## Profile Comparison between http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest vs http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest

Left: | QICore MedicationRequest (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest)
Right: | QICore MedicationRequest (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest)

### Messages

Error | StructureDefinition.version | Values for version differ: '8.0.0-ballot' vs '7.0.2'
Information | MedicationRequest.dosageInstruction.timing.code | Example/preferred bindings differ at MedicationRequest.dosageInstruction.timing.code using binding from QICoreMedicationRequest
Warning | MedicationRequest.dosageInstruction.route | Elements differ in definition for mustSupport: 'true' vs 'false'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest |
copyright |  |
date | 2018-08-22 |
description | Profile of MedicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. |
experimental | false |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | QICoreMedicationRequest |
publisher | HL7 International / Clinical Quality Information |
purpose |  |
status | active |
title | QICore MedicationRequest |
type | MedicationRequest |
url | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest |
version | 8.0.0-ballot | 7.0.2 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group Constraints: mrq-1 | C | 0..* | USCoreMedicationRequestProfile | Ordering of medication for patient or group Constraints: mrq-1 |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..* | Resource | Contained, inline Resources |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier |  | 0..* | Identifier | External ids for this request |  | 0..* | Identifier | External ids for this request |
status | ?!S Σ | 1..1 | code | (QI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. | ?!S Σ | 1..1 | code | (QI) active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: ?? (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: ?? (example): Identifies the reasons for a given status. |  | 0..1 | CodeableConcept | Reason for current status Binding: ?? (example): Identifies the reasons for a given status. |
intent | ?!S Σ C | 1..1 | code | (QI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. | ?!S Σ C | 1..1 | code | (QI) proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of medication order. |
Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by value:$this Binding: ?? (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: ?? (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. |
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. |
doNotPerform | ?!Σ | 0..1 | boolean | (QI) True if the order is not to provide the medication | ?!Σ | 0..1 | boolean | (QI) True if the order is not to provide the medication |
reported[x] | S Σ | 0..1 | boolean S, Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) | (QI) Reported rather than primary record | S Σ | 0..1 | boolean S, Reference S(QICore Practitioner | QICore PractitionerRole | QICore Patient | QICore RelatedPerson) | (QI) Reported rather than primary record |
medication[x] | S Σ C | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | (QI) Medication to be taken Binding: ?? (preferred) | S Σ C | 1..1 | CodeableConcept, Reference(US Core Medication Profile) | (QI) Medication to be taken Binding: ?? (preferred) |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) Who or group medication request is for | S Σ | 1..1 | Reference(QICore Patient) | (QI) Who or group medication request is for |
encounter | S | 0..1 | Reference(QICore Encounter) | (QI) Encounter created as part of encounter/admission/stay | S | 0..1 | Reference(QICore Encounter) | (QI) Encounter created as part of encounter/admission/stay |
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication |  | 0..* | Reference(Resource) | Information to support ordering of the medication |
authoredOn | S Σ | 0..1 | dateTime | (QI) When request was initially authored | S Σ | 0..1 | dateTime | (QI) When request was initially authored |
requester | S Σ C | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) | (QI) Who/What requested the Request | S Σ C | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Patient) | (QI) Who/What requested the Request |
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration |  | 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: ?? (example): Identifies the type of individual that is desired to administer the medication. | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ?? (example): Identifies the type of individual that is desired to administer the medication. |
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request |
reasonCode |  | 0..* | CodeableConcept | (QI) Reason or indication for ordering or not ordering the medication Binding: ?? (extensible) |  | 0..* | CodeableConcept | (QI) Reason or indication for ordering or not ordering the medication Binding: ?? (extensible) |
reasonReference |  | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (QI) QI-Core Condition or Observation that supports the prescription |  | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Simple Observation) | (QI) QI-Core Condition or Observation that supports the prescription |
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills |
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | Σ | 0..1 | Identifier | Composite request this is part of |
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio. |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: ?? (example): Identifies the overall pattern of medication administratio. |
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage |
note |  | 0..* | Annotation | Information about the prescription |  | 0..* | Annotation | Information about the prescription |
dosageInstruction | S | 0..* | Dosage | (QI) How medication should be taken | S | 0..* | Dosage | (QI) How medication should be taken |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 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 | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence | Σ | 0..1 | integer | The order of the dosage instructions | Σ | 0..1 | integer | The order of the dosage instructions |
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG |
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: ?? (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 | Σ | 0..1 | string | Patient or consumer oriented instructions |
timing | S Σ | 0..1 | Timing | (QI) When medication should be administered | S Σ | 0..1 | Timing | (QI) When medication should be administered |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 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 | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
event | Σ | 0..* | dateTime | When the event occurs | Σ | 0..* | dateTime | When the event occurs |
repeat | Σ C | 0..1 | Element | (QI) When the event is to occur | Σ C | 0..1 | Element | (QI) When the event is to occur |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
bounds[x] | Σ | 0..1 | Duration, Range, Period | (QI) Length/Range of lengths, or (Start and/or end) limits | Σ | 0..1 | Duration, Range, Period | (QI) Length/Range of lengths, or (Start and/or end) limits |
count | Σ | 0..1 | positiveInt | Number of times to repeat | Σ | 0..1 | positiveInt | Number of times to repeat |
countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat | Σ | 0..1 | positiveInt | Maximum number of times to repeat |
duration | Σ | 0..1 | decimal | How long when it happens | Σ | 0..1 | decimal | How long when it happens |
durationMax | Σ | 0..1 | decimal | How long when it happens (Max) | 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: ?? (required): A unit of time (units from UCUM). | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: ?? (required): A unit of time (units from UCUM). |
frequency | Σ | 0..1 | positiveInt | (QI) Event occurs frequency times per period | Σ | 0..1 | positiveInt | (QI) Event occurs frequency times per period |
frequencyMax | Σ | 0..1 | positiveInt | (QI) Event occurs frequencyMax times per period | Σ | 0..1 | positiveInt | (QI) Event occurs frequencyMax times per period |
period | Σ | 0..1 | decimal | (QI) Event occurs frequency times per period | Σ | 0..1 | decimal | (QI) Event occurs frequency times per period |
periodMax | Σ | 0..1 | decimal | (QI) Upper limit of period (3-4 hours) | Σ | 0..1 | decimal | (QI) Upper limit of period (3-4 hours) |
periodUnit | Σ | 0..1 | code | (QI) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: ?? (required): A unit of time (units from UCUM). | Σ | 0..1 | code | (QI) s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: ?? (required): A unit of time (units from UCUM). |
dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: ?? (required) | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: ?? (required) |
timeOfDay | Σ | 0..* | time | Time of day for action | Σ | 0..* | time | Time of day for action |
when | Σ | 0..* | code | Code for time period of occurrence Binding: ?? (required): Real world event relating to the schedule. | Σ | 0..* | code | Code for time period of occurrence Binding: ?? (required): Real world event relating to the schedule. |
offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after) | Σ | 0..1 | unsignedInt | Minutes from event (before or after) |
code | Σ | 0..1 | CodeableConcept | BID | TID | QID | AM | PM | QD | QOD | + Binding: ?? (preferred): Code for a known / defined timing pattern. | Σ | 0..1 | CodeableConcept | BID | TID | QID | AM | PM | QD | QOD | + Binding: ?? (preferred): Code for a known / defined timing pattern. | Example/preferred bindings differ at MedicationRequest.dosageInstruction.timing.code using binding from QICoreMedicationRequest
asNeeded[x] | Σ | 0..1 | boolean, CodeableConcept | (QI) Take "as needed" (for x) Binding: ?? (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. | Σ | 0..1 | boolean, CodeableConcept | (QI) Take "as needed" (for x) Binding: ?? (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. |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: ?? (example): A coded concept describing the site location the medicine enters into or onto the body. |
route | S Σ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (extensible): SNOMED CT and NCI Thesaurus SPL route of administration codes | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: ?? (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. | Elements differ in definition for mustSupport: 'true' vs 'false'
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: ?? (example): A coded concept describing the technique by which the medicine is administered. |
doseAndRate | S Σ | 0..* | Element | (QI) Amount of medication administered | S Σ | 0..* | Element | (QI) Amount of medication administered |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 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: ?? (example): The kind of dose or rate specified. | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: ?? (example): The kind of dose or rate specified. |
dose[x] | S Σ | 0..1 | ??, Range | (QI) Amount of medication per dose Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
| S Σ | 0..1 | ??, Range | (QI) Amount of medication per dose Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Max Binding
rate[x] | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time | Σ | 0..1 | Ratio, Range, ?? | Amount of medication per unit of time |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time | Σ | 0..1 | Ratio | Upper limit on medication per unit of time |
maxDosePerAdministration | Σ | 0..1 | ?? | Upper limit on medication per administration | Σ | 0..1 | ?? | Upper limit on medication per administration |
maxDosePerLifetime | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient | Σ | 0..1 | ?? | Upper limit on medication per lifetime of the patient |
dispenseRequest | S | 0..1 | BackboneElement | (QI) Medication supply authorization | S | 0..1 | BackboneElement | (QI) Medication supply authorization |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
initialFill |  | 0..0 |  | First fill details |  | 0..0 |  | First fill details |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
quantity |  | 0..1 | ?? | First fill quantity |  | 0..1 | ?? | First fill quantity |
duration |  | 0..1 | Duration | First fill duration |  | 0..1 | Duration | First fill duration |
dispenseInterval |  | 0..1 | Duration | (QI) Minimum period of time between dispenses |  | 0..1 | Duration | (QI) Minimum period of time between dispenses |
validityPeriod |  | 0..1 | Period | (QI) Time period supply is authorized for |  | 0..1 | Period | (QI) Time period supply is authorized for |
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | (QI) Number of refills authorized | S | 0..1 | unsignedInt | (QI) Number of refills authorized |
quantity | S | 0..1 | ?? | (QI) Amount of medication to supply per dispense | S | 0..1 | ?? | (QI) Amount of medication to supply per dispense |
expectedSupplyDuration |  | 0..1 | Duration | (QI) Number of days supply per dispense |  | 0..1 | Duration | (QI) Number of days supply per dispense |
performer |  | 0..1 | Reference(Organization) | Intended dispenser |  | 0..1 | Reference(Organization) | Intended dispenser |
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
allowed[x] |  | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed. |  | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Binding: ?? (example): Identifies the type of substitution allowed. |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: ?? (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: ?? (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 |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced |
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action |
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle |
Documentation for this format