Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

12.21 Resource VisionPrescription - Content

Orders and Observations icon

Work Group

Maturity Level: 3

Trial Use

Security Category: Patient

Compartments: Encounter, Patient, Practitioner

An authorization for the provision of glasses and/or contact lenses to a patient.

12.21.1 Scope and Usage

The VisionPrescription resource is intended to support the information requirements for a prescription for glasses and contact lenses for a patient. Corrective optical lenses are considered a controlled substance and therefore a prescription is typically required for the provision of patient-specific lenses.

Vision prescriptions may only be issued by providers who have optical diagnosis within their scope of practice, typically ophthalmologists and optometrists. The prescription is a time-limited, typically two years, authorization for the provision of an unlimited number of lenses, glasses or contacts, which conform to the authorized specification by providers which have lens provision within their scope of practice, typically ophthalmologists , optometrists and opticians.

Health insurers typically require a copy of the prescription to ensure that a vision professional has examined the patient and that the power of the lenses exceeds some minimum, such as +- 0.75 diopters, to qualify for reimbursement under the insurance coverage.

The VisionPrescription resource is an "request" resource from a FHIR workflow perspective - see Workflow Request.

12.21.1.1 Additional Information

Additional information regarding resources conveying electronic claims content and usage may be found at:

Financial Resource Status Lifecycle: how .status is used in the financial resources.

12.21.2 Boundaries and Relationships

The VisionPrescription resource is used to provide the authorized specification of lenses for glasses and contacts which have well known and internationally consistent requirements, which is distinct from other types of health care authorizations detailed below.

The health care domain includes a number of related resources

VisionPrescription	The VisionPrescription resource is used to provide the authorized specification of lenses for glasses and contacts.
DeviceRequest	This resource is used to prescribe, authorize, and request provision of a health care device such as a halter monitor or a wheelchair services.
MedicationRequest	This resource is used to prescribe, authorize, and request provision of medications such a pharmaceuticals and vaccines.
ServiceRequest	This resource is used to prescribe, authorize, and request provision of health care services such as consultative or rehabilitative services.

12.21.3 References to this Resource

Implements: Request
Resource References: CarePlan, Claim, ClaimResponse, DocumentReference, ExplanationOfBenefit and GuidanceResponse

Structure

Name	Flags	Card.	Type	Description & Constraints
VisionPrescription	TU		DomainResource	Prescription for vision correction products for a patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier		0..*	Identifier	Business Identifier for vision prescription
status	?!Σ	1..1	code	active \| cancelled \| draft \| entered-in-error Binding: Financial Resource Status Codes (Required)
created	Σ	1..1	dateTime	Response creation date
patient	Σ	1..1	Reference(Patient)	Who prescription is for
encounter		0..1	Reference(Encounter)	Created during encounter / admission / stay
dateWritten	Σ	1..1	dateTime	When prescription was authorized
prescriber	Σ	1..1	Reference(Practitioner \| PractitionerRole)	Who authorized the vision prescription
lensSpecification	Σ	1..*	BackboneElement	Vision lens authorization
product	Σ	1..1	CodeableConcept	Product to be supplied Binding: Example Vision Prescription Product Codes (Example)
eye	Σ	1..1	code	right \| left Binding: Vision Eyes (Required)
sphere		0..1	decimal	Power of the lens
cylinder		0..1	decimal	Lens power for astigmatism
axis		0..1	integer	Lens meridian which contain no power for astigmatism
prism		0..*	BackboneElement	Eye alignment compensation
amount		1..1	decimal	Amount of adjustment
base		1..1	code	up \| down \| in \| out Binding: Vision Base (Required)
add		0..1	decimal	Added power for multifocal levels
power		0..1	decimal	Contact lens power
backCurve		0..1	decimal	Contact lens back curvature
diameter		0..1	decimal	Contact lens diameter
duration		0..1	SimpleQuantity	Lens wear duration
color		0..1	string	Color required
brand		0..1	string	Brand required
note		0..*	Annotation	Notes for coatings
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<VisionPrescription xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for vision prescription --></identifier>
 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <created value="[dateTime]"/><!-- 1..1 Response creation date -->
 <patient><!-- 1..1 Reference(Patient) Who prescription is for --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Created during encounter / admission / stay --></encounter>
 <dateWritten value="[dateTime]"/><!-- 1..1 When prescription was authorized -->
 <prescriber><!-- 1..1 Reference(Practitioner|PractitionerRole) Who authorized the vision prescription --></prescriber>
 <lensSpecification>  <!-- 1..* Vision lens authorization -->
  <product><!-- 1..1 CodeableConcept Product to be supplied --></product>
  <eye value="[code]"/><!-- 1..1 right | left -->
  <sphere value="[decimal]"/><!-- 0..1 Power of the lens -->
  <cylinder value="[decimal]"/><!-- 0..1 Lens power for astigmatism -->
  <axis value="[integer]"/><!-- 0..1 Lens meridian which contain no power for astigmatism -->
  <prism>  <!-- 0..* Eye alignment compensation -->
   <amount value="[decimal]"/><!-- 1..1 Amount of adjustment -->
   <base value="[code]"/><!-- 1..1 up | down | in | out -->
  </prism>
  <add value="[decimal]"/><!-- 0..1 Added power for multifocal levels -->
  <power value="[decimal]"/><!-- 0..1 Contact lens power -->
  <backCurve value="[decimal]"/><!-- 0..1 Contact lens back curvature -->
  <diameter value="[decimal]"/><!-- 0..1 Contact lens diameter -->
  <duration><!-- 0..1 Quantity(SimpleQuantity) Lens wear duration --></duration>
  <color value="[string]"/><!-- 0..1 Color required -->
  <brand value="[string]"/><!-- 0..1 Brand required -->
  <note><!-- 0..* Annotation Notes for coatings --></note>
 </lensSpecification>
</VisionPrescription>

JSON Template

{
  "resourceType" : "VisionPrescription",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for vision prescription
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "created" : "<dateTime>", // R!  Response creation date
  "patient" : { Reference(Patient) }, // R!  Who prescription is for
  "encounter" : { Reference(Encounter) }, // Created during encounter / admission / stay
  "dateWritten" : "<dateTime>", // R!  When prescription was authorized
  "prescriber" : { Reference(Practitioner|PractitionerRole) }, // R!  Who authorized the vision prescription
  "lensSpecification" : [{ // R!  Vision lens authorization
    "product" : { CodeableConcept }, // R!  Product to be supplied
    "eye" : "<code>", // R!  right | left
    "sphere" : <decimal>, // Power of the lens
    "cylinder" : <decimal>, // Lens power for astigmatism
    "axis" : <integer>, // Lens meridian which contain no power for astigmatism
    "prism" : [{ // Eye alignment compensation
      "amount" : <decimal>, // R!  Amount of adjustment
      "base" : "<code>" // R!  up | down | in | out
    }],
    "add" : <decimal>, // Added power for multifocal levels
    "power" : <decimal>, // Contact lens power
    "backCurve" : <decimal>, // Contact lens back curvature
    "diameter" : <decimal>, // Contact lens diameter
    "duration" : { Quantity(SimpleQuantity) }, // Lens wear duration
    "color" : "<string>", // Color required
    "brand" : "<string>", // Brand required
    "note" : [{ Annotation }] // Notes for coatings
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:VisionPrescription;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for vision prescription
  fhir:status [ code ] ; # 1..1 active | cancelled | draft | entered-in-error
  fhir:created [ dateTime ] ; # 1..1 Response creation date
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who prescription is for
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Created during encounter / admission / stay
  fhir:dateWritten [ dateTime ] ; # 1..1 When prescription was authorized
  fhir:prescriber [ Reference(Practitioner|PractitionerRole) ] ; # 1..1 Who authorized the vision prescription
  fhir:lensSpecification ( [ # 1..* Vision lens authorization
    fhir:product [ CodeableConcept ] ; # 1..1 Product to be supplied
    fhir:eye [ code ] ; # 1..1 right | left
    fhir:sphere [ decimal ] ; # 0..1 Power of the lens
    fhir:cylinder [ decimal ] ; # 0..1 Lens power for astigmatism
    fhir:axis [ integer ] ; # 0..1 Lens meridian which contain no power for astigmatism
    fhir:prism ( [ # 0..* Eye alignment compensation
      fhir:amount [ decimal ] ; # 1..1 Amount of adjustment
      fhir:base [ code ] ; # 1..1 up | down | in | out
    ] ... ) ;
    fhir:add [ decimal ] ; # 0..1 Added power for multifocal levels
    fhir:power [ decimal ] ; # 0..1 Contact lens power
    fhir:backCurve [ decimal ] ; # 0..1 Contact lens back curvature
    fhir:diameter [ decimal ] ; # 0..1 Contact lens diameter
    fhir:duration [ Quantity(SimpleQuantity) ] ; # 0..1 Lens wear duration
    fhir:color [ string ] ; # 0..1 Color required
    fhir:brand [ string ] ; # 0..1 Brand required
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Notes for coatings
  ] ... ) ;
]

Changes from both R4 and R4B

VisionPrescription

No Changes

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Structure

Name	Flags	Card.	Type	Description & Constraints
VisionPrescription	TU		DomainResource	Prescription for vision correction products for a patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier		0..*	Identifier	Business Identifier for vision prescription
status	?!Σ	1..1	code	active \| cancelled \| draft \| entered-in-error Binding: Financial Resource Status Codes (Required)
created	Σ	1..1	dateTime	Response creation date
patient	Σ	1..1	Reference(Patient)	Who prescription is for
encounter		0..1	Reference(Encounter)	Created during encounter / admission / stay
dateWritten	Σ	1..1	dateTime	When prescription was authorized
prescriber	Σ	1..1	Reference(Practitioner \| PractitionerRole)	Who authorized the vision prescription
lensSpecification	Σ	1..*	BackboneElement	Vision lens authorization
product	Σ	1..1	CodeableConcept	Product to be supplied Binding: Example Vision Prescription Product Codes (Example)
eye	Σ	1..1	code	right \| left Binding: Vision Eyes (Required)
sphere		0..1	decimal	Power of the lens
cylinder		0..1	decimal	Lens power for astigmatism
axis		0..1	integer	Lens meridian which contain no power for astigmatism
prism		0..*	BackboneElement	Eye alignment compensation
amount		1..1	decimal	Amount of adjustment
base		1..1	code	up \| down \| in \| out Binding: Vision Base (Required)
add		0..1	decimal	Added power for multifocal levels
power		0..1	decimal	Contact lens power
backCurve		0..1	decimal	Contact lens back curvature
diameter		0..1	decimal	Contact lens diameter
duration		0..1	SimpleQuantity	Lens wear duration
color		0..1	string	Color required
brand		0..1	string	Brand required
note		0..*	Annotation	Notes for coatings
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<VisionPrescription xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for vision prescription --></identifier>
 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <created value="[dateTime]"/><!-- 1..1 Response creation date -->
 <patient><!-- 1..1 Reference(Patient) Who prescription is for --></patient>
 <encounter><!-- 0..1 Reference(Encounter) Created during encounter / admission / stay --></encounter>
 <dateWritten value="[dateTime]"/><!-- 1..1 When prescription was authorized -->
 <prescriber><!-- 1..1 Reference(Practitioner|PractitionerRole) Who authorized the vision prescription --></prescriber>
 <lensSpecification>  <!-- 1..* Vision lens authorization -->
  <product><!-- 1..1 CodeableConcept Product to be supplied --></product>
  <eye value="[code]"/><!-- 1..1 right | left -->
  <sphere value="[decimal]"/><!-- 0..1 Power of the lens -->
  <cylinder value="[decimal]"/><!-- 0..1 Lens power for astigmatism -->
  <axis value="[integer]"/><!-- 0..1 Lens meridian which contain no power for astigmatism -->
  <prism>  <!-- 0..* Eye alignment compensation -->
   <amount value="[decimal]"/><!-- 1..1 Amount of adjustment -->
   <base value="[code]"/><!-- 1..1 up | down | in | out -->
  </prism>
  <add value="[decimal]"/><!-- 0..1 Added power for multifocal levels -->
  <power value="[decimal]"/><!-- 0..1 Contact lens power -->
  <backCurve value="[decimal]"/><!-- 0..1 Contact lens back curvature -->
  <diameter value="[decimal]"/><!-- 0..1 Contact lens diameter -->
  <duration><!-- 0..1 Quantity(SimpleQuantity) Lens wear duration --></duration>
  <color value="[string]"/><!-- 0..1 Color required -->
  <brand value="[string]"/><!-- 0..1 Brand required -->
  <note><!-- 0..* Annotation Notes for coatings --></note>
 </lensSpecification>
</VisionPrescription>

JSON Template

{
  "resourceType" : "VisionPrescription",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for vision prescription
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "created" : "<dateTime>", // R!  Response creation date
  "patient" : { Reference(Patient) }, // R!  Who prescription is for
  "encounter" : { Reference(Encounter) }, // Created during encounter / admission / stay
  "dateWritten" : "<dateTime>", // R!  When prescription was authorized
  "prescriber" : { Reference(Practitioner|PractitionerRole) }, // R!  Who authorized the vision prescription
  "lensSpecification" : [{ // R!  Vision lens authorization
    "product" : { CodeableConcept }, // R!  Product to be supplied
    "eye" : "<code>", // R!  right | left
    "sphere" : <decimal>, // Power of the lens
    "cylinder" : <decimal>, // Lens power for astigmatism
    "axis" : <integer>, // Lens meridian which contain no power for astigmatism
    "prism" : [{ // Eye alignment compensation
      "amount" : <decimal>, // R!  Amount of adjustment
      "base" : "<code>" // R!  up | down | in | out
    }],
    "add" : <decimal>, // Added power for multifocal levels
    "power" : <decimal>, // Contact lens power
    "backCurve" : <decimal>, // Contact lens back curvature
    "diameter" : <decimal>, // Contact lens diameter
    "duration" : { Quantity(SimpleQuantity) }, // Lens wear duration
    "color" : "<string>", // Color required
    "brand" : "<string>", // Brand required
    "note" : [{ Annotation }] // Notes for coatings
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:VisionPrescription;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for vision prescription
  fhir:status [ code ] ; # 1..1 active | cancelled | draft | entered-in-error
  fhir:created [ dateTime ] ; # 1..1 Response creation date
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who prescription is for
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Created during encounter / admission / stay
  fhir:dateWritten [ dateTime ] ; # 1..1 When prescription was authorized
  fhir:prescriber [ Reference(Practitioner|PractitionerRole) ] ; # 1..1 Who authorized the vision prescription
  fhir:lensSpecification ( [ # 1..* Vision lens authorization
    fhir:product [ CodeableConcept ] ; # 1..1 Product to be supplied
    fhir:eye [ code ] ; # 1..1 right | left
    fhir:sphere [ decimal ] ; # 0..1 Power of the lens
    fhir:cylinder [ decimal ] ; # 0..1 Lens power for astigmatism
    fhir:axis [ integer ] ; # 0..1 Lens meridian which contain no power for astigmatism
    fhir:prism ( [ # 0..* Eye alignment compensation
      fhir:amount [ decimal ] ; # 1..1 Amount of adjustment
      fhir:base [ code ] ; # 1..1 up | down | in | out
    ] ... ) ;
    fhir:add [ decimal ] ; # 0..1 Added power for multifocal levels
    fhir:power [ decimal ] ; # 0..1 Contact lens power
    fhir:backCurve [ decimal ] ; # 0..1 Contact lens back curvature
    fhir:diameter [ decimal ] ; # 0..1 Contact lens diameter
    fhir:duration [ Quantity(SimpleQuantity) ] ; # 0..1 Lens wear duration
    fhir:color [ string ] ; # 0..1 Color required
    fhir:brand [ string ] ; # 0..1 Brand required
    fhir:note  ( [ Annotation ] ... ) ; # 0..* Notes for coatings
  ] ... ) ;
]

Changes from both R4 and R4B

VisionPrescription

No Changes

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

12.21.4.1 Terminology Bindings

Path	ValueSet	Type	Documentation
VisionPrescription.status	FinancialResourceStatusCodes	Required	This value set includes Status codes.
VisionPrescription.lensSpecification.product	ExampleVisionPrescriptionProductCodes	Example	This value set includes a smattering of Prescription Product codes.
VisionPrescription.lensSpecification.eye	VisionEyes	Required	A coded concept listing the eye codes.
VisionPrescription.lensSpecification.prism.base	VisionBase	Required	A coded concept listing the base codes.

Path

ValueSet

Type

Documentation

VisionPrescription.status

FinancialResourceStatusCodes

Required

This value set includes Status codes.

VisionPrescription.lensSpecification.product

ExampleVisionPrescriptionProductCodes

Example

This value set includes a smattering of Prescription Product codes.

VisionPrescription.lensSpecification.eye

VisionEyes

Required

A coded concept listing the eye codes.

VisionPrescription.lensSpecification.prism.base

VisionBase

Required

A coded concept listing the base codes.

12.21.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
datewritten	date	Return prescriptions written on this date	VisionPrescription.dateWritten
encounter	reference	Return prescriptions with this encounter identifier	VisionPrescription.encounter (Encounter)	29 Resources
identifier	token	Return prescriptions with this external identifier	VisionPrescription.identifier	65 Resources
patient	reference	The identity of a patient to list dispenses for	VisionPrescription.patient (Patient)	66 Resources
prescriber	reference	Who authorized the vision prescription	VisionPrescription.prescriber (Practitioner, PractitionerRole)
status	token	The status of the vision prescription	VisionPrescription.status