QI-Core Implementation Guide
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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

Resource Profile: QICore MedicationRequest

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Version: 6.0.0
Active as of 2018-08-22 Computable Name: QICoreMedicationRequest

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

Usage

To create an expression specifically requesting information that a MedicationRequest intentionally did not occur for a medical, patient or system reason, use the profile QICore-Medicationnotrequested.

The following example illustrates the use of the MedicationRequest profile:

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'

See the patterns page for implementation and usage patterns.

Examples

Penicillin MedicationRequest Example
Cumulative Medication Duration Example
Patient Reported MedicationRequest Example
Patient Requested MedicationRequest Example
Practitioner Ordered MedicationRequest Example

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreMedicationRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*USCoreMedicationRequestProfileOrdering of medication for patient or group
dom-7: if doNotPerform is present, it SHALL be false
... status 1..1code(QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
... doNotPerform 0..1boolean(QI-Core) True if medication was not requested
Fixed Value: false
... reported[x] 0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)(QI-Core)(USCDI) Reported rather than primary record
... encounter 0..1Reference(QICore Encounter)(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
... authoredOn 0..1dateTime(QI-Core)(USCDI) When request was initially authored
... requester 0..1Reference(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..1Timing(QI-Core)(USCDI) When medication should be administered
..... repeat 0..1Element(QI-Core) When the event is to occur
...... bounds[x] 0..1Duration, Range, Period(QI-Core) Length/Range of lengths, or (Start and/or end) limits
...... frequency 0..1positiveInt(QI-Core) Event occurs frequency times per period
...... frequencyMax 0..1positiveInt(QI-Core) Event occurs frequencyMax times per period
...... period 0..1decimal(QI-Core) Event occurs frequency times per period
...... periodMax 0..1decimal(QI-Core) Upper limit of period (3-4 hours)
...... periodUnit 0..1code(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
.... asNeeded[x] 0..1boolean, CodeableConcept(QI-Core) Take "as needed" (for x)
.... doseAndRate 0..*Element(QI-Core)(USCDI) Amount of medication administered
..... dose[x] 0..1Quantity, Range(QI-Core)(USCDI) Amount of medication per dose
... dispenseRequest 0..1BackboneElement(QI-Core)(USCDI) Medication supply authorization
.... initialFill 0..0
.... dispenseInterval 0..1Duration(QI-Core) Minimum period of time between dispenses
.... numberOfRepeatsAllowed 0..1unsignedInt(QI-Core)(USCDI) Number of refills authorized
.... quantity 0..1SimpleQuantity(QI-Core)(USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1Duration(QI-Core) Number of days supply per dispense

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
dom-7errorMedicationRequestif doNotPerform is present, it SHALL be false
: doNotPerform.empty() or doNotPerform=false
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C0..*USCoreMedicationRequestProfileOrdering of medication for patient or group
dom-7: if doNotPerform is present, it SHALL be false
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1code(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.

... Slices for category S0..*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 S0..*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 ?!Σ0..1boolean(QI-Core) True if medication was not requested
Fixed Value: false
... reported[x] SΣ0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)(QI-Core)(USCDI) Reported rather than primary record
... medication[x] SΣ1..1(USCDI) Medication to be taken
Binding: Medication Clinical Drug (extensible)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(US Core Medication Profile)
... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who or group medication request is for
... encounter S0..1Reference(QICore Encounter)(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
... authoredOn SΣ0..1dateTime(QI-Core)(USCDI) When request was initially authored
... requester SΣC0..1Reference(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 S0..*Dosage(QI-Core)(USCDI) How medication should be taken
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text SΣ0..1string(USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ0..1Timing(QI-Core)(USCDI) When medication should be administered
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... repeat ΣC0..1Element(QI-Core) When the event is to occur
...... bounds[x] Σ0..1(QI-Core) Length/Range of lengths, or (Start and/or end) limits
....... boundsDurationDuration
....... boundsRangeRange
....... boundsPeriodPeriod
...... frequency Σ0..1positiveInt(QI-Core) Event occurs frequency times per period
...... frequencyMax Σ0..1positiveInt(QI-Core) Event occurs frequencyMax times per period
...... period Σ0..1decimal(QI-Core) Event occurs frequency times per period
...... periodMax Σ0..1decimal(QI-Core) Upper limit of period (3-4 hours)
...... periodUnit Σ0..1code(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] Σ0..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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... doseAndRate SΣ0..*Element(QI-Core)(USCDI) Amount of medication administered
..... dose[x] SΣ0..1(QI-Core)(USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodesMax Binding
...... doseQuantityQuantity
... dispenseRequest S0..1BackboneElement(QI-Core)(USCDI) Medication supply authorization
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... dispenseInterval 0..1Duration(QI-Core) Minimum period of time between dispenses
.... numberOfRepeatsAllowed S0..1unsignedInt(QI-Core)(USCDI) Number of refills authorized
.... quantity S0..1SimpleQuantity(QI-Core)(USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1Duration(QI-Core) Number of days supply per dispense

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
dom-7errorMedicationRequestif doNotPerform is present, it SHALL be false
: doNotPerform.empty() or doNotPerform=false
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf 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-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()
us-core-21errorMedicationRequestrequester 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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C0..*USCoreMedicationRequestProfileOrdering of medication for patient or group
dom-7: if doNotPerform is present, it SHALL be false
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal ids for this request
... status ?!SΣ1..1code(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..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣC1..1code(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 S0..*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 S0..*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 Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ0..1boolean(QI-Core) True if medication was not requested
Fixed Value: false
... reported[x] SΣ0..1Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)(QI-Core)(USCDI) Reported rather than primary record
... medication[x] SΣ1..1(USCDI) Medication to be taken
Binding: Medication Clinical Drug (extensible)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(US Core Medication Profile)
... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who or group medication request is for
... encounter S0..1Reference(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 SΣ0..1dateTime(QI-Core)(USCDI) When request was initially authored
... requester SΣC0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)(QI-Core)(USCDI) Who/What requested the Request
... performer 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)Intended performer of administration
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1Reference(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 Σ0..*canonical()Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... courseOfTherapyType 0..1CodeableConceptOverall 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..*AnnotationInformation about the prescription
... dosageInstruction S0..*Dosage(QI-Core)(USCDI) How medication should be taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1string(USCDI) Free text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental 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 Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1Timing(QI-Core)(USCDI) When medication should be administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... event Σ0..*dateTimeWhen the event occurs
..... repeat ΣC0..1Element(QI-Core) When the event is to occur
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... bounds[x] Σ0..1(QI-Core) Length/Range of lengths, or (Start and/or end) limits
....... boundsDurationDuration
....... boundsRangeRange
....... boundsPeriodPeriod
...... count Σ0..1positiveIntNumber of times to repeat
...... countMax Σ0..1positiveIntMaximum number of times to repeat
...... duration Σ0..1decimalHow long when it happens
...... durationMax Σ0..1decimalHow long when it happens (Max)
...... durationUnit Σ0..1codes | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... frequency Σ0..1positiveInt(QI-Core) Event occurs frequency times per period
...... frequencyMax Σ0..1positiveInt(QI-Core) Event occurs frequencyMax times per period
...... period Σ0..1decimal(QI-Core) Event occurs frequency times per period
...... periodMax Σ0..1decimal(QI-Core) Upper limit of period (3-4 hours)
...... periodUnit Σ0..1code(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... dayOfWeek Σ0..*codemon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
...... timeOfDay Σ0..*timeTime of day for action
...... when Σ0..*codeCode for time period of occurrence
Binding: EventTiming (required): Real world event relating to the schedule.


...... offset Σ0..1unsignedIntMinutes from event (before or after)
..... code Σ0..1CodeableConceptBID | TID | QID | AM | PM | QD | QOD | +
Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.

.... asNeeded[x] Σ0..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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ0..1CodeableConceptHow 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 Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ0..*Element(QI-Core)(USCDI) Amount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣ0..1(QI-Core)(USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodesMax Binding
...... doseQuantityQuantity S
...... doseRangeRange
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... dispenseRequest S0..1BackboneElement(QI-Core)(USCDI) Medication supply authorization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... dispenseInterval 0..1Duration(QI-Core) Minimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed S0..1unsignedInt(QI-Core)(USCDI) Number of refills authorized
.... quantity S0..1SimpleQuantity(QI-Core)(USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1Duration(QI-Core) Number of days supply per dispense
.... performer 0..1Reference(Organization)Intended dispenser
... substitution 0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy 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..1Reference(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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeekrequiredDaysOfWeek
http://hl7.org/fhir/ValueSet/days-of-week|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.whenrequiredEventTiming
http://hl7.org/fhir/ValueSet/event-timing|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.codepreferredTimingAbbreviation
http://hl7.org/fhir/ValueSet/timing-abbreviation
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
dom-7errorMedicationRequestif doNotPerform is present, it SHALL be false
: doNotPerform.empty() or doNotPerform=false
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf 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-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()
us-core-21errorMedicationRequestrequester SHALL be present if intent is "order"
: (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Differential View

This structure is derived from USCoreMedicationRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest 0..*USCoreMedicationRequestProfileOrdering of medication for patient or group
dom-7: if doNotPerform is present, it SHALL be false
... status 1..1code(QI-Core)(USCDI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
... doNotPerform 0..1boolean(QI-Core) True if medication was not requested
Fixed Value: false
... reported[x] 0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)(QI-Core)(USCDI) Reported rather than primary record
... encounter 0..1Reference(QICore Encounter)(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
... authoredOn 0..1dateTime(QI-Core)(USCDI) When request was initially authored
... requester 0..1Reference(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..1Timing(QI-Core)(USCDI) When medication should be administered
..... repeat 0..1Element(QI-Core) When the event is to occur
...... bounds[x] 0..1Duration, Range, Period(QI-Core) Length/Range of lengths, or (Start and/or end) limits
...... frequency 0..1positiveInt(QI-Core) Event occurs frequency times per period
...... frequencyMax 0..1positiveInt(QI-Core) Event occurs frequencyMax times per period
...... period 0..1decimal(QI-Core) Event occurs frequency times per period
...... periodMax 0..1decimal(QI-Core) Upper limit of period (3-4 hours)
...... periodUnit 0..1code(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
.... asNeeded[x] 0..1boolean, CodeableConcept(QI-Core) Take "as needed" (for x)
.... doseAndRate 0..*Element(QI-Core)(USCDI) Amount of medication administered
..... dose[x] 0..1Quantity, Range(QI-Core)(USCDI) Amount of medication per dose
... dispenseRequest 0..1BackboneElement(QI-Core)(USCDI) Medication supply authorization
.... initialFill 0..0
.... dispenseInterval 0..1Duration(QI-Core) Minimum period of time between dispenses
.... numberOfRepeatsAllowed 0..1unsignedInt(QI-Core)(USCDI) Number of refills authorized
.... quantity 0..1SimpleQuantity(QI-Core)(USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1Duration(QI-Core) Number of days supply per dispense

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
dom-7errorMedicationRequestif doNotPerform is present, it SHALL be false
: doNotPerform.empty() or doNotPerform=false

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C0..*USCoreMedicationRequestProfileOrdering of medication for patient or group
dom-7: if doNotPerform is present, it SHALL be false
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1code(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.

... Slices for category S0..*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 S0..*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 ?!Σ0..1boolean(QI-Core) True if medication was not requested
Fixed Value: false
... reported[x] SΣ0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)(QI-Core)(USCDI) Reported rather than primary record
... medication[x] SΣ1..1(USCDI) Medication to be taken
Binding: Medication Clinical Drug (extensible)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(US Core Medication Profile)
... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who or group medication request is for
... encounter S0..1Reference(QICore Encounter)(QI-Core)(USCDI) Encounter created as part of encounter/admission/stay
... authoredOn SΣ0..1dateTime(QI-Core)(USCDI) When request was initially authored
... requester SΣC0..1Reference(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 S0..*Dosage(QI-Core)(USCDI) How medication should be taken
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... text SΣ0..1string(USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ0..1Timing(QI-Core)(USCDI) When medication should be administered
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... repeat ΣC0..1Element(QI-Core) When the event is to occur
...... bounds[x] Σ0..1(QI-Core) Length/Range of lengths, or (Start and/or end) limits
....... boundsDurationDuration
....... boundsRangeRange
....... boundsPeriodPeriod
...... frequency Σ0..1positiveInt(QI-Core) Event occurs frequency times per period
...... frequencyMax Σ0..1positiveInt(QI-Core) Event occurs frequencyMax times per period
...... period Σ0..1decimal(QI-Core) Event occurs frequency times per period
...... periodMax Σ0..1decimal(QI-Core) Upper limit of period (3-4 hours)
...... periodUnit Σ0..1code(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] Σ0..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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... doseAndRate SΣ0..*Element(QI-Core)(USCDI) Amount of medication administered
..... dose[x] SΣ0..1(QI-Core)(USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodesMax Binding
...... doseQuantityQuantity
... dispenseRequest S0..1BackboneElement(QI-Core)(USCDI) Medication supply authorization
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... dispenseInterval 0..1Duration(QI-Core) Minimum period of time between dispenses
.... numberOfRepeatsAllowed S0..1unsignedInt(QI-Core)(USCDI) Number of refills authorized
.... quantity S0..1SimpleQuantity(QI-Core)(USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1Duration(QI-Core) Number of days supply per dispense

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
dom-7errorMedicationRequestif doNotPerform is present, it SHALL be false
: doNotPerform.empty() or doNotPerform=false
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf 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-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()
us-core-21errorMedicationRequestrequester 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

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationRequest C0..*USCoreMedicationRequestProfileOrdering of medication for patient or group
dom-7: if doNotPerform is present, it SHALL be false
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal ids for this request
... status ?!SΣ1..1code(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..1CodeableConceptReason for current status
Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.

... intent ?!SΣC1..1code(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 S0..*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 S0..*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 Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!Σ0..1boolean(QI-Core) True if medication was not requested
Fixed Value: false
... reported[x] SΣ0..1Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson)(QI-Core)(USCDI) Reported rather than primary record
... medication[x] SΣ1..1(USCDI) Medication to be taken
Binding: Medication Clinical Drug (extensible)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(US Core Medication Profile)
... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who or group medication request is for
... encounter S0..1Reference(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 SΣ0..1dateTime(QI-Core)(USCDI) When request was initially authored
... requester SΣC0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient)(QI-Core)(USCDI) Who/What requested the Request
... performer 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)Intended performer of administration
... performerType Σ0..1CodeableConceptDesired kind of performer of the medication administration
Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.

... recorder 0..1Reference(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 Σ0..*canonical()Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)What request fulfills
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... courseOfTherapyType 0..1CodeableConceptOverall 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..*AnnotationInformation about the prescription
... dosageInstruction S0..*Dosage(QI-Core)(USCDI) How medication should be taken
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1string(USCDI) Free text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental 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 Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1Timing(QI-Core)(USCDI) When medication should be administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... event Σ0..*dateTimeWhen the event occurs
..... repeat ΣC0..1Element(QI-Core) When the event is to occur
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... bounds[x] Σ0..1(QI-Core) Length/Range of lengths, or (Start and/or end) limits
....... boundsDurationDuration
....... boundsRangeRange
....... boundsPeriodPeriod
...... count Σ0..1positiveIntNumber of times to repeat
...... countMax Σ0..1positiveIntMaximum number of times to repeat
...... duration Σ0..1decimalHow long when it happens
...... durationMax Σ0..1decimalHow long when it happens (Max)
...... durationUnit Σ0..1codes | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... frequency Σ0..1positiveInt(QI-Core) Event occurs frequency times per period
...... frequencyMax Σ0..1positiveInt(QI-Core) Event occurs frequencyMax times per period
...... period Σ0..1decimal(QI-Core) Event occurs frequency times per period
...... periodMax Σ0..1decimal(QI-Core) Upper limit of period (3-4 hours)
...... periodUnit Σ0..1code(QI-Core) s | min | h | d | wk | mo | a - unit of time (UCUM)
Binding: UnitsOfTime (required): A unit of time (units from UCUM).

...... dayOfWeek Σ0..*codemon | tue | wed | thu | fri | sat | sun
Binding: DaysOfWeek (required)
...... timeOfDay Σ0..*timeTime of day for action
...... when Σ0..*codeCode for time period of occurrence
Binding: EventTiming (required): Real world event relating to the schedule.


...... offset Σ0..1unsignedIntMinutes from event (before or after)
..... code Σ0..1CodeableConceptBID | TID | QID | AM | PM | QD | QOD | +
Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.

.... asNeeded[x] Σ0..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.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ0..1CodeableConceptHow 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 Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ0..*Element(QI-Core)(USCDI) Amount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣ0..1(QI-Core)(USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodesMax Binding
...... doseQuantityQuantity S
...... doseRangeRange
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... dispenseRequest S0..1BackboneElement(QI-Core)(USCDI) Medication supply authorization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... dispenseInterval 0..1Duration(QI-Core) Minimum period of time between dispenses
.... validityPeriod 0..1PeriodTime period supply is authorized for
.... numberOfRepeatsAllowed S0..1unsignedInt(QI-Core)(USCDI) Number of refills authorized
.... quantity S0..1SimpleQuantity(QI-Core)(USCDI) Amount of medication to supply per dispense
.... expectedSupplyDuration 0..1Duration(QI-Core) Number of days supply per dispense
.... performer 0..1Reference(Organization)Intended dispenser
... substitution 0..1BackboneElementAny restrictions on medication substitution
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... allowed[x] 1..1Whether substitution is allowed or not
Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.

..... allowedBooleanboolean
..... allowedCodeableConceptCodeableConcept
.... reason 0..1CodeableConceptWhy 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..1Reference(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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
MedicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
MedicationRequest.statusrequiredmedicationrequest Status
http://hl7.org/fhir/ValueSet/medicationrequest-status
from the FHIR Standard
MedicationRequest.statusReasonexamplemedicationRequest Status Reason Codes
http://hl7.org/fhir/ValueSet/medicationrequest-status-reason
from the FHIR Standard
MedicationRequest.intentrequiredmedicationRequest Intent
http://hl7.org/fhir/ValueSet/medicationrequest-intent
from the FHIR Standard
MedicationRequest.categoryexamplemedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.category:us-corerequiredmedicationRequest Category Codes
http://hl7.org/fhir/ValueSet/medicationrequest-category
from the FHIR Standard
MedicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
MedicationRequest.medication[x]extensibleMedicationClinicalDrug
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4
MedicationRequest.performerTypeexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
MedicationRequest.reasonCodeextensibleUSCoreConditionCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyTypeexamplemedicationRequest Course of Therapy Codes
http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
http://hl7.org/fhir/ValueSet/additional-instruction-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.durationUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.periodUnitrequiredUnitsOfTime
http://hl7.org/fhir/ValueSet/units-of-time|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.dayOfWeekrequiredDaysOfWeek
http://hl7.org/fhir/ValueSet/days-of-week|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.repeat.whenrequiredEventTiming
http://hl7.org/fhir/ValueSet/event-timing|4.0.1
from the FHIR Standard
MedicationRequest.dosageInstruction.timing.codepreferredTimingAbbreviation
http://hl7.org/fhir/ValueSet/timing-abbreviation
from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
MedicationRequest.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
http://hl7.org/fhir/ValueSet/approach-site-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.routeexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
http://hl7.org/fhir/ValueSet/administration-method-codes
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
http://hl7.org/fhir/ValueSet/dose-rate-type
from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]preferredCommon UCUM units
Additional Bindings Purpose
UCUMCodes Max Binding
http://hl7.org/fhir/ValueSet/ucum-common
from the FHIR Standard
MedicationRequest.substitution.allowed[x]exampleActSubstanceAdminSubstitutionCode
http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reasonexampleSubstanceAdminSubstitutionReason
http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationRequestIf 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-4errorMedicationRequestIf 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-5errorMedicationRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationRequestA resource should have narrative for robust management
: text.`div`.exists()
dom-7errorMedicationRequestif doNotPerform is present, it SHALL be false
: doNotPerform.empty() or doNotPerform=false
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
tim-1errorMedicationRequest.dosageInstruction.timing.repeatif there's a duration, there needs to be duration units
: duration.empty() or durationUnit.exists()
tim-2errorMedicationRequest.dosageInstruction.timing.repeatif there's a period, there needs to be period units
: period.empty() or periodUnit.exists()
tim-4errorMedicationRequest.dosageInstruction.timing.repeatduration SHALL be a non-negative value
: duration.exists() implies duration >= 0
tim-5errorMedicationRequest.dosageInstruction.timing.repeatperiod SHALL be a non-negative value
: period.exists() implies period >= 0
tim-6errorMedicationRequest.dosageInstruction.timing.repeatIf there's a periodMax, there must be a period
: periodMax.empty() or period.exists()
tim-7errorMedicationRequest.dosageInstruction.timing.repeatIf there's a durationMax, there must be a duration
: durationMax.empty() or duration.exists()
tim-8errorMedicationRequest.dosageInstruction.timing.repeatIf there's a countMax, there must be a count
: countMax.empty() or count.exists()
tim-9errorMedicationRequest.dosageInstruction.timing.repeatIf 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-10errorMedicationRequest.dosageInstruction.timing.repeatIf there's a timeOfDay, there cannot be a when, or vice versa
: timeOfDay.empty() or when.empty()
us-core-21errorMedicationRequestrequester 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()

 

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