table can be foundhere

                                            0. MedicationRequest
                                            Definition

                                            An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

                                            ShortOrdering of medication for patient or group
                                            Control0..*
                                            Alternate NamesPrescription, Order
                                            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
                                            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
                                            2. MedicationRequest.id
                                            Definition

                                            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                            ShortLogical id of this artifact
                                            Comments

                                            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                            Control0..1
                                            Typeid
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            4. MedicationRequest.meta
                                            Definition

                                            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

                                            ShortMetadata about the resource
                                            Control0..1
                                            TypeMeta
                                            Summarytrue
                                            6. MedicationRequest.implicitRules
                                            Definition

                                            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

                                            ShortA set of rules under which this content was created
                                            Comments

                                            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

                                            This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

                                            Control0..1
                                            Typeuri
                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            8. MedicationRequest.language
                                            Definition

                                            The base language in which the resource is written.

                                            ShortLanguage of the resource content
                                            Comments

                                            Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                            Control0..1
                                            BindingUnless not suitable, these codes SHALL be taken from Common Languages .
                                            (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

                                            A human language.

                                            Additional BindingsPurpose
                                            All LanguagesMax Binding
                                            Typecode
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            10. MedicationRequest.text
                                            Definition

                                            A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                            ShortText summary of the resource, for human interpretation
                                            Comments

                                            Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

                                            Control0..1
                                            This element is affected by the following invariants: dom-1
                                            TypeNarrative
                                            Alternate Namesnarrative, html, xhtml, display
                                            12. MedicationRequest.contained
                                            Definition

                                            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                            ShortContained, inline Resources
                                            Comments

                                            This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

                                            Control0..*
                                            TypeResource
                                            Alternate Namesinline resources, anonymous resources, contained resources
                                            14. MedicationRequest.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control0..*
                                            TypeExtension
                                            SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 16. MedicationRequest.extension:statusReason
                                              Slice NamestatusReason
                                              Definition

                                              R5: MedicationRequest.statusReason (new:CodeableConcept)

                                              ShortR5: Reason for current status (new)
                                              Comments

                                              Element MedicationRequest.statusReason has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.statusReason has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Reason for current status (new)) (Extension Type: CodeableConcept)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              18. MedicationRequest.extension:statusChanged
                                              Slice NamestatusChanged
                                              Definition

                                              R5: MedicationRequest.statusChanged (new:dateTime)

                                              ShortR5: When the status was changed (new)
                                              Comments

                                              Element MedicationRequest.statusChanged has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.statusChanged has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: When the status was changed (new)) (Extension Type: dateTime)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              20. MedicationRequest.extension:informationSource
                                              Slice NameinformationSource
                                              Definition

                                              R5: MedicationRequest.informationSource (new:Reference(Patient,Practitioner,PractitionerRole,RelatedPerson,Organization))

                                              ShortR5: The person or organization who provided the information about this request, if the source is someone other than the requestor (new)
                                              Comments

                                              Element MedicationRequest.informationSource has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.informationSource has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: The person or organization who provided the information about this request, if the source is someone other than the requestor (new)) (Extension Type: Reference(Cross-version Profile for R5.Patient for use in FHIR STU3, Patient, Cross-version Profile for R5.Practitioner for use in FHIR STU3, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR STU3, PractitionerRole, Cross-version Profile for R5.RelatedPerson for use in FHIR STU3, RelatedPerson, Cross-version Profile for R5.Organization for use in FHIR STU3, Organization))
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              22. MedicationRequest.extension:reported
                                              Slice Namereported
                                              Definition

                                              R5: MedicationRequest.reported (new:boolean)

                                              ShortR5: Reported rather than primary record (new)
                                              Comments

                                              Element MedicationRequest.reported has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.reported has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If not populated, then assume that this is the original record and not reported

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Reported rather than primary record (new)) (Extension Type: boolean)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              24. MedicationRequest.extension:performerType
                                              Slice NameperformerType
                                              Definition

                                              R5: MedicationRequest.performerType (new:CodeableConcept)

                                              ShortR5: Desired kind of performer of the medication administration (new)
                                              Comments

                                              Element MedicationRequest.performerType has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.performerType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Desired kind of performer of the medication administration (new)) (Extension Type: CodeableConcept)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              26. MedicationRequest.extension:performer
                                              Slice Nameperformer
                                              Definition

                                              R5: MedicationRequest.performer (new:Reference(Practitioner,PractitionerRole,Organization,Patient,DeviceDefinition,RelatedPerson,CareTeam,HealthcareService))

                                              ShortR5: Intended performer of administration (new)
                                              Comments

                                              Element MedicationRequest.performer has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.performer has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Intended performer of administration (new)) (Extension Type: Reference(Cross-version Profile for R5.Practitioner for use in FHIR STU3, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR STU3, PractitionerRole, Cross-version Profile for R5.Organization for use in FHIR STU3, Organization, Cross-version Profile for R5.Patient for use in FHIR STU3, Patient, Cross-version Profile for R5.DeviceDefinition for use in FHIR STU3, Basic, Cross-version Profile for R5.RelatedPerson for use in FHIR STU3, RelatedPerson, Cross-version Profile for R5.CareTeam for use in FHIR STU3, CareTeam, Cross-version Profile for R5.HealthcareService for use in FHIR STU3, HealthcareService))
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              28. MedicationRequest.extension:device
                                              Slice Namedevice
                                              Definition

                                              R5: MedicationRequest.device (new:CodeableReference(DeviceDefinition))

                                              ShortR5: Intended type of device for the administration (new)
                                              Comments

                                              Element MedicationRequest.device has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.device has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Intended type of device for the administration (new)) (Complex Extension)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              30. MedicationRequest.extension:courseOfTherapyType
                                              Slice NamecourseOfTherapyType
                                              Definition

                                              R5: MedicationRequest.courseOfTherapyType (new:CodeableConcept)

                                              ShortR5: Overall pattern of medication administration (new)
                                              Comments

                                              Element MedicationRequest.courseOfTherapyType has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.courseOfTherapyType has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This attribute should not be confused with the protocol of the medication.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Overall pattern of medication administration (new)) (Extension Type: CodeableConcept)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              32. MedicationRequest.extension:insurance
                                              Slice Nameinsurance
                                              Definition

                                              R5: MedicationRequest.insurance (new:Reference(Coverage,ClaimResponse))

                                              ShortR5: Associated insurance coverage (new)
                                              Comments

                                              Element MedicationRequest.insurance has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.insurance has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Associated insurance coverage (new)) (Extension Type: Reference(Cross-version Profile for R5.Coverage for use in FHIR STU3, Coverage, Cross-version Profile for R5.ClaimResponse for use in FHIR STU3, ClaimResponse))
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              34. MedicationRequest.extension:renderedDosageInstruction
                                              Slice NamerenderedDosageInstruction
                                              Definition

                                              R5: MedicationRequest.renderedDosageInstruction (new:markdown)

                                              ShortR5: Full representation of the dosage instructions (new)
                                              Comments

                                              Element MedicationRequest.renderedDosageInstruction has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.renderedDosageInstruction has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              36. MedicationRequest.extension:effectiveDosePeriod
                                              Slice NameeffectiveDosePeriod
                                              Definition

                                              R5: MedicationRequest.effectiveDosePeriod (new:Period)

                                              ShortR5: Period over which the medication is to be taken (new)
                                              Comments

                                              Element MedicationRequest.effectiveDosePeriod has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.effectiveDosePeriod has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Period over which the medication is to be taken (new)) (Extension Type: Period)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              38. MedicationRequest.modifierExtension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                              SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 40. MedicationRequest.modifierExtension:doNotPerform
                                                Slice NamedoNotPerform
                                                Definition

                                                R5: MedicationRequest.doNotPerform (new:boolean)

                                                ShortR5: True if patient is to stop taking or not to start taking the medication (new)
                                                Comments

                                                Element MedicationRequest.doNotPerform has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.doNotPerform has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If do not perform is not specified, the request is a positive request e.g. "do perform".

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(R5: True if patient is to stop taking or not to start taking the medication (new)) (Extension Type: boolean)
                                                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                42. MedicationRequest.identifier
                                                Definition

                                                This records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created. This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.

                                                ShortExternal ids for this request
                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                Control0..*
                                                TypeIdentifier
                                                44. MedicationRequest.definition
                                                Definition

                                                Protocol or definition followed by this request.

                                                ShortProtocol or definition
                                                Control0..*
                                                TypeReference(ActivityDefinition, PlanDefinition)
                                                Summarytrue
                                                46. MedicationRequest.basedOn
                                                Definition

                                                A plan or request that is fulfilled in whole or in part by this medication request.

                                                ShortWhat request fulfills
                                                Control0..*
                                                TypeReference(CarePlan, MedicationRequest, ProcedureRequest, ReferralRequest)
                                                Summarytrue
                                                48. MedicationRequest.basedOn.id
                                                Definition

                                                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                Shortxml:id (or equivalent in JSON)
                                                Control0..1
                                                Typestring
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                50. MedicationRequest.basedOn.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                SlicingThis element introduces a set of slices on MedicationRequest.basedOn.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 52. MedicationRequest.basedOn.extension:basedOn
                                                  Slice NamebasedOn
                                                  Definition

                                                  R5: MedicationRequest.basedOn

                                                  ShortR5: A plan or request that is fulfilled in whole or in part by this medication request
                                                  Comments

                                                  Element MedicationRequest.basedOn is mapped to FHIR STU3 element MedicationRequest.basedOn as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.basedOn with unmapped reference targets: CarePlan, ImmunizationRecommendation, MedicationRequest, ServiceRequest.

                                                  Control0..*
                                                  TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                  54. MedicationRequest.basedOn.reference
                                                  Definition

                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                  Comments

                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                  Control0..1
                                                  This element is affected by the following invariants: ref-1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  56. MedicationRequest.basedOn.identifier
                                                  Definition

                                                  An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                  ShortLogical reference, when literal reference is not known
                                                  Comments

                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..1
                                                  TypeIdentifier
                                                  Summarytrue
                                                  58. MedicationRequest.basedOn.display
                                                  Definition

                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                  ShortText alternative for the resource
                                                  Comments

                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                  Control0..1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  60. MedicationRequest.groupIdentifier
                                                  Definition

                                                  A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

                                                  ShortComposite request this is part of
                                                  Control0..1
                                                  TypeIdentifier
                                                  Summarytrue
                                                  Requirements

                                                  Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                                                  62. MedicationRequest.status
                                                  Definition

                                                  A code specifying the current state of the order. Generally this will be active or completed state.

                                                  Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
                                                  Comments

                                                  This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from MedicationRequestStatus
                                                  (required to http://hl7.org/fhir/ValueSet/medication-request-status|3.0.2)

                                                  A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription

                                                  Typecode
                                                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  64. MedicationRequest.status.id
                                                  Definition

                                                  unique id for the element within a resource (for internal references)

                                                  Shortxml:id (or equivalent in JSON)
                                                  Control0..1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  66. MedicationRequest.status.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control1..*
                                                  TypeExtension
                                                  SlicingThis element introduces a set of slices on MedicationRequest.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 68. MedicationRequest.status.extension:status
                                                    Slice Namestatus
                                                    Definition

                                                    R5: MedicationRequest.status additional codes

                                                    ShortR5: active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown additional codes
                                                    Comments

                                                    Element MedicationRequest.status is mapped to FHIR STU3 element MedicationRequest.status as RelatedTo. The mappings for MedicationRequest.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationRequest.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                    Clinical decision support systems should take the status into account when determining which medications to include in their algorithms.

                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(R5: active | on-hold | ended | stopped | completed | cancelled | entered-in-error | draft | unknown additional codes) (Extension Type: code)
                                                    Is Modifierfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    70. MedicationRequest.status.value
                                                    Definition

                                                    Primitive value for code

                                                    ShortPrimitive value for code
                                                    Control0..1
                                                    Typecode
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    72. MedicationRequest.intent
                                                    Definition

                                                    Whether the request is a proposal, plan, or an original order.

                                                    Shortproposal | plan | order | instance-order
                                                    Comments

                                                    It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                                                    An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                                                    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                                                    Control1..1
                                                    BindingThe codes SHALL be taken from MedicationRequestIntent
                                                    (required to http://hl7.org/fhir/ValueSet/medication-request-intent|3.0.2)

                                                    The kind of medication order

                                                    Typecode
                                                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    74. MedicationRequest.intent.id
                                                    Definition

                                                    unique id for the element within a resource (for internal references)

                                                    Shortxml:id (or equivalent in JSON)
                                                    Control0..1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    76. MedicationRequest.intent.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    SlicingThis element introduces a set of slices on MedicationRequest.intent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 78. MedicationRequest.intent.extension:intent
                                                      Slice Nameintent
                                                      Definition

                                                      R5: MedicationRequest.intent

                                                      ShortR5: proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
                                                      Comments

                                                      Element MedicationRequest.intent is mapped to FHIR STU3 element MedicationRequest.intent as SourceIsBroaderThanTarget. The target context MedicationRequest.intent is a modifier element, so this extension does not need to be defined as a modifier. It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                                                      An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                                                      This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(R5: proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option) (Extension Type: code)
                                                      Is Modifierfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      80. MedicationRequest.intent.value
                                                      Definition

                                                      Primitive value for code

                                                      ShortPrimitive value for code
                                                      Control0..1
                                                      Typecode
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      82. MedicationRequest.category
                                                      Definition

                                                      Indicates the type of medication order and where the medication is expected to be consumed or administered.

                                                      ShortType of medication usage
                                                      Control0..1
                                                      BindingThe codes SHOULD be taken from MedicationRequestCategory
                                                      (preferred to http://hl7.org/fhir/ValueSet/medication-request-category|3.0.2)

                                                      A coded concept identifying where the medication ordered is expected to be consumed or administered

                                                      TypeCodeableConcept
                                                      84. MedicationRequest.priority
                                                      Definition

                                                      Indicates how quickly the Medication Request should be addressed with respect to other requests.

                                                      Shortroutine | urgent | stat | asap
                                                      Control0..1
                                                      BindingThe codes SHALL be taken from MedicationRequestPriority
                                                      (required to http://hl7.org/fhir/ValueSet/medication-request-priority|3.0.2)

                                                      Identifies the level of importance to be assigned to actioning the request

                                                      Typecode
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      86. MedicationRequest.medication[x]
                                                      Definition

                                                      Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                                                      ShortMedication to be taken
                                                      Comments

                                                      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .

                                                      Control1..1
                                                      BindingFor example codes, see SNOMED CT Medication Codes
                                                      (example to http://hl7.org/fhir/ValueSet/medication-codes|3.0.2)

                                                      A coded concept identifying substance or product that can be ordered.

                                                      TypeChoice of: CodeableConcept, Reference(Medication)
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Summarytrue
                                                      88. MedicationRequest.subject
                                                      Definition

                                                      A link to a resource representing the person or set of individuals to whom the medication will be given.

                                                      ShortWho or group medication request is for
                                                      Comments

                                                      The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                                                      Control1..1
                                                      TypeReference(Patient, Group)
                                                      Summarytrue
                                                      90. MedicationRequest.subject.id
                                                      Definition

                                                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      Shortxml:id (or equivalent in JSON)
                                                      Control0..1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      92. MedicationRequest.subject.extension
                                                      Definition

                                                      An Extension

                                                      ShortExtension
                                                      Control0..*
                                                      TypeExtension
                                                      SlicingThis element introduces a set of slices on MedicationRequest.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 94. MedicationRequest.subject.extension:subject
                                                        Slice Namesubject
                                                        Definition

                                                        R5: MedicationRequest.subject additional types from child elements (display, identifier, reference, type)

                                                        ShortR5: Individual or group for whom the medication has been requested additional types
                                                        Comments

                                                        Element MedicationRequest.subject is mapped to FHIR STU3 element MedicationRequest.subject as SourceIsBroaderThanTarget. The mappings for MedicationRequest.subject do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.subject with unmapped reference targets: Group, Patient. The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                                                        Control0..1
                                                        TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                        96. MedicationRequest.subject.reference
                                                        Definition

                                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                        ShortLiteral reference, Relative, internal or absolute URL
                                                        Comments

                                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                        Control0..1
                                                        This element is affected by the following invariants: ref-1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        98. MedicationRequest.subject.identifier
                                                        Definition

                                                        An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                        ShortLogical reference, when literal reference is not known
                                                        Comments

                                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                        Control0..1
                                                        TypeIdentifier
                                                        Summarytrue
                                                        100. MedicationRequest.subject.display
                                                        Definition

                                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                                        ShortText alternative for the resource
                                                        Comments

                                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                        Control0..1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        102. MedicationRequest.context
                                                        Definition

                                                        A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider.

                                                        ShortCreated during encounter/admission/stay
                                                        Comments

                                                        SubstanceAdministration->component->EncounterEvent.

                                                        Control0..1
                                                        TypeReference(Encounter, EpisodeOfCare)
                                                        104. MedicationRequest.context.id
                                                        Definition

                                                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        Shortxml:id (or equivalent in JSON)
                                                        Control0..1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        106. MedicationRequest.context.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..*
                                                        TypeExtension
                                                        SlicingThis element introduces a set of slices on MedicationRequest.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 108. MedicationRequest.context.extension:encounter
                                                          Slice Nameencounter
                                                          Definition

                                                          R5: MedicationRequest.encounter additional types from child elements (display, identifier, reference, type)

                                                          ShortR5: Encounter created as part of encounter/admission/stay additional types
                                                          Comments

                                                          Element MedicationRequest.encounter is mapped to FHIR STU3 element MedicationRequest.context as SourceIsBroaderThanTarget. The mappings for MedicationRequest.encounter do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.encounter with unmapped reference targets: Encounter. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

                                                          Control0..1
                                                          TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                          110. MedicationRequest.context.reference
                                                          Definition

                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                          Comments

                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                          Control0..1
                                                          This element is affected by the following invariants: ref-1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          112. MedicationRequest.context.identifier
                                                          Definition

                                                          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                          ShortLogical reference, when literal reference is not known
                                                          Comments

                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control0..1
                                                          TypeIdentifier
                                                          Summarytrue
                                                          114. MedicationRequest.context.display
                                                          Definition

                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                          ShortText alternative for the resource
                                                          Comments

                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          116. MedicationRequest.supportingInformation
                                                          Definition

                                                          Include additional information (for example, patient height and weight) that supports the ordering of the medication.

                                                          ShortInformation to support ordering of the medication
                                                          Control0..*
                                                          TypeReference(Resource)
                                                          118. MedicationRequest.supportingInformation.id
                                                          Definition

                                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          120. MedicationRequest.supportingInformation.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..*
                                                          TypeExtension
                                                          SlicingThis element introduces a set of slices on MedicationRequest.supportingInformation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 122. MedicationRequest.supportingInformation.extension:supportingInformation
                                                            Slice NamesupportingInformation
                                                            Definition

                                                            R5: MedicationRequest.supportingInformation additional types from child elements (display, identifier, reference, type)

                                                            ShortR5: Information to support fulfilling of the medication additional types
                                                            Comments

                                                            Element MedicationRequest.supportingInformation is mapped to FHIR STU3 element MedicationRequest.supportingInformation as SourceIsBroaderThanTarget. The mappings for MedicationRequest.supportingInformation do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.supportingInformation with unmapped reference targets: Resource. This attribute can be used to reference a MedicationStatement about the patients' medication use.

                                                            Control0..*
                                                            TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                            124. MedicationRequest.supportingInformation.reference
                                                            Definition

                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                            Comments

                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                            Control0..1
                                                            This element is affected by the following invariants: ref-1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            126. MedicationRequest.supportingInformation.identifier
                                                            Definition

                                                            An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                            ShortLogical reference, when literal reference is not known
                                                            Comments

                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                            Control0..1
                                                            TypeIdentifier
                                                            Summarytrue
                                                            128. MedicationRequest.supportingInformation.display
                                                            Definition

                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                            ShortText alternative for the resource
                                                            Comments

                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            130. MedicationRequest.authoredOn
                                                            Definition

                                                            The date (and perhaps time) when the prescription was initially written or authored on.

                                                            ShortWhen request was initially authored
                                                            Control0..1
                                                            TypedateTime
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            132. MedicationRequest.requester
                                                            Definition

                                                            The individual, organization or device that initiated the request and has responsibility for its activation.

                                                            ShortWho/What requested the Request
                                                            Control0..1
                                                            TypeBackboneElement
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                            mps-1: onBehalfOf can only be specified if agent is practitioner or device ((agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not())
                                                            134. MedicationRequest.requester.id
                                                            Definition

                                                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            Shortxml:id (or equivalent in JSON)
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            136. MedicationRequest.requester.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional Content defined by implementations
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Alternate Namesextensions, user content
                                                            138. MedicationRequest.requester.modifierExtension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                            ShortExtensions that cannot be ignored
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                            Summarytrue
                                                            Alternate Namesextensions, user content, modifiers
                                                            140. MedicationRequest.requester.agent
                                                            Definition

                                                            The healthcare professional responsible for authorizing the initial prescription.

                                                            ShortWho ordered the initial medication(s)
                                                            Comments

                                                            It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                                                            Control1..1
                                                            TypeReference(Practitioner, Organization, Patient, RelatedPerson, Device)
                                                            Summarytrue
                                                            142. MedicationRequest.requester.agent.id
                                                            Definition

                                                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            Shortxml:id (or equivalent in JSON)
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            144. MedicationRequest.requester.agent.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..*
                                                            TypeExtension
                                                            SlicingThis element introduces a set of slices on MedicationRequest.requester.agent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 146. MedicationRequest.requester.agent.extension:requester
                                                              Slice Namerequester
                                                              Definition

                                                              R5: MedicationRequest.requester

                                                              ShortR5: Who/What requested the Request
                                                              Comments

                                                              Element MedicationRequest.requester is mapped to FHIR STU3 element MedicationRequest.requester.agent as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.requester with unmapped reference targets: Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

                                                              Control0..1
                                                              TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                              148. MedicationRequest.requester.agent.reference
                                                              Definition

                                                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                              ShortLiteral reference, Relative, internal or absolute URL
                                                              Comments

                                                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                              Control0..1
                                                              This element is affected by the following invariants: ref-1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              150. MedicationRequest.requester.agent.identifier
                                                              Definition

                                                              An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                              ShortLogical reference, when literal reference is not known
                                                              Comments

                                                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                              Control0..1
                                                              TypeIdentifier
                                                              Summarytrue
                                                              152. MedicationRequest.requester.agent.display
                                                              Definition

                                                              Plain text narrative that identifies the resource in addition to the resource reference.

                                                              ShortText alternative for the resource
                                                              Comments

                                                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              154. MedicationRequest.requester.onBehalfOf
                                                              Definition

                                                              The organization the device or practitioner was acting on behalf of.

                                                              ShortOrganization agent is acting for
                                                              Control0..1
                                                              This element is affected by the following invariants: mps-1
                                                              TypeReference(Organization)
                                                              Summarytrue
                                                              Requirements

                                                              Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.

                                                              156. MedicationRequest.recorder
                                                              Definition

                                                              The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

                                                              ShortPerson who entered the request
                                                              Control0..1
                                                              TypeReference(Practitioner)
                                                              158. MedicationRequest.recorder.id
                                                              Definition

                                                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              Shortxml:id (or equivalent in JSON)
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              160. MedicationRequest.recorder.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              SlicingThis element introduces a set of slices on MedicationRequest.recorder.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 162. MedicationRequest.recorder.extension:recorder
                                                                Slice Namerecorder
                                                                Definition

                                                                R5: MedicationRequest.recorder additional types from child elements (display, identifier, reference, type)

                                                                ShortR5: recorder additional types
                                                                Comments

                                                                Element MedicationRequest.recorder is mapped to FHIR STU3 element MedicationRequest.recorder as SourceIsBroaderThanTarget. The mappings for MedicationRequest.recorder do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.recorder with unmapped reference targets: Practitioner, PractitionerRole.

                                                                Control0..1
                                                                TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                                164. MedicationRequest.recorder.reference
                                                                Definition

                                                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                ShortLiteral reference, Relative, internal or absolute URL
                                                                Comments

                                                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                Control0..1
                                                                This element is affected by the following invariants: ref-1
                                                                Typestring
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                166. MedicationRequest.recorder.identifier
                                                                Definition

                                                                An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                ShortLogical reference, when literal reference is not known
                                                                Comments

                                                                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control0..1
                                                                TypeIdentifier
                                                                Summarytrue
                                                                168. MedicationRequest.recorder.display
                                                                Definition

                                                                Plain text narrative that identifies the resource in addition to the resource reference.

                                                                ShortText alternative for the resource
                                                                Comments

                                                                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                Control0..1
                                                                Typestring
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                170. MedicationRequest.reasonCode
                                                                Definition

                                                                The reason or the indication for ordering the medication.

                                                                ShortReason or indication for writing the prescription
                                                                Comments

                                                                This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

                                                                Control0..*
                                                                BindingFor example codes, see Condition/Problem/Diagnosis Codes
                                                                (example to http://hl7.org/fhir/ValueSet/condition-code|3.0.2)

                                                                A coded concept indicating why the medication was ordered.

                                                                TypeCodeableConcept
                                                                172. MedicationRequest.reasonReference
                                                                Definition

                                                                Condition or observation that supports why the medication was ordered.

                                                                ShortCondition or Observation that supports why the prescription is being written
                                                                Comments

                                                                This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

                                                                Control0..*
                                                                TypeReference(Condition, Observation)
                                                                174. MedicationRequest.note
                                                                Definition

                                                                Extra information about the prescription that could not be conveyed by the other attributes.

                                                                ShortInformation about the prescription
                                                                Control0..*
                                                                TypeAnnotation
                                                                176. MedicationRequest.dosageInstruction
                                                                Definition

                                                                Indicates how the medication is to be used by the patient.

                                                                ShortHow the medication should be taken
                                                                Comments

                                                                There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                                                                Control0..*
                                                                TypeDosage
                                                                178. MedicationRequest.dispenseRequest
                                                                Definition

                                                                Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

                                                                ShortMedication supply authorization
                                                                Control0..1
                                                                TypeBackboneElement
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                180. MedicationRequest.dispenseRequest.id
                                                                Definition

                                                                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                Shortxml:id (or equivalent in JSON)
                                                                Control0..1
                                                                Typestring
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                182. MedicationRequest.dispenseRequest.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension
                                                                SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 184. MedicationRequest.dispenseRequest.extension:initialFill
                                                                  Slice NameinitialFill
                                                                  Definition

                                                                  R5: MedicationRequest.dispenseRequest.initialFill (new:BackboneElement)

                                                                  ShortR5: First fill details (new)
                                                                  Comments

                                                                  Element MedicationRequest.dispenseRequest.initialFill has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.initialFill has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If populating this element, either the quantity or the duration must be included.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(R5: First fill details (new)) (Complex Extension)
                                                                  Is Modifierfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  186. MedicationRequest.dispenseRequest.extension:dispenseInterval
                                                                  Slice NamedispenseInterval
                                                                  Definition

                                                                  R5: MedicationRequest.dispenseRequest.dispenseInterval (new:Duration)

                                                                  ShortR5: Minimum period of time between dispenses (new)
                                                                  Comments

                                                                  Element MedicationRequest.dispenseRequest.dispenseInterval has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.dispenseInterval has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(R5: Minimum period of time between dispenses (new)) (Extension Type: Duration)
                                                                  Is Modifierfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  188. MedicationRequest.dispenseRequest.extension:dispenserInstruction
                                                                  Slice NamedispenserInstruction
                                                                  Definition

                                                                  R5: MedicationRequest.dispenseRequest.dispenserInstruction (new:Annotation)

                                                                  ShortR5: Additional information for the dispenser (new)
                                                                  Comments

                                                                  Element MedicationRequest.dispenseRequest.dispenserInstruction has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.dispenserInstruction has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(R5: Additional information for the dispenser (new)) (Extension Type: Annotation)
                                                                  Is Modifierfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  190. MedicationRequest.dispenseRequest.extension:doseAdministrationAid
                                                                  Slice NamedoseAdministrationAid
                                                                  Definition

                                                                  R5: MedicationRequest.dispenseRequest.doseAdministrationAid (new:CodeableConcept)

                                                                  ShortR5: Type of adherence packaging to use for the dispense (new)
                                                                  Comments

                                                                  Element MedicationRequest.dispenseRequest.doseAdministrationAid has a context of MedicationRequest.dispenseRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.dispenseRequest.doseAdministrationAid has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(R5: Type of adherence packaging to use for the dispense (new)) (Extension Type: CodeableConcept)
                                                                  Is Modifierfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  192. MedicationRequest.dispenseRequest.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                  ShortExtensions that cannot be ignored
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                  Summarytrue
                                                                  Alternate Namesextensions, user content, modifiers
                                                                  194. MedicationRequest.dispenseRequest.validityPeriod
                                                                  Definition

                                                                  This indicates the validity period of a prescription (stale dating the Prescription).

                                                                  ShortTime period supply is authorized for
                                                                  Comments

                                                                  It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

                                                                  Control0..1
                                                                  TypePeriod
                                                                  Requirements

                                                                  Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

                                                                  196. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                                                  Definition

                                                                  An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.

                                                                  ShortNumber of refills authorized
                                                                  Comments

                                                                  If displaying "number of authorized fills", add 1 to this number.

                                                                  Control0..1
                                                                  TypepositiveInt
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  198. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.id
                                                                  Definition

                                                                  unique id for the element within a resource (for internal references)

                                                                  Shortxml:id (or equivalent in JSON)
                                                                  Control0..1
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  200. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension
                                                                  SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 202. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.extension:numberOfRepeatsAllowed
                                                                    Slice NamenumberOfRepeatsAllowed
                                                                    Definition

                                                                    R5: MedicationRequest.dispenseRequest.numberOfRepeatsAllowed additional types (unsignedInt) additional types from child elements (value)

                                                                    ShortR5: numberOfRepeatsAllowed additional types
                                                                    Comments

                                                                    Element MedicationRequest.dispenseRequest.numberOfRepeatsAllowed is mapped to FHIR STU3 element MedicationRequest.dispenseRequest.numberOfRepeatsAllowed as SourceIsBroaderThanTarget. The mappings for MedicationRequest.dispenseRequest.numberOfRepeatsAllowed do not cover the following types: unsignedInt. The mappings for MedicationRequest.dispenseRequest.numberOfRepeatsAllowed do not cover the following types based on type expansion: value. If displaying "number of authorized fills", add 1 to this number.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension(R5: numberOfRepeatsAllowed additional types) (Extension Type: unsignedInt)
                                                                    Is Modifierfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    204. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed.value
                                                                    Definition

                                                                    Primitive value for positiveInt

                                                                    ShortPrimitive value for positiveInt
                                                                    Control0..1
                                                                    TypepositiveInt
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    206. MedicationRequest.dispenseRequest.quantity
                                                                    Definition

                                                                    The amount that is to be dispensed for one fill.

                                                                    ShortAmount of medication to supply per dispense
                                                                    Control0..1
                                                                    TypeQuantity(SimpleQuantity)
                                                                    208. MedicationRequest.dispenseRequest.expectedSupplyDuration
                                                                    Definition

                                                                    Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

                                                                    ShortNumber of days supply per dispense
                                                                    Comments

                                                                    In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

                                                                    Control0..1
                                                                    TypeDuration
                                                                    210. MedicationRequest.dispenseRequest.performer
                                                                    Definition

                                                                    Indicates the intended dispensing Organization specified by the prescriber.

                                                                    ShortIntended dispenser
                                                                    Control0..1
                                                                    TypeReference(Organization)
                                                                    212. MedicationRequest.dispenseRequest.performer.id
                                                                    Definition

                                                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    Shortxml:id (or equivalent in JSON)
                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    214. MedicationRequest.dispenseRequest.performer.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..*
                                                                    TypeExtension
                                                                    SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 216. MedicationRequest.dispenseRequest.performer.extension:dispenser
                                                                      Slice Namedispenser
                                                                      Definition

                                                                      R5: MedicationRequest.dispenseRequest.dispenser additional types from child elements (display, identifier, reference, type)

                                                                      ShortR5: Intended performer of dispense additional types
                                                                      Comments

                                                                      Element MedicationRequest.dispenseRequest.dispenser is mapped to FHIR STU3 element MedicationRequest.dispenseRequest.performer as SourceIsBroaderThanTarget. The mappings for MedicationRequest.dispenseRequest.dispenser do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.dispenseRequest.dispenser with unmapped reference targets: Organization.

                                                                      Control0..1
                                                                      TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                                      218. MedicationRequest.dispenseRequest.performer.reference
                                                                      Definition

                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                      Comments

                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ref-1
                                                                      Typestring
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      220. MedicationRequest.dispenseRequest.performer.identifier
                                                                      Definition

                                                                      An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                      ShortLogical reference, when literal reference is not known
                                                                      Comments

                                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                      Control0..1
                                                                      TypeIdentifier
                                                                      Summarytrue
                                                                      222. MedicationRequest.dispenseRequest.performer.display
                                                                      Definition

                                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                                      ShortText alternative for the resource
                                                                      Comments

                                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                      Control0..1
                                                                      Typestring
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      224. MedicationRequest.substitution
                                                                      Definition

                                                                      Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

                                                                      ShortAny restrictions on medication substitution
                                                                      Control0..1
                                                                      TypeBackboneElement
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                      226. MedicationRequest.substitution.id
                                                                      Definition

                                                                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                      Shortxml:id (or equivalent in JSON)
                                                                      Control0..1
                                                                      Typestring
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      228. MedicationRequest.substitution.extension
                                                                      Definition

                                                                      An Extension

                                                                      ShortExtension
                                                                      Control0..*
                                                                      TypeExtension
                                                                      SlicingThis element introduces a set of slices on MedicationRequest.substitution.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 230. MedicationRequest.substitution.extension:allowed
                                                                        Slice Nameallowed
                                                                        Definition

                                                                        R5: MedicationRequest.substitution.allowed[x] additional types (CodeableConcept) additional types from child elements (coding, text)

                                                                        ShortR5: Whether substitution is allowed or not additional types
                                                                        Comments

                                                                        Element MedicationRequest.substitution.allowed[x] is mapped to FHIR STU3 element MedicationRequest.substitution.allowed as SourceIsBroaderThanTarget. The mappings for MedicationRequest.substitution.allowed[x] do not cover the following types: CodeableConcept. The mappings for MedicationRequest.substitution.allowed[x] do not cover the following types based on type expansion: coding, text. This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension(R5: Whether substitution is allowed or not additional types) (Extension Type: CodeableConcept)
                                                                        Is Modifierfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        232. MedicationRequest.substitution.modifierExtension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                        ShortExtensions that cannot be ignored
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                        Summarytrue
                                                                        Alternate Namesextensions, user content, modifiers
                                                                        234. MedicationRequest.substitution.allowed
                                                                        Definition

                                                                        True if the prescriber allows a different drug to be dispensed from what was prescribed.

                                                                        ShortWhether substitution is allowed or not
                                                                        Comments

                                                                        This element is labeled as a modifer because whether substitution is allow or not cannot be ignored.

                                                                        Control1..1
                                                                        Typeboolean
                                                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        236. MedicationRequest.substitution.reason
                                                                        Definition

                                                                        Indicates the reason for the substitution, or why substitution must or must not be performed.

                                                                        ShortWhy should (not) substitution be made
                                                                        Control0..1
                                                                        BindingFor example codes, see SubstanceAdminSubstitutionReason|2014-03-26
                                                                        (example to http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason|2014-03-26)

                                                                        A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                                                                        TypeCodeableConcept
                                                                        238. MedicationRequest.priorPrescription
                                                                        Definition

                                                                        A link to a resource representing an earlier order related order or prescription.

                                                                        ShortAn order/prescription that is being replaced
                                                                        Control0..1
                                                                        TypeReference(MedicationRequest)
                                                                        240. MedicationRequest.priorPrescription.id
                                                                        Definition

                                                                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        Shortxml:id (or equivalent in JSON)
                                                                        Control0..1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        242. MedicationRequest.priorPrescription.extension
                                                                        Definition

                                                                        An Extension

                                                                        ShortExtension
                                                                        Control0..*
                                                                        TypeExtension
                                                                        SlicingThis element introduces a set of slices on MedicationRequest.priorPrescription.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 244. MedicationRequest.priorPrescription.extension:priorPrescription
                                                                          Slice NamepriorPrescription
                                                                          Definition

                                                                          R5: MedicationRequest.priorPrescription additional types from child elements (display, identifier, reference, type)

                                                                          ShortR5: Reference to an order/prescription that is being replaced by this MedicationRequest additional types
                                                                          Comments

                                                                          Element MedicationRequest.priorPrescription is mapped to FHIR STU3 element MedicationRequest.priorPrescription as SourceIsBroaderThanTarget. The mappings for MedicationRequest.priorPrescription do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.priorPrescription with unmapped reference targets: MedicationRequest.

                                                                          Control0..1
                                                                          TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                                          246. MedicationRequest.priorPrescription.reference
                                                                          Definition

                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                          Comments

                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ref-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          248. MedicationRequest.priorPrescription.identifier
                                                                          Definition

                                                                          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                          ShortLogical reference, when literal reference is not known
                                                                          Comments

                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                          Control0..1
                                                                          TypeIdentifier
                                                                          Summarytrue
                                                                          250. MedicationRequest.priorPrescription.display
                                                                          Definition

                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                          ShortText alternative for the resource
                                                                          Comments

                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          252. MedicationRequest.detectedIssue
                                                                          Definition

                                                                          Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

                                                                          ShortClinical Issue with action
                                                                          Control0..*
                                                                          TypeReference(DetectedIssue)
                                                                          Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                                          254. MedicationRequest.eventHistory
                                                                          Definition

                                                                          Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

                                                                          ShortA list of events of interest in the lifecycle
                                                                          Comments

                                                                          This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                                                          Control0..*
                                                                          TypeReference(Provenance)
                                                                          256. MedicationRequest.eventHistory.id
                                                                          Definition

                                                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          Shortxml:id (or equivalent in JSON)
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          258. MedicationRequest.eventHistory.extension
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control0..*
                                                                          TypeExtension
                                                                          SlicingThis element introduces a set of slices on MedicationRequest.eventHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 260. MedicationRequest.eventHistory.extension:eventHistory
                                                                            Slice NameeventHistory
                                                                            Definition

                                                                            R5: MedicationRequest.eventHistory additional types from child elements (display, identifier, reference, type)

                                                                            ShortR5: eventHistory additional types
                                                                            Comments

                                                                            Element MedicationRequest.eventHistory is mapped to FHIR STU3 element MedicationRequest.eventHistory as SourceIsBroaderThanTarget. The mappings for MedicationRequest.eventHistory do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element MedicationRequest.eventHistory with unmapped reference targets: Provenance. This might not include provenances for all versions of the request – only those deemed "relevant" or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                                                            Control0..*
                                                                            TypeExtension(http://hl7.org/fhir/StructureDefinition/alternate-reference)
                                                                            262. MedicationRequest.eventHistory.reference
                                                                            Definition

                                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                                            Comments

                                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ref-1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            264. MedicationRequest.eventHistory.identifier
                                                                            Definition

                                                                            An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                            ShortLogical reference, when literal reference is not known
                                                                            Comments

                                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                            Control0..1
                                                                            TypeIdentifier
                                                                            Summarytrue
                                                                            266. MedicationRequest.eventHistory.display
                                                                            Definition

                                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                                            ShortText alternative for the resource
                                                                            Comments

                                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue