Canadian Baseline
1.2.0 - CI Build

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions

## Resource Profile: MedicationRequest Profile

Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest | Version: 1.2.0
Draft as of 2024-08-09 | Computable Name: MedicationRequestProfile

Proposed constraints and extensions on the MedicationRequest resource. Generated as a first step toward creating a set of Canadian Baseline FHIR profiles.

This profile was generated from HL7 StructureDefinition on 2019-03-28 and constrained during a review of US Core against Canadian sources.

Key differences from USCoreR4 MedicationRequest:

- MedicationRequest.medication updated:
  - CodeableConcept binding to ValueSet-prescriptionmedicinalproduct
  - Reference to profile-medication
- MedicationRequest.subject reference updated to profile-patient
- MedicationRequest.requester reference updated to profile-practitioner

Usages:

- Refer to this Profile: MedicationAdministration Profile, MedicationDispense Profile, MedicationRequest Profile, MedicationStatement Profile and ServiceRequest Profile for Results Reporting

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | MedicationRequest Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) |
medication[x] | S Σ | 1..1 |  | Medication to be taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter Profile) | Encounter created as part of encounter/admission/stay
authoredOn | S Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | RelatedPerson | Device Profile (Implantable)) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson | CareTeam) | Intended performer of administration
recorder |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General)) | Person who entered the request
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use)) | Condition or observation that supports why the prescription is being written
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest Profile | ServiceRequest | ImmunizationRecommendation Profile) | What request fulfills
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
priorPrescription |  | 0..1 | Reference(MedicationRequest Profile) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | MedicationRequest Profile
status | S | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
reported[x] |  | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) |
medication[x] | S | 1..1 |  | Medication to be taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S | 1..1 | Reference(Patient Profile) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter Profile) | Encounter created as part of encounter/admission/stay
authoredOn | S | 0..1 | dateTime | When request was initially authored
requester |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | RelatedPerson | Device Profile (Implantable)) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson | CareTeam) | Intended performer of administration
recorder |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General)) | Person who entered the request
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use)) | Condition or observation that supports why the prescription is being written
basedOn |  | 0..* | Reference(CarePlan | MedicationRequest Profile | ServiceRequest | ImmunizationRecommendation Profile) | What request fulfills
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
text | S | 0..1 | string | Free text dosage instructions e.g. SIG
dispenseRequest |  |  |  |
performer |  | 0..1 | Reference(Organization Profile) | Intended dispenser
priorPrescription |  | 0..1 | Reference(MedicationRequest Profile) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | MedicationRequest Profile
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External ids for this request
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept 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 | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage 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.
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] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) |
medication[x] | S Σ | 1..1 |  | Medication to be taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter Profile) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | RelatedPerson | Device Profile (Implantable)) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | 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 Profile (General) | PractitionerRole Profile (General)) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use)) | Condition or observation that supports why the prescription is being written
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest Profile | ServiceRequest | ImmunizationRecommendation Profile) | 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 | S Σ | 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 | Σ | 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 | Σ | 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] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
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(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 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(4.0.1) | 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 |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization Profile) | 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 Profile) | 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 | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v6.5
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v6.5

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

This structure is derived from MedicationRequest

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

- Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
- Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
- PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
- Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
- Medication Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication)
- Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
- Device Profile (Implantable) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device)
- Condition Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-condition)
- Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)
- MedicationRequest Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest)
- ImmunizationRecommendation Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-immunizationrecommendation)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | MedicationRequest Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) |
medication[x] | S Σ | 1..1 |  | Medication to be taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter Profile) | Encounter created as part of encounter/admission/stay
authoredOn | S Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | RelatedPerson | Device Profile (Implantable)) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson | CareTeam) | Intended performer of administration
recorder |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General)) | Person who entered the request
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use)) | Condition or observation that supports why the prescription is being written
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest Profile | ServiceRequest | ImmunizationRecommendation Profile) | What request fulfills
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
priorPrescription |  | 0..1 | Reference(MedicationRequest Profile) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Differential View

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | MedicationRequest Profile
status | S | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
reported[x] |  | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) |
medication[x] | S | 1..1 |  | Medication to be taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S | 1..1 | Reference(Patient Profile) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter Profile) | Encounter created as part of encounter/admission/stay
authoredOn | S | 0..1 | dateTime | When request was initially authored
requester |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | RelatedPerson | Device Profile (Implantable)) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | RelatedPerson | CareTeam) | Intended performer of administration
recorder |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General)) | Person who entered the request
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use)) | Condition or observation that supports why the prescription is being written
basedOn |  | 0..* | Reference(CarePlan | MedicationRequest Profile | ServiceRequest | ImmunizationRecommendation Profile) | What request fulfills
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
text | S | 0..1 | string | Free text dosage instructions e.g. SIG
dispenseRequest |  |  |  |
performer |  | 0..1 | Reference(Organization Profile) | Intended dispenser
priorPrescription |  | 0..1 | Reference(MedicationRequest Profile) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | MedicationRequest Profile
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External ids for this request
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept 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 | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage 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.
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] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General) | RelatedPerson | Organization Profile) |
medication[x] | S Σ | 1..1 |  | Medication to be taken Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication Profile) |
subject | S Σ | 1..1 | Reference(Patient Profile) | Who or group medication request is for
encounter |  | 0..1 | Reference(Encounter Profile) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 0..1 | dateTime | When request was initially authored
requester | Σ | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | RelatedPerson | Device Profile (Implantable)) | Who/What requested the Request
performer |  | 0..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable) | 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 Profile (General) | PractitionerRole Profile (General)) | Person who entered the request
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference |  | 0..* | Reference(Condition Profile | Observation Profile (General Use)) | Condition or observation that supports why the prescription is being written
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest Profile | ServiceRequest | ImmunizationRecommendation Profile) | 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 | S Σ | 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 | Σ | 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 | Σ | 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] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
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(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest |  | 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(4.0.1) | 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 |  | 0..1 | unsignedInt | Number of refills authorized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization Profile) | 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 Profile) | 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 | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | preferred | https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct | Not Stated | Unknown
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v6.5
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v6.5

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

This structure is derived from MedicationRequest

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

- Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
- Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
- PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
- Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
- Medication Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication)
- Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
- Device Profile (Implantable) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device)
- Condition Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-condition)
- Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)
- MedicationRequest Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest)
- ImmunizationRecommendation Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-immunizationrecommendation)

Other representations of profile: CSV, Excel, Schematron