R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Medicationrequest0317.xml

Pharmacy Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Encounter, Patient, Practitioner

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Order for Intravenous Chemotherapy (inpatient order) - Alemtuzumab - completed with multiple dosageInstruction lines (id = "medrx0317")

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="medrx0317"/> 
    <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : medrx0317</p> <p> <b> contained</b> : </p> <p> <b> identifier</b> : 12345689 (OFFICIAL)</p> <p> <b> status</b> : completed</p> <p> <b> intent</b> : order</p> <p> <b> medication</b> : id: med0303; Alemtuzumab 10mg/ml (Lemtrada) <span> (Details : {RxNorm code '1594660' = 'alemtuzumab 10 MG/ML [Lemtrada]', given as 'Alemtuzumab
           10mg/ml (Lemtrada)'})</span> </p> <p> <b> subject</b> : <a> Donald Duck</a> </p> <p> <b> authoredOn</b> : 15/01/2015</p> <p> <b> requester</b> : <a> Patrick Pump</a> </p> <p> <b> reasonCode</b> : Chronic Lymphoid Leukemia (disorder) <span> (Details : {SNOMED CT code '92814006' = 'Chronic lymphoid leukemia', given as 'Chronic
           Lymphoid Leukemia (disorder)'})</span> </p> <p> <b> dosageInstruction</b> : , , </p> </div> </text> <contained> 
        <Medication> 
            <id value="med0303"/> 
            <code> 
                <coding> 
                    <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
                    <code value="1594660"/> 
                    <display value="Alemtuzumab 10mg/ml (Lemtrada)"/> 
                </coding> 
            </code> 
        </Medication> 
    </contained> 
    <identifier> 
        <use value="official"/> 
        <system value="http://www.bmc.nl/portal/prescriptions"/> 
        <value value="12345689"/> 
    </identifier> 
    <status value="completed"/> 
    <intent value="order"/> 
    <medicationReference> 
        <reference value="#med0303"/> 
    </medicationReference> 
    <subject> 
        <!--    Linked to the resource patient who needs the medication    -->
        <reference value="Patient/pat1"/> 
        <display value="Donald Duck"/> 
    </subject> 
    <authoredOn value="2015-01-15"/> 
    <requester> 
        <reference value="Practitioner/f007"/> 
        <display value="Patrick Pump"/> 
    </requester> 
    <reasonCode> 
        <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="92814006"/> 
            <display value="Chronic Lymphoid Leukemia (disorder)"/> 
        </coding> 
    </reasonCode> 
    <dosageInstruction> 
        <sequence value="1"/> 
        <text value="Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended
     maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to
     12 wk"/> 
        <additionalInstruction> 
            <text value="Rapidly increase dose until tolerated"/> 
        </additionalInstruction> 
        <additionalInstruction> 
            <text value="Administer on alternate days"/> 
        </additionalInstruction> 
        <timing> 
            <repeat> 
                <duration value="12"/> 
                <durationUnit value="wk"/> 
                <frequency value="3"/> 
                <period value="1"/> 
                <periodUnit value="wk"/> 
            </repeat> 
        </timing> 
        <route> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="47625008"/> 
                <display value="Intravenous route (qualifier value)"/> 
            </coding> 
        </route> 
        <method> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="422145002"/> 
                <display value="Inject - dosing instruction imperative (qualifier value)"/> 
            </coding> 
        </method> 
        <doseQuantity> 
            <value value="3"/> 
            <unit value="mg"/> 
            <system value="http://unitsofmeasure.org"/> 
            <code value="mg"/> 
        </doseQuantity> 
    </dosageInstruction> 
    <dosageInstruction> 
        <sequence value="2"/> 
        <text value="Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended
     maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to
     12 wk"/> 
        <additionalInstruction> 
            <text value="Rapidly increase dose until tolerated"/> 
        </additionalInstruction> 
        <additionalInstruction> 
        <text value="Administer on alternate days"/> 
        </additionalInstruction> 
        <timing> 
            <repeat> 
                <duration value="12"/> 
                <durationUnit value="wk"/> 
                <frequency value="3"/> 
                <period value="1"/> 
                <periodUnit value="wk"/> 
            </repeat> 
        </timing> 
        <route> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="47625008"/> 
                <display value="Intravenous route (qualifier value)"/> 
            </coding> 
        </route> 
        <method> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="422145002"/> 
                <display value="Inject - dosing instruction imperative (qualifier value)"/> 
            </coding> 
        </method> 
        <doseQuantity> 
            <value value="10"/> 
            <unit value="mg"/> 
            <system value="http://unitsofmeasure.org"/> 
            <code value="mg"/> 
        </doseQuantity> 
    </dosageInstruction>   
    <dosageInstruction> 
        <sequence value="3"/> 
        <text value="Rapid daily-dose escalation, until tolerated, from 3 mg/d, and then 10 mg/d, to the recommended
     maintenance dose of 30 mg IV over 120 min, 3 times per wk on alternate days for up to
     12 wk"/> 
        <additionalInstruction> 
            <text value="Rapidly increase dose until tolerated"/> 
        </additionalInstruction> 
        <additionalInstruction> 
        <text value="Administer on alternate days"/> 
        </additionalInstruction> 
        <timing> 
            <repeat> 
                <duration value="12"/> 
                <durationUnit value="wk"/> 
                <frequency value="3"/> 
                <period value="1"/> 
                <periodUnit value="wk"/> 
            </repeat> 
        </timing> 
        <route> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="47625008"/> 
                <display value="Intravenous route (qualifier value)"/> 
            </coding> 
        </route> 
        <method> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="422145002"/> 
                <display value="Inject - dosing instruction imperative (qualifier value)"/> 
            </coding> 
        </method> 
        <doseQuantity> 
            <value value="30"/> 
            <unit value="mg"/> 
            <system value="http://unitsofmeasure.org"/> 
            <code value="mg"/> 
        </doseQuantity> 
    </dosageInstruction> 
</MedicationRequest>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.