Example Usage Scenarios:

The following are example usage scenarios for the US Core-MedicationRequest profile. See the Medication List section for guidance on accessing a patient medications:

• Fetching all medications that have been prescribed to a particular patient
• Fetching all active medications that have been prescribed to particular patient
• Fetching all medications that have been prescribed to particular patient during a particular encounter
• Record or update medications that have been prescribed for a particular patient

Mandatory and Must Support Data Elements

The following data-elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each MedicationRequest Must Have:

1. a status
2. an intent code
3. a medication*
4. a patient

Each MedicationRequest Must Support:

1. the category (e.g., Discharge Medication)
2. the reported flag or reference signaling that information is from a secondary source such as a patient
3. the encounters
4. a prescriber
5. a date for when written
6. the prescription Sig
7. the amount dispensed and number of refills
8. the dose and rate

1. the reason or indication for the prescription*
2. reported adherence to prescribed medication instructions*

* see guidance below

Profile Specific Implementation Guidance:

• See the Medication List section for guidance on accessing a patient medications including over the counter (OTC) medication and other substances taken for medical and recreational use.
  • When recording “self-prescribed” medication, requester SHOULD be used to indicate the Patient or RelatedPerson as the prescriber.
• *This Profile can represent a medication using a code or reference a Medication resource.
  • When using a code, RXNorm concepts are used. They are defined as an extensible binding to .medicationCodeableConcept. USCDI V3+ recommends the National Drug Codes (NDC) as an optional terminology. They can be supplied as an additional coding element.
  • When referencing a Medication resource in .medicationReference, the resource may be contained or an external resource.
  • The server systems are not required to support both a code and a reference, but SHALL support at least one of these methods.
  • If an external reference to a Medication resource is used, the server SHALL support the _include parameter for searching this element.
  • The client application SHALL support all methods.

• The MedicationRequest resource can represent that information is from a secondary source using either a boolean flag or a reference using MedicationRequest.reportedReference.
  • Although both are marked as Must Support, the server system is not required to support both, but SHALL support at least one of these elements.
  • The client application SHALL support both elements.
• *The MedicationRequest resource can communicate the reason or indication for treatment using either a code in MedicationRequest.reasonCode or a reference using MedicationRequest.reasonReference.
  • As documented here, when using MedicationRequest.reasonReference, the referenced Condition or Observation SHOULD be a US Core Profile.
• Source EHR identifiers SHOULD be included to support deduplication across MedicationRequest resources. Exposing the EHR identifiers helps client applications identify duplicates.

• Servers SHALL follow the guidance in the Medication List page and return all active Medications as MedicationRequest. It is always best practice to confirm this list with the Patient or Caregiver.

• * This profile uses the US Core Medication Adherence Extension to report medication adherence. This extension communicates whether a medication has been consumed according to instruction.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
status	S	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	SC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
reported[x]	S	0..1		Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)
medication[x]	S	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	S	1..1	Reference(US Core Patient Profile S | Group)	Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay
authoredOn	S	0..1	dateTime	When request was initially authored
requester	SC	0..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	Who/What requested the Request
reasonCode		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
text	S	0..1	string	Free text dosage instructions e.g. SIG
timing	S	0..1	Timing	When medication should be administered
doseAndRate	S	0..*	Element	Amount of medication administered
dose[x]	S	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category:us-core	required	medicationRequest Category Codes
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug
MedicationRequest.reasonCode	extensible	USCoreConditionCodes
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Practitioner Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile)	Who/What requested the Request
reasonCode		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	When medication should be administered
doseAndRate	SΣ	0..*	Element	Amount of medication administered
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category	example	medicationRequest Category Codes
MedicationRequest.category:us-core	required	medicationRequest Category Codes
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug
MedicationRequest.reasonCode	extensible	USCoreConditionCodes
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	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-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile S | Group)	Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category	example	medicationRequest Category Codes
MedicationRequest.category:us-core	required	medicationRequest Category Codes
MedicationRequest.priority	required	RequestPriority
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes
MedicationRequest.reasonCode	extensible	USCoreConditionCodes
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	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-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Differential View

This structure is derived from MedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
status	S	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	SC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
reported[x]	S	0..1		Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)
medication[x]	S	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	S	1..1	Reference(US Core Patient Profile S | Group)	Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay
authoredOn	S	0..1	dateTime	When request was initially authored
requester	SC	0..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	Who/What requested the Request
reasonCode		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
text	S	0..1	string	Free text dosage instructions e.g. SIG
timing	S	0..1	Timing	When medication should be administered
doseAndRate	S	0..*	Element	Amount of medication administered
dose[x]	S	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category:us-core	required	medicationRequest Category Codes
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug
MedicationRequest.reasonCode	extensible	USCoreConditionCodes
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Practitioner Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile)	Who/What requested the Request
reasonCode		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	When medication should be administered
doseAndRate	SΣ	0..*	Element	Amount of medication administered
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category	example	medicationRequest Category Codes
MedicationRequest.category:us-core	required	medicationRequest Category Codes
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug
MedicationRequest.reasonCode	extensible	USCoreConditionCodes
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	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-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	MedicationRequest	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile S | Group)	Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category	example	medicationRequest Category Codes
MedicationRequest.category:us-core	required	medicationRequest Category Codes
MedicationRequest.priority	required	RequestPriority
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes
MedicationRequest.reasonCode	extensible	USCoreConditionCodes
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	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-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

This structure is derived from MedicationRequest

Summary

Must-Support: 18 elements

Structures

This structure refers to these other structures:

• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson)
• US Core Medication Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication)
• US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence

Slices

This structure defines the following Slices:

• The element MedicationRequest.category is sliced based on the value of pattern:$this

Maturity: 3

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• The syntax used to describe the interactions is described here.
• See the General Requirements section for additional rules and expectations when a server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

Mandatory Search Parameters:

1. SHALL support searching using the combination of the patient and intent search parameters:
   • including optional support for these _include parameters: MedicationRequest:medication
   • including support for OR search on intent (e.g.intent={system|}[code],{system|}[code],...)

   GET [base]/MedicationRequest?patient={Type/}[id]&intent=order,plan

   Example:

   1. GET [base]/MedicationRequest?patient=14676&intent=order,plan
   2. GET [base]/MedicationRequest?patient=14676&intent=order,plan&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent code = order,plan (how to search by reference and how to search by token)

2. SHALL support searching using the combination of the patient and intent and status search parameters:
   • including optional support for these _include parameters: MedicationRequest:medication
   • including support for OR search on intent (e.g.intent={system|}[code],{system|}[code],...)
   • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

   GET [base]/MedicationRequest?patient={Type/}[id]&intent=order,plan&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/MedicationRequest?patient=1137192&intent=order,plan&status=active
   2. GET [base]/MedicationRequest?patient=1137192&intent=order,plan&status=active&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent code = order,plan and status (how to search by reference and how to search by token)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and intent and encounter search parameters:
   • including optional support for these _include parameters: MedicationRequest:medication
   • including support for OR search on intent (e.g.intent={system|}[code],{system|}[code],...)

   GET [base]/MedicationRequest?patient={Type/}[id]&intent=order,plan&encounter={Type/}[id]

   Example:

   1. GET [base]/MedicationRequest?patient=1137192&intent=order,plan&status=active&encounter=Encounter/123
   2. GET [base]/MedicationRequest?patient=1137192&intent=order,plan&status=active&&encounter=Encounter/123&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent code = order,plan and encounter (how to search by reference and how to search by token)

2. SHOULD support searching using the combination of the patient and intent and authoredon search parameters:
   • including optional support for these _include parameters: MedicationRequest:medication
   • including support for OR search on intent (e.g.intent={system|}[code],{system|}[code],...)
   • including support for these authoredon comparators: gt,lt,ge,le
   • including optional support for AND search on authoredon (e.g.authoredon=[date]&authoredon=[date]]&...)

   GET [base]/MedicationRequest?patient={Type/}[id]&intent=order,plan&authoredon={gt|lt|ge|le}[date]{&authoredon={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/MedicationRequest?patient=1137192&intent=order,plan&authoredon=ge2019-01-01T00:00:00Z
   2. GET [base]/MedicationRequest?patient=1137192&intent=order,plan&authoredon=ge2019-01-01T00:00:00Z&_include=MedicationRequest:medication

   Implementation Notes: Fetches a bundle of all MedicationRequest resources for the specified patient and intent code = order,plan and authoredon date (how to search by reference and how to search by token and how to search by date)