CHMED Implementation Guide, published by IG eMediplan. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ahdis/chmed/ and changes regularly. See the Directory of published versions

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Resource Profile: CHMED MedicationRequest

Profile for the MedicationRequest resource of the Medication Prescription document

Usage:

• Use this Resource Profile: CHMED Medication Prescription document
• Refer to this Resource Profile: CHMED Medication Prescription Composition
• Examples for this Resource Profile: MedicationRequest/pre1-medicationrequest-antibiotikum

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 CHEMEDMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CHMED MedicationRequest
exts		0..*	(Complex)	CHMED Extension URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
sic		0..1	boolean	CHMED Sic URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic
medication[x]:medicationReference		0..1	Reference(CHMED Medication) {c}	Medicament
subject		1..1	Reference(CHMED Patient (PRE))	The patient
reasonCode
text		0..1	string	Reason for applying the medication (the reason for the medication treatment)
dosageInstruction		1..*	Dosage	Posology
additionalInstruction		0..*	CodeableConcept	Information whether a medicament must be taken relative to a meal
patientInstruction		0..1	string	Application instructions (further information on how to apply the medication, e.g. take before meals)
timing
repeat
Slices for bounds[x]		0..1	Duration, Range, Period	Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Open by type:$this
bounds[x]:boundsPeriod		0..1	Period	Length/Range of lengths, or (Start and/or end) limits
start		0..1	dateTime	From date (start date of medication treatment)
end		0..1	dateTime	To date (end date of medication treatment)
when		0..*	code	Details of the posology
Slices for asNeeded[x]		0..1	boolean, CodeableConcept	Take "as needed" (for x) Slice: Unordered, Open by type:$this
asNeeded[x]:asNeededBoolean		0..1	boolean	Reserve medication (true if in reserve; false otherwise)
route		0..1	CodeableConcept	The route of administration
method		0..1	CodeableConcept	The method of administration
doseAndRate
dose[x]		0..1	Range, SimpleQuantity	The quantity unit
dosageInstruction:baseEntry		1..1	CHEMEDDosageMedicationRequest	CH EMED Dosage (MedicationRequest)
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
dispenseRequest		0..1	BackboneElement	Medication supply authorization
validityPeriod		0..1	Period	How long the prescription is valid
numberOfRepeatsAllowed		0..1	unsignedInt	How often a prescription can be repeated
quantity		0..1	SimpleQuantity	Number of packages to be delivered
substitution
allowed[x]:allowedCodeableConcept		0..1	CodeableConcept	Whether substitution is allowed or not
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CHMED MedicationRequest
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		1..*	Resource	Contained, inline Resources
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
exts		0..*	(Complex)	CHMED Extension URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
sic		0..1	boolean	CHMED Sic URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	0..1	Reference(CHMED Medication) {c}	Medicament
subject	Σ	1..1	Reference(CHMED Patient (PRE))	The patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
reasonCode		0..1	CodeableConcept	Treatment reason Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
text	Σ	0..1	string	Reason for applying the medication (the reason for the medication treatment)
Slices for dosageInstruction		1..*	Dosage	Posology Slice: Unordered, Closed by profile:$this
dosageInstruction:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
additionalInstruction	Σ	0..*	CodeableConcept	Information whether a medicament must be taken relative to a meal Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Application instructions (further information on how to apply the medication, e.g. take before meals)
Slices for asNeeded[x]	Σ	0..1		Take "as needed" (for x) Slice: Unordered, Open by type:$this 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
asNeeded[x]:asNeededBoolean	Σ	0..1	boolean	Reserve medication (true if in reserve; false otherwise)
route	Σ	0..1	CodeableConcept	The route of administration 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	The method of administration Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	CH EMED Dosage (MedicationRequest) ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
dispenseRequest		0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
validityPeriod		0..1	Period	How long the prescription is valid
numberOfRepeatsAllowed		0..1	unsignedInt	How often a prescription can be repeated
quantity		0..1	SimpleQuantity	Number of packages to be delivered
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes 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.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

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CHMED MedicationRequest
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		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
exts		0..*	(Complex)	CHMED Extension URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
sic		0..1	boolean	CHMED Sic URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	0..1	Reference(CHMED Medication) {c}	Medicament
subject	Σ	1..1	Reference(CHMED Patient (PRE))	The patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..1	CodeableConcept	Treatment reason Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Reason for applying the medication (the reason for the medication treatment)
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | 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
Slices for dosageInstruction		1..*	Dosage	Posology Slice: Unordered, Closed by profile:$this
dosageInstruction:All Slices				Content/Rules for all slices
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	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Information whether a medicament must be taken relative to a meal Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Application instructions (further information on how to apply the medication, e.g. take before meals)
timing	Σ	0..1	Timing	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	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
Slices for bounds[x]	Σ	0..1		Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Open by type:$this
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
bounds[x]:boundsPeriod	Σ	0..1	Period	Length/Range of lengths, or (Start and/or end) limits
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	From date (start date of medication treatment)
end	ΣC	0..1	dateTime	To date (end date of medication treatment)
count	Σ	0..1	positiveInt	Number of times to repeat
countMax	Σ	0..1	positiveInt	Maximum number of times to repeat
duration	Σ	0..1	decimal	How long when it happens
durationMax	Σ	0..1	decimal	How long when it happens (Max)
durationUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	Σ	0..1	positiveInt	Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	Event occurs up to frequencyMax times per period
period	Σ	0..1	decimal	Event occurs frequency times per period
periodMax	Σ	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	Σ	0..*	time	Time of day for action
when	Σ	0..*	code	Details of the posology Binding: EventTiming (required): Real world event relating to the schedule.
offset	Σ	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
Slices for asNeeded[x]	Σ	0..1		Take "as needed" (for x) Slice: Unordered, Open by type:$this 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
asNeeded[x]:asNeededBoolean	Σ	0..1	boolean	Reserve medication (true if in reserve; false otherwise)
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	The route of administration 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	The method of administration Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		The quantity unit
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	CH EMED Dosage (MedicationRequest) ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	How long the prescription is valid
numberOfRepeatsAllowed		0..1	unsignedInt	How often a prescription can be repeated
quantity		0..1	SimpleQuantity	Number of packages to be delivered
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for allowed[x]		1..1	CodeableConcept	Whether substitution is allowed or not Slice: Unordered, Closed by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowed[x]:allowedCodeableConcept		0..1	CodeableConcept	Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (preferred)
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.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 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|4.0.1 from the FHIR Standard
MedicationRequest.category	example	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.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
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.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.allowed[x]:allowedCodeableConcept	preferred	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
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
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()

This structure is derived from CHEMEDMedicationRequest

Summary

Structures

This structure refers to these other structures:

• CHMED Medication (http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-medication)
• CHMED Patient (PRE) (http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-pre-patient)

Extensions

This structure refers to these extensions:

• http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
• http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.asNeeded[x]

Differential View

This structure is derived from CHEMEDMedicationRequest

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CHMED MedicationRequest
exts		0..*	(Complex)	CHMED Extension URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
sic		0..1	boolean	CHMED Sic URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic
medication[x]:medicationReference		0..1	Reference(CHMED Medication) {c}	Medicament
subject		1..1	Reference(CHMED Patient (PRE))	The patient
reasonCode
text		0..1	string	Reason for applying the medication (the reason for the medication treatment)
dosageInstruction		1..*	Dosage	Posology
additionalInstruction		0..*	CodeableConcept	Information whether a medicament must be taken relative to a meal
patientInstruction		0..1	string	Application instructions (further information on how to apply the medication, e.g. take before meals)
timing
repeat
Slices for bounds[x]		0..1	Duration, Range, Period	Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Open by type:$this
bounds[x]:boundsPeriod		0..1	Period	Length/Range of lengths, or (Start and/or end) limits
start		0..1	dateTime	From date (start date of medication treatment)
end		0..1	dateTime	To date (end date of medication treatment)
when		0..*	code	Details of the posology
Slices for asNeeded[x]		0..1	boolean, CodeableConcept	Take "as needed" (for x) Slice: Unordered, Open by type:$this
asNeeded[x]:asNeededBoolean		0..1	boolean	Reserve medication (true if in reserve; false otherwise)
route		0..1	CodeableConcept	The route of administration
method		0..1	CodeableConcept	The method of administration
doseAndRate
dose[x]		0..1	Range, SimpleQuantity	The quantity unit
dosageInstruction:baseEntry		1..1	CHEMEDDosageMedicationRequest	CH EMED Dosage (MedicationRequest)
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
dispenseRequest		0..1	BackboneElement	Medication supply authorization
validityPeriod		0..1	Period	How long the prescription is valid
numberOfRepeatsAllowed		0..1	unsignedInt	How often a prescription can be repeated
quantity		0..1	SimpleQuantity	Number of packages to be delivered
substitution
allowed[x]:allowedCodeableConcept		0..1	CodeableConcept	Whether substitution is allowed or not
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CHMED MedicationRequest
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		1..*	Resource	Contained, inline Resources
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
exts		0..*	(Complex)	CHMED Extension URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
sic		0..1	boolean	CHMED Sic URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	0..1	Reference(CHMED Medication) {c}	Medicament
subject	Σ	1..1	Reference(CHMED Patient (PRE))	The patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
reasonCode		0..1	CodeableConcept	Treatment reason Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
text	Σ	0..1	string	Reason for applying the medication (the reason for the medication treatment)
Slices for dosageInstruction		1..*	Dosage	Posology Slice: Unordered, Closed by profile:$this
dosageInstruction:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
additionalInstruction	Σ	0..*	CodeableConcept	Information whether a medicament must be taken relative to a meal Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Application instructions (further information on how to apply the medication, e.g. take before meals)
Slices for asNeeded[x]	Σ	0..1		Take "as needed" (for x) Slice: Unordered, Open by type:$this 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
asNeeded[x]:asNeededBoolean	Σ	0..1	boolean	Reserve medication (true if in reserve; false otherwise)
route	Σ	0..1	CodeableConcept	The route of administration 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	The method of administration Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	CH EMED Dosage (MedicationRequest) ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
dispenseRequest		0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
validityPeriod		0..1	Period	How long the prescription is valid
numberOfRepeatsAllowed		0..1	unsignedInt	How often a prescription can be repeated
quantity		0..1	SimpleQuantity	Number of packages to be delivered
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1 from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes 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.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

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	CHEMEDMedicationRequest	CHMED MedicationRequest
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		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentplan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
exts		0..*	(Complex)	CHMED Extension URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
sic		0..1	boolean	CHMED Sic URL: http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationRequest Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!Σ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	Σ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)
Slices for medication[x]	Σ	1..1	Reference()	Medication to be taken Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	0..1	Reference(CHMED Medication) {c}	Medicament
subject	Σ	1..1	Reference(CHMED Patient (PRE))	The patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter		0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	Σ	0..1	dateTime	When request was initially authored
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode		0..1	CodeableConcept	Treatment reason Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Reason for applying the medication (the reason for the medication treatment)
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | 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
Slices for dosageInstruction		1..*	Dosage	Posology Slice: Unordered, Closed by profile:$this
dosageInstruction:All Slices				Content/Rules for all slices
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	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Information whether a medicament must be taken relative to a meal Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Application instructions (further information on how to apply the medication, e.g. take before meals)
timing	Σ	0..1	Timing	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	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
Slices for bounds[x]	Σ	0..1		Length/Range of lengths, or (Start and/or end) limits Slice: Unordered, Open by type:$this
boundsDuration			Duration
boundsRange			Range
boundsPeriod			Period
bounds[x]:boundsPeriod	Σ	0..1	Period	Length/Range of lengths, or (Start and/or end) limits
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	From date (start date of medication treatment)
end	ΣC	0..1	dateTime	To date (end date of medication treatment)
count	Σ	0..1	positiveInt	Number of times to repeat
countMax	Σ	0..1	positiveInt	Maximum number of times to repeat
duration	Σ	0..1	decimal	How long when it happens
durationMax	Σ	0..1	decimal	How long when it happens (Max)
durationUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency	Σ	0..1	positiveInt	Event occurs frequency times per period
frequencyMax	Σ	0..1	positiveInt	Event occurs up to frequencyMax times per period
period	Σ	0..1	decimal	Event occurs frequency times per period
periodMax	Σ	0..1	decimal	Upper limit of period (3-4 hours)
periodUnit	Σ	0..1	code	s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek	Σ	0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay	Σ	0..*	time	Time of day for action
when	Σ	0..*	code	Details of the posology Binding: EventTiming (required): Real world event relating to the schedule.
offset	Σ	0..1	unsignedInt	Minutes from event (before or after)
code	Σ	0..1	CodeableConcept	BID | TID | QID | AM | PM | QD | QOD | + Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
Slices for asNeeded[x]	Σ	0..1		Take "as needed" (for x) Slice: Unordered, Open by type:$this 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
asNeeded[x]:asNeededBoolean	Σ	0..1	boolean	Reserve medication (true if in reserve; false otherwise)
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	The route of administration 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	The method of administration Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	Σ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	Σ	0..1		The quantity unit
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dosageInstruction:baseEntry	C	1..1	CHEMEDDosageMedicationRequest	CH EMED Dosage (MedicationRequest) ch-dosage-4: For split dosage timing event and dose/rate are required ch-dosage-3: Patient instruction/free text dosage instruction, timing or as needed has to be specified
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	CH EMED Dosage Split (MedicationStatement / MedicationDispense / MedicationRequest)
dispenseRequest		0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	How long the prescription is valid
numberOfRepeatsAllowed		0..1	unsignedInt	How often a prescription can be repeated
quantity		0..1	SimpleQuantity	Number of packages to be delivered
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for allowed[x]		1..1	CodeableConcept	Whether substitution is allowed or not Slice: Unordered, Closed by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowed[x]:allowedCodeableConcept		0..1	CodeableConcept	Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (preferred)
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.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationRequest.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1 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|4.0.1 from the FHIR Standard
MedicationRequest.category	example	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.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
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.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.allowed[x]:allowedCodeableConcept	preferred	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
ch-dosage-3	error	MedicationRequest.dosageInstruction:baseEntry	Patient instruction/free text dosage instruction, timing or as needed has to be specified : patientInstruction.exists() or timing.exists() or asNeeded.exists()
ch-dosage-4	error	MedicationRequest.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
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()

This structure is derived from CHEMEDMedicationRequest

Summary

Structures

This structure refers to these other structures:

• CHMED Medication (http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-medication)
• CHMED Patient (PRE) (http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-pre-patient)

Extensions

This structure refers to these extensions:

• http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-extension
• http://chmed.emediplan.ch/fhir/StructureDefinition/chmed-sic

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
• The element 1 is sliced based on the value of MedicationRequest.dosageInstruction.asNeeded[x]