QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

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Resource Profile: QICore MedicationRequest

Profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

define "Antithrombotic Therapy at Discharge":
  ["MedicationRequest": medication in "Antithrombotic Therapy"] Antithrombotic
    where (Antithrombotic.isCommunity() or Antithrombotic.isDischarge())
      and Antithrombotic.status in { 'active', 'completed' }
      and Antithrombotic.intent = 'order'

Usage:

• Refer to this Resource Profile: QICore Claim, QICore DiagnosticReport Profile for Laboratory Results Reporting, QICore MedicationAdministration, QICore MedicationAdministration Not Done... Show 2 more, QICore MedicationDispense and QICore MedicationDispense Declined
• Examples for this Resource Profile: MedicationRequest/cmd-example, MedicationRequest/example, MedicationRequest/patient-reported-example, MedicationRequest/patient-requester-example and MedicationRequest/practitioner-ordered-example

Formal Views of Profile Content

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

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

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group dom-7: if doNotPerform is present, it SHALL be false
status		1..1	code	(QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
doNotPerform		0..1	boolean	(QI-Core) True if medication was not requested Fixed Value: false
reported[x]		0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(QI-Core)(USCDI) Reported rather than primary record
subject		1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who or group medication request is for
encounter		0..1	Reference(QICore Encounter)	(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
authoredOn		0..1	dateTime	(QI-Core)(USCDI) When request was initially authored
requester		0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) Who/What requested the Request
reasonCode		0..*	CodeableConcept	(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
reasonReference		0..*	Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation)	(QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
dosageInstruction		0..*	Dosage	(QI-Core)(USCDI) How medication should be taken
timing		0..1	Timing	(QI-Core)(USCDI) When medication should be administered
repeat		0..1	Element	(QI-Core) When the event is to occur
bounds[x]		0..1	Duration, Range, Period	(QI-Core) Length/Range of lengths, or (Start and/or end) limits
frequency		0..1	positiveInt	(QI-Core) Event occurs frequency times per period
frequencyMax		0..1	positiveInt	(QI-Core) Event occurs frequencyMax times per period
period		0..1	decimal	(QI-Core) Event occurs frequency times per period
periodMax		0..1	decimal	(QI-Core) Upper limit of period (3-4 hours)
periodUnit		0..1	code	(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
asNeeded[x]		0..1	boolean, CodeableConcept	(QI-Core) Take "as needed" (for x)
doseAndRate		0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]		0..1	Quantity, Range	(QI-Core)(USCDI) Amount of medication per dose
dispenseRequest		0..1	BackboneElement	(QI-Core)(USCDI) Medication supply authorization
initialFill		0..0
dispenseInterval		0..1	Duration	(QI-Core) Minimum period of time between dispenses
numberOfRepeatsAllowed		0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized
quantity		0..1	SimpleQuantity	(QI-Core)(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	(QI-Core) Number of days supply per dispense
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-7	error	MedicationRequest	if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order" dom-7: if doNotPerform is present, it SHALL be false
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(QI-Core)(USCDI) 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	(USCDI) 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	(USCDI) 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	(USCDI) 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	(QI-Core) True if medication was not requested Fixed Value: false
reported[x]	SΣ	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(QI-Core)(USCDI) Reported rather than primary record
medication[x]	SΣ	1..1		(USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(QICore Encounter)	(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	(QI-Core)(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) Who/What requested the Request
reasonCode		0..*	CodeableConcept	(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation)	(QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	(QI-Core)(USCDI) How medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(QI-Core)(USCDI) When medication should be administered
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
repeat	ΣC	0..1	Element	(QI-Core) When the event is to occur tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
bounds[x]	Σ	0..1		(QI-Core) Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
frequency	Σ	0..1	positiveInt	(QI-Core) Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	(QI-Core) Event occurs frequencyMax times per period
period	Σ	0..1	decimal	(QI-Core) Event occurs frequency times per period
periodMax	Σ	0..1	decimal	(QI-Core) Upper limit of period (3-4 hours)
periodUnit	Σ	0..1	code	(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
asNeeded[x]	Σ	0..1		(QI-Core) 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
doseAndRate	SΣ	0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
dispenseRequest	S	0..1	BackboneElement	(QI-Core)(USCDI) Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dispenseInterval		0..1	Duration	(QI-Core) Minimum period of time between dispenses
numberOfRepeatsAllowed	S	0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(QI-Core)(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	(QI-Core) Number of days supply per dispense
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

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()
dom-7	error	MedicationRequest	if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false
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()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()
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..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order" dom-7: if doNotPerform is present, it SHALL be false
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
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	?!SΣ	1..1	code	(QI-Core)(USCDI) 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	(USCDI) 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	(USCDI) 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	(USCDI) 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	(QI-Core) True if medication was not requested Fixed Value: false
reported[x]	SΣ	0..1	Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(QI-Core)(USCDI) Reported rather than primary record
medication[x]	SΣ	1..1		(USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(QICore Encounter)	(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	(QI-Core)(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) 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	(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation)	(QI-Core)(USCDI) QI-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	(QI-Core)(USCDI) How 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	(USCDI) 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	(QI-Core)(USCDI) When medication should be 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
event	Σ	0..*	dateTime	When the event occurs
repeat	ΣC	0..1	Element	(QI-Core) When the event is to occur tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x]	Σ	0..1		(QI-Core) Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
count	Σ	0..1	positiveInt	Number of times to repeat
countMax	Σ	0..1	positiveInt	Maximum number of times to repeat
duration	Σ	0..1	decimal	How long when it happens
durationMax	Σ	0..1	decimal	How long when it happens (Max)
durationUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	Σ	0..1	positiveInt	(QI-Core) Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	(QI-Core) Event occurs frequencyMax times per period
period	Σ	0..1	decimal	(QI-Core) Event occurs frequency times per period
periodMax	Σ	0..1	decimal	(QI-Core) Upper limit of period (3-4 hours)
periodUnit	Σ	0..1	code	(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	Σ	0..*	time	Time of day for action
when	Σ	0..*	code	Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset	Σ	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x]	Σ	0..1		(QI-Core) 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	(QI-Core)(USCDI) 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		(QI-Core)(USCDI) 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	(QI-Core)(USCDI) 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
dispenseInterval		0..1	Duration	(QI-Core) Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed	S	0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(QI-Core)(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	(QI-Core) 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	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	required	DaysOfWeek http://hl7.org/fhir/ValueSet/days-of-week|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	TimingAbbreviation http://hl7.org/fhir/ValueSet/timing-abbreviation from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-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()
dom-7	error	MedicationRequest	if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false
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()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()
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 USCoreMedicationRequestProfile

Summary

Fixed Value: 1 element
Prohibited: 1 element

Structures

This structure refers to these other structures:

• QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
• QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
• QICore Encounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)
• QICore Condition Encounter Diagnosis (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis)
• QICore Condition Problems Health Concerns (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns)
• QICore Simple Observation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation)

Differential View

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group dom-7: if doNotPerform is present, it SHALL be false
status		1..1	code	(QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
doNotPerform		0..1	boolean	(QI-Core) True if medication was not requested Fixed Value: false
reported[x]		0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(QI-Core)(USCDI) Reported rather than primary record
subject		1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who or group medication request is for
encounter		0..1	Reference(QICore Encounter)	(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
authoredOn		0..1	dateTime	(QI-Core)(USCDI) When request was initially authored
requester		0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) Who/What requested the Request
reasonCode		0..*	CodeableConcept	(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication
reasonReference		0..*	Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation)	(QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
dosageInstruction		0..*	Dosage	(QI-Core)(USCDI) How medication should be taken
timing		0..1	Timing	(QI-Core)(USCDI) When medication should be administered
repeat		0..1	Element	(QI-Core) When the event is to occur
bounds[x]		0..1	Duration, Range, Period	(QI-Core) Length/Range of lengths, or (Start and/or end) limits
frequency		0..1	positiveInt	(QI-Core) Event occurs frequency times per period
frequencyMax		0..1	positiveInt	(QI-Core) Event occurs frequencyMax times per period
period		0..1	decimal	(QI-Core) Event occurs frequency times per period
periodMax		0..1	decimal	(QI-Core) Upper limit of period (3-4 hours)
periodUnit		0..1	code	(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
asNeeded[x]		0..1	boolean, CodeableConcept	(QI-Core) Take "as needed" (for x)
doseAndRate		0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]		0..1	Quantity, Range	(QI-Core)(USCDI) Amount of medication per dose
dispenseRequest		0..1	BackboneElement	(QI-Core)(USCDI) Medication supply authorization
initialFill		0..0
dispenseInterval		0..1	Duration	(QI-Core) Minimum period of time between dispenses
numberOfRepeatsAllowed		0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized
quantity		0..1	SimpleQuantity	(QI-Core)(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	(QI-Core) Number of days supply per dispense
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-7	error	MedicationRequest	if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order" dom-7: if doNotPerform is present, it SHALL be false
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(QI-Core)(USCDI) 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	(USCDI) 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	(USCDI) 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	(USCDI) 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	(QI-Core) True if medication was not requested Fixed Value: false
reported[x]	SΣ	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(QI-Core)(USCDI) Reported rather than primary record
medication[x]	SΣ	1..1		(USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(QICore Encounter)	(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	(QI-Core)(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) Who/What requested the Request
reasonCode		0..*	CodeableConcept	(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation)	(QI-Core)(USCDI) QI-Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	(QI-Core)(USCDI) How medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(QI-Core)(USCDI) When medication should be administered
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
repeat	ΣC	0..1	Element	(QI-Core) When the event is to occur tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
bounds[x]	Σ	0..1		(QI-Core) Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
frequency	Σ	0..1	positiveInt	(QI-Core) Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	(QI-Core) Event occurs frequencyMax times per period
period	Σ	0..1	decimal	(QI-Core) Event occurs frequency times per period
periodMax	Σ	0..1	decimal	(QI-Core) Upper limit of period (3-4 hours)
periodUnit	Σ	0..1	code	(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
asNeeded[x]	Σ	0..1		(QI-Core) 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
doseAndRate	SΣ	0..*	Element	(QI-Core)(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(QI-Core)(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
dispenseRequest	S	0..1	BackboneElement	(QI-Core)(USCDI) Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dispenseInterval		0..1	Duration	(QI-Core) Minimum period of time between dispenses
numberOfRepeatsAllowed	S	0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(QI-Core)(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	(QI-Core) Number of days supply per dispense
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

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()
dom-7	error	MedicationRequest	if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false
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()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()
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..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order" dom-7: if doNotPerform is present, it SHALL be false
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
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	?!SΣ	1..1	code	(QI-Core)(USCDI) 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	(USCDI) 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	(USCDI) 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	(USCDI) 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	(QI-Core) True if medication was not requested Fixed Value: false
reported[x]	SΣ	0..1	Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)	(QI-Core)(USCDI) Reported rather than primary record
medication[x]	SΣ	1..1		(USCDI) Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(QICore Patient)	(QI-Core)(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(QICore Encounter)	(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	(QI-Core)(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)	(QI-Core)(USCDI) 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	(QI-Core)(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference		0..*	Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation)	(QI-Core)(USCDI) QI-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	(QI-Core)(USCDI) How 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	(USCDI) 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	(QI-Core)(USCDI) When medication should be 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
event	Σ	0..*	dateTime	When the event occurs
repeat	ΣC	0..1	Element	(QI-Core) When the event is to occur tim-1: if there's a duration, there needs to be duration units tim-2: if there's a period, there needs to be period units tim-4: duration SHALL be a non-negative value tim-5: period SHALL be a non-negative value tim-6: If there's a periodMax, there must be a period tim-7: If there's a durationMax, there must be a duration tim-8: If there's a countMax, there must be a count tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x]	Σ	0..1		(QI-Core) Length/Range of lengths, or (Start and/or end) limits
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
count	Σ	0..1	positiveInt	Number of times to repeat
countMax	Σ	0..1	positiveInt	Maximum number of times to repeat
duration	Σ	0..1	decimal	How long when it happens
durationMax	Σ	0..1	decimal	How long when it happens (Max)
durationUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	Σ	0..1	positiveInt	(QI-Core) Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	(QI-Core) Event occurs frequencyMax times per period
period	Σ	0..1	decimal	(QI-Core) Event occurs frequency times per period
periodMax	Σ	0..1	decimal	(QI-Core) Upper limit of period (3-4 hours)
periodUnit	Σ	0..1	code	(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	Σ	0..*	time	Time of day for action
when	Σ	0..*	code	Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset	Σ	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x]	Σ	0..1		(QI-Core) 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	(QI-Core)(USCDI) 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		(QI-Core)(USCDI) 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	(QI-Core)(USCDI) 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
dispenseInterval		0..1	Duration	(QI-Core) Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed	S	0..1	unsignedInt	(QI-Core)(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(QI-Core)(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	(QI-Core) 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	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnit	required	UnitsOfTime http://hl7.org/fhir/ValueSet/units-of-time|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek	required	DaysOfWeek http://hl7.org/fhir/ValueSet/days-of-week|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.when	required	EventTiming http://hl7.org/fhir/ValueSet/event-timing|4.0.1 from the FHIR Standard
MedicationRequest.dosageInstruction.timing.code	preferred	TimingAbbreviation http://hl7.org/fhir/ValueSet/timing-abbreviation from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-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()
dom-7	error	MedicationRequest	if doNotPerform is present, it SHALL be false : doNotPerform.empty() or doNotPerform=false
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()
tim-1	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a duration, there needs to be duration units : duration.empty() or durationUnit.exists()
tim-2	error	MedicationRequest.dosageInstruction.timing.repeat	if there's a period, there needs to be period units : period.empty() or periodUnit.exists()
tim-4	error	MedicationRequest.dosageInstruction.timing.repeat	duration SHALL be a non-negative value : duration.exists() implies duration >= 0
tim-5	error	MedicationRequest.dosageInstruction.timing.repeat	period SHALL be a non-negative value : period.exists() implies period >= 0
tim-6	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a periodMax, there must be a period : periodMax.empty() or period.exists()
tim-7	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a durationMax, there must be a duration : durationMax.empty() or duration.exists()
tim-8	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a countMax, there must be a count : countMax.empty() or count.exists()
tim-9	error	MedicationRequest.dosageInstruction.timing.repeat	If there's an offset, there must be a when (and not C, CM, CD, CV) : offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10	error	MedicationRequest.dosageInstruction.timing.repeat	If there's a timeOfDay, there cannot be a when, or vice versa : timeOfDay.empty() or when.empty()
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 USCoreMedicationRequestProfile

Summary

Fixed Value: 1 element
Prohibited: 1 element

Structures

This structure refers to these other structures:

• QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
• QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
• QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
• QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
• QICore Encounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)
• QICore Condition Encounter Diagnosis (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis)
• QICore Condition Problems Health Concerns (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns)
• QICore Simple Observation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation)

Other representations of profile: CSV, Excel, Schematron