Release 4B Ballot #1

This page is part of the FHIR Specification (v4.1.0: Release 4B 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

Medicationrequest0301.json

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

Raw JSON (canonical form + also see JSON Format Specification)

Order with as needed (PRN) dosage with pre-condition - Oxycodone - active with reasonCode, note, dispenseRequest and substitution

{
  "resourceType": "MedicationRequest",
  "id": "medrx0301",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 12345689 (OFFICIAL)</p><p><b>status</b>: completed</p><p><b>statusReason</b>: <span>Try another treatment first</span></p><p><b>intent</b>: order</p><p><b>category</b>: <span>Inpatient</span></p><p><b>medication</b>: <a> </a></p><blockquote><p><b>code</b>: <span>Oral Form Oxycodone (product)</span></p></blockquote><p><b>subject</b>: <a>Donald Duck. Generated Summary: Medical record number: 654321 (USUAL); active; Duck Donald (OFFICIAL); gender: male</a></p><p><b>encounter</b>: <a>encounter who leads to this prescription. Generated Summary: id: Encounter_Roel_20130404 (TEMP); status: finished; <span>ambulatory</span>; <span>Consultation</span>; <span>Normal</span>; <span>The patient had fever peaks over the last couple of days. He is worried about these peaks.</span></a></p><p><b>supportingInformation</b>: <a>Generated Summary: status: completed; <span>Diagnostic procedure</span>; <span>Biopsy of suspected melanoma L) arm</span>; performed: 2014-02-03; <span>Dark lesion l) forearm. getting darker last 3 months.</span>; <span>Left forearm</span>; <span>Ineffective airway clearance</span>; <span>Review in clinic</span>; Standard Biopsy; <span>30-guage needle</span></a></p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a>Patrick Pump. Generated Summary: id: 874635264 (OFFICIAL), id: 567IUI51C154 (USUAL); Simone Heps (OFFICIAL); Phone: 020556936, S.M.Heps@bmc.nl, Fax: 0205669283; gender: female; birthDate: 1971-11-07</a></p><p><b>performer</b>: <a>Carla Espinosa. Generated Summary: UZI-nummer: 12345678904 (OFFICIAL); Carla Espinosa; Phone: +31715262169; gender: female; birthDate: 1967-11-05</a></p><p><b>performerType</b>: <span>Public Health Nurse</span></p><p><b>reasonCode</b>: <span>Rib Pain (finding)</span></p><p><b>insurance</b>: <a>Generated Summary: id: 12345; status: active; <span>extended healthcare</span>; dependent: 0; <span>self</span>; period: 2011-05-23 --&gt; 2012-05-23</a></p><p><b>note</b>: Patient told to take with food</p><h3>DosageInstructions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr></table><blockquote><p><b>dispenseRequest</b></p><p><b>validityPeriod</b>: 2015-01-15 --&gt; 2016-01-15</p><p><b>numberOfRepeatsAllowed</b>: 0</p><p><b>quantity</b>: 30 TAB</p><h3>ExpectedSupplyDurations</h3><table><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote><h3>Substitutions</h3><table><tr><td>-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td>*</td><td>true</td><td><span>formulary policy</span></td></tr></table><p><b>detectedIssue</b>: <a>Generated Summary: status: final</a></p><p><b>eventHistory</b>: <a> </a></p><blockquote><p><b>target</b>: <a>Generated Summary: Placer: 20170201-0001; status: completed; intent: order; <span>Physiotherapy of chest (regime/therapy) </span>; Duration 15days, Do 1-1 per 1 days; <span>as needed to clear mucus</span>; authoredOn: 2 Feb. 2017, 4:23:07 am</a></p><p><b>recorded</b>: 2 Feb. 2017, 4:23:07 am</p><h3>Agents</h3><table><tr><td>-</td><td><b>Role</b></td><td><b>Who</b></td></tr><tr><td>*</td><td><span>author (originator)</span></td><td><a>Dr Adam Careful. Generated Summary: id: 23; active; Adam Careful </a></td></tr></table><h3>Signatures</h3><table><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0310",
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "430127000",
            "display": "Oral Form Oxycodone (product)"
          }
        ]
      }
    },
    {
      "resourceType": "Provenance",
      "id": "signature",
      "target": [
        {
          "reference": "ServiceRequest/physiotherapy"
        }
      ],
      "recorded": "2017-02-01T17:23:07Z",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                  "code": "AUT"
                }
              ]
            }
          ],
          "who": {
            "reference": "Practitioner/example",
            "display": "Dr Adam Careful"
          }
        }
      ],
      "signature": [
        {
          "type": [
            {
              "system": "urn:iso-astm:E1762-95:2013",
              "code": "1.2.840.10065.1.12.1.1",
              "display": "Author's Signature"
            }
          ],
          "when": "2017-02-01T17:23:07Z",
          "who": {
            "reference": "Practitioner/example",
            "display": "Dr Adam Careful"
          },
          "targetFormat": "application/fhir+xml",
          "sigFormat": "application/signature+xml",
          "data": "dGhpcyBibG9iIGlzIHNuaXBwZWQ="
        }
      ]
    }
  ],
  "identifier": [
    {
      "use": "official",
      "system": "http://www.bmc.nl/portal/prescriptions",
      "value": "12345689"
    }
  ],
  "status": "completed",
  "statusReason": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-status-reason",
        "code": "altchoice",
        "display": "Try another treatment first"
      }
    ]
  },
  "intent": "order",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-admin-location",
          "code": "inpatient",
          "display": "Inpatient"
        }
      ]
    }
  ],
  "medicationReference": {
    "reference": "#med0310"
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "encounter": {
    "reference": "Encounter/f201",
    "display": "encounter who leads to this prescription"
  },
  "supportingInformation": [
    {
      "reference": "Procedure/biopsy"
    }
  ],
  "authoredOn": "2015-01-15",
  "requester": {
    "reference": "Practitioner/f007",
    "display": "Patrick Pump"
  },
  "performer": {
    "reference": "Practitioner/f204",
    "display": "Carla Espinosa"
  },
  "performerType": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "26369006",
        "display": "Public Health Nurse"
      }
    ]
  },
  "reasonCode": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "297217002",
          "display": "Rib Pain (finding)"
        }
      ]
    }
  ],
  "insurance": [
    {
      "reference": "Coverage/9876B1"
    }
  ],
  "note": [
    {
      "text": "Patient told to take with food"
    }
  ],
  "dosageInstruction": [
    {
      "sequence": 1,
      "text": "one to two tablets every 4-6 hours as needed for rib pain",
      "additionalInstruction": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "418914006",
              "display": "Warning. May cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink (qualifier value)"
            }
          ]
        }
      ],
      "patientInstruction": "Take one to two tablets every four to six hours as needed for rib pain",
      "timing": {
        "repeat": {
          "frequency": 1,
          "period": 4,
          "periodMax": 6,
          "periodUnit": "h"
        }
      },
      "asNeededCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "297217002",
            "display": "Rib Pain (finding)"
          }
        ]
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "26643006",
            "display": "Oral Route"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "421521009",
            "display": "Swallow - dosing instruction imperative (qualifier value)"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseRange": {
            "low": {
              "value": 1,
              "unit": "TAB",
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "TAB"
            },
            "high": {
              "value": 2,
              "unit": "TAB",
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "TAB"
            }
          }
        }
      ]
    }
  ],
  "dispenseRequest": {
    "validityPeriod": {
      "start": "2015-01-15",
      "end": "2016-01-15"
    },
    "numberOfRepeatsAllowed": 0,
    "quantity": {
      "value": 30,
      "unit": "TAB",
      "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
      "code": "TAB"
    },
    "expectedSupplyDuration": {
      "value": 10,
      "unit": "days",
      "system": "http://unitsofmeasure.org",
      "code": "d"
    }
  },
  "substitution": {
    "allowedBoolean": true,
    "reason": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "code": "FP",
          "display": "formulary policy"
        }
      ]
    }
  },
  "detectedIssue": [
    {
      "reference": "DetectedIssue/allergy"
    }
  ],
  "eventHistory": [
    {
      "reference": "#signature",
      "display": "Author's Signature"
    }
  ]
}

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.